2018/03/04 by JS Kenkre, J. H. Duncan Bassett, JHD Bassett · 681 citations
Biochemistry, Genetics and Molecular Biology · Chemistry · Medicine · #Activator (genetics) #Biology #Bone Metabolism and Diseases #Bone cell #Bone health and osteoporosis research #Bone health and treatments #Bone remodeling #Bone remodeling period #Bone resorption #Calcium #Cell biology #Chemistry #Endocrinology #Internal medicine #Medicine #Osteoblast #Osteoclast #Osteoporosis #Osteoprotegerin #Parathyroid hormone #Receptor
paper · doi:10.1177/0004563218759371
published in Annals of Clinical Biochemistry International Journal of Laboratory Medicine 55(3), 308-327 (SAGE Publishing)
crossref issued 2018/03/04 · crossref published 2018/03/04 · crossref published-online 2018/03/04 · openalex publication_date 2018/03/04 · crossref created 2018/04/26 · crossref published-print 2018/05/01 · openalex created_date 2025/10/10 · crossref deposited 2026/04/28 · crossref indexed 2026/08/03 · openalex updated_date 2026/08/06
The bone remodelling cycle replaces old and damaged bone and is a highly regulated, lifelong process essential for preserving bone integrity and maintaining mineral homeostasis. During the bone remodelling cycle, osteoclastic resorption is tightly coupled to osteoblastic bone formation. The remodelling cycle occurs within the basic multicellular unit and comprises five co-ordinated steps; activation, resorption, reversal, formation and termination. These steps occur simultaneously but asynchronously at multiple different locations within the skeleton. Study of rare human bone disease and animal models have helped to elucidate the cellular and molecular mechanisms that regulate the bone remodelling cycle. The key signalling pathways controlling osteoclastic bone resorption and osteoblastic bone formation are receptor activator of nuclear factor-κB (RANK)/RANK ligand/osteoprotegerin and canonical Wnt signalling. Cytokines, growth factors and prostaglandins act as paracrine regulators of the cycle, whereas endocrine regulators include parathyroid hormone, vitamin D, calcitonin, growth hormone, glucocorticoids, sex hormones, and thyroid hormone. Disruption of the bone remodelling cycle and any resulting imbalance between bone resorption and formation leads to metabolic bone disease, most commonly osteoporosis. The advances in understanding the cellular and molecular mechanisms underlying bone remodelling have also provided targets for pharmacological interventions which include antiresorptive and anabolic therapies. This review will describe the remodelling process and its regulation, discuss osteoporosis and summarize the commonest pharmacological interventions used in its management.