title: Bone remodeling, humoral networks and smart biomaterial technology for osteoporosis.
abstract: One of the unfortunate sequelae of increased life expectancy is a growing number of age-related degenerative diseases, a prime example being osteoporosis. This form of metabolic bone disease and related co-morbidities consume tremendous resources and costs from a nation's health care system. Osteoporosis results from genetic, age-related, and hormone-dependent causes as well as a compendium of secondary pathophysiological states. The presence of osteoporosis as a comorbidity confers a significant negative prognostic element following orthopedic procedures. In vitro and in vivo studies of osteoporotic bone implicate microarchitectural bone rarefaction, microenvironmental and functional disturbance of osteoblast-osteoclast coupling, and abnormal tissue and signalling molecule repertoires, each having detrimental effects on the regenerative and osteointegration processes. This review explores the pathophysiology of bone remodeling from a macro- and micro- systems biology standpoint with a focus on cytokine interactions. Furthermore, therapeutic interventions exploiting vulnerable nodes in these physiological networks will be posited. One exciting development in this area is the use of novel biomaterials.
authors.affiliation: Laboratory of Surgical and Preclinical Studies, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Milena
authors.initials: M
authors.lastname: Fini
authors.forename: Angelo
authors.initials: A
authors.lastname: Carpi
authors.forename: Veronica
authors.initials: V
authors.lastname: Borsari
authors.forename: Matilde
authors.initials: M
authors.lastname: Tschon
authors.forename: Andrea
authors.initials: A
authors.lastname: Nicolini
authors.forename: Maria
authors.initials: M
authors.lastname: Sartori
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Mechanick
authors.forename: Roberto
authors.initials: R
authors.lastname: Giardino
mesh_terms: D016723:Bone Remodeling / Q000502:physiology*; D018786:Bone Substitutes / Q000627:therapeutic use; D016207:Cytokines / Q000378:metabolism*; D006728:Hormones / Q000378:metabolism; D006801:Humans; D010006:Osteoblasts / Q000378:metabolism; D010010:Osteoclasts / Q000378:metabolism; D010024:Osteoporosis / Q000276:immunology* / Q000503:physiopathology* / Q000628:therapy*
chemical_list: D018786:Bone Substitutes; D016207:Cytokines; D006728:Hormones