Osteopetrosis: genetics, treatment and new insights into osteoclast function
Abstract
Osteopetrosis is a genetic condition of increased bone mass, which is caused by defects in osteoclast formation and function. Both autosomal recessive and autosomal dominant forms exist, but this Review focuses on autosomal recessive osteopetrosis (ARO), also known as malignant infantile osteopetrosis. The genetic basis of this disease is now largely uncovered: mutations in TCIRG1, CLCN7, OSTM1, SNX10 and PLEKHM1 lead to osteoclast-rich ARO (in which osteoclasts are abundant but have severely impaired resorptive function), whereas mutations in TNFSF11 and TNFRSF11A lead to osteoclast-poor ARO. In osteoclast-rich ARO, impaired endosomal and lysosomal vesicle trafficking results in defective osteoclast ruffled-border formation and, hence, the inability to resorb bone and mineralized cartilage. ARO presents soon after birth and can be fatal if left untreated. However, the disease is heterogeneous in clinical presentation and often misdiagnosed. This article describes the genetics of ARO and discusses the diagnostic role of next-generation sequencing methods. The management of affected patients, including guidelines for the indication of haematopoietic stem cell transplantation (which can provide a cure for many types of ARO), are outlined. Finally, novel treatments, including preclinical data on in utero stem cell treatment, RANKL replacement therapy and denosumab therapy for hypercalcaemia are also discussed.
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The contrary imbalance, excessive formation without resorption, may result in osteopetrosis.
“whereas the contrary may result in osteopetrosis [17].”
From Biology of Bone Tissue: Structure, Function, and Factors That Influence Bone Cells (2015) · cites this paper as [17]
In osteopetrosis, a rare bone disease, genetic mutations that affect formation and resorption functions in osteoclasts lead to decreased bone resorption, resulting in a disproportionate accumulation of bone mass.
“On the other hand, in osteopetrosis, which is a rare bone disease, genetic mutations that affect formation and resorption functions in osteoclasts lead to decreased bone resorption, resulting in a disproportionate accumulation of bone mass [17].”
From Biology of Bone Tissue: Structure, Function, and Factors That Influence Bone Cells (2015) · cites this paper as [17]
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- Authors
- Sobacchi, C., Schulz, A., Coxon, F. P., Villa, A., & Helfrich, M. H.
- Affiliations
- Institute of Genetic and Biomedical Research (IT)
- Universität Ulm (DE)
- University of Aberdeen (GB)
- Corresponding author
- Helfrich, Miep H.
- Venue
- Nature Reviews Endocrinology
- Published
- 2013-07-23
- Volume
- 9
- Issue
- 9
- Pages
- 522-536
- ISSN
- 1759-5029 (ISSN-L)
- 1759-5037
- OpenAlex
- W2006582030
- Cited by
- 580
- References
- 161
- Citations by year
- 2026: 28 · 2025: 38 · 2024: 38 · 2023: 43 · 2022: 43 · 2021: 64 · 2020: 76 · 2019: 51 · 2018: 47 · 2017: 44 · 2016: 33 · 2015: 49 · 2014: 21 · 2013: 5
- FWCI
- 3.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministero della Salute
- Versus Arthritis (19379, 17285)
- Army Research Office
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Life Sciences › Immunology and Microbiology › Immunology › Immunodeficiency and Autoimmune Disorders
- Health Sciences › Medicine › Rheumatology › Osteomyelitis and Bone Disorders Research
- Keywords
- autosomal recessive osteopetrosis, malignant infantile osteopetrosis, osteoclast function, TCIRG1, CLCN7, OSTM1, SNX10, PLEKHM1, TNFSF11, RANK, lysosomal trafficking, ruffled border, bone resorption, hematopoietic stem cell transplantation, denosumab, hypercalcemia, genetic diagnosis, next-generation sequencing
- MeSH terms
- Animals, Humans, Osteopetrosis, Signal Transduction, RANK Ligand
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