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Disorders of Bone Remodeling
Open accessAbstract
The skeleton provides mechanical support for stature and locomotion, protects vital organs, and controls mineral homeostasis. A healthy skeleton must be maintained by constant bone modeling to carry out these crucial functions throughout life. Bone remodeling involves the removal of old or damaged bone by osteoclasts (bone resorption) and the subsequent replacement of new bone formed by osteoblasts (bone formation). Normal bone remodeling requires a tight coupling of bone resorption to bone formation to guarantee no alteration in bone mass or quality after each remodeling cycle. However, this important physiological process can be derailed by a variety of factors, including menopause-associated hormonal changes, age-related factors, changes in physical activity, drugs, and secondary diseases, which lead to the development of various bone disorders in both women and men. We review the major diseases of bone remodeling, emphasizing our current understanding of the underlying pathophysiological mechanisms.
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“OPG, a soluble receptor also produced by osteoblasts that acts as a decoy receptor and neutralizes RANKL, prevents RANKL from interacting with RANK and consequently inhibits osteoclast proliferation, activity, and survival [73, 74].”
From The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms (2018) · cites this paper as [73]
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“Once RANKL binds to its natural receptor, expressed by osteoclast precursor cells, it stimulates osteoclast precursor differentiation to active mature osteoclasts and accelerates bone resorption [73].”
From The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms (2018) · cites this paper as [73]
In the citing paper
“Abnormal increase in osteoclast formation and activity leads to some bone diseases such as osteoporosis, where resorption exceeds formation causing decreased bone density and increased bone fractures [105].”
From Biology of Bone Tissue: Structure, Function, and Factors That Influence Bone Cells (2015) · cites this paper as [105]
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“In patients with chronic liver disease, the balance between osteoclasts and osteoblasts is affected by liver disease, resulting in BRU imbalance [46,50].”
From Bone diseases in patients with chronic liver disease (2019) · cites this paper as [46]
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“Dysregulation of bone remodeling causes metabolic disorders, e.g., osteop-etrosis, osteoporosis, and Paget’s disease ( Feng and McDonald, 2011 ).”
Insights into the Mechanism of Osteoporosis and the Available Treatment Options
Muniyasamy, R., & Manjubala, I. (2023) · Current Pharmaceutical Biotechnology · doi:10.2174/0113892010273783231027073117 · Cited by 12
Impact of omeprazole on bone remodeling in normal and ovariectomized Wistar rats.
Hasanin, A. H. (2014) · PubMed · Cited by 12
Kim, Y. K., KAMEO, Y., Tanaka, S., & ADACHI, T. (2017) · Biomechanics and Modeling in Mechanobiology · doi:10.1007/s10237-017-0914-6 · Cited by 12
“…bone, postmenopausal osteoporosis, and secondary osteoporosis with specific causes such as rheumatoid arthritis, glucocorticoid use, and endocrine disorders (Hirayamaet al. 2002;Canalis 2003; Fattore et al. 2008; Mosekilde 2008; Frenkel et al. 2010; Feng and McDonald 2011; Redlich and Smolen 2012).”
Jules, J., Chen, W., Feng, X., & Li, Y. (2017) · Journal of Biological Chemistry · doi:10.1074/jbc.m116.736009 · Cited by 12
“As such, deregulated OC differentiation has been regarded among the main causes of many osteolytic bone disorders (4, 5).”
BackgroundSelf-citationThe positive association of total protein intake with femoral neck strength (KNHANES IV)
Kim, B., Lee, S. H., Isales, C. M., Koh, J., & Hamrick, M. W. (2018) · Osteoporosis International · doi:10.1007/s00198-018-4451-7 · Cited by 13
“[44], but also involves diverse, indirect mechanisms, such as ROS, cytokines, and growth factors, that result in adverse outcomes of bone remodeling [45].”
BackgroundTorvanger, I., Metz, J. R., Olsvik, P. A., Søfteland, L., & Lie, K. K. (2018) · Journal of Applied Ichthyology · doi:10.1111/jai.13666 · Cited by 12
Qi, D., Liu, H., Sun, X., Luo, D., Zhu, M., Tao, T., Gao, C., Zhou, C., Zhou, W., & Xiao, J. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2020.621110 · Cited by 12
“Osteoclastic bone resorption and osteoblastic bone formation maintain bone homeostasis together (Feng and McDonald, 2011), thus some experiments on osteogenesis in BMSCs were performed as a supplement.”
BackgroundLiu, F., Xue, L., Li, X., Liu, J., Xie, C., Chen, C., & Liu, Y. (2022) · Materials & Design · doi:10.1016/j.matdes.2022.110479 · Cited by 12
Distinct Actions of Akt1 on Skeletal Architecture and Function
Mukherjee, A., Larson, E. A., Klein, R. F., & Rotwein, P. S. (2014) · PLoS ONE · doi:10.1371/journal.pone.0093040 · Cited by 13
“Bone remodeling in the adult skeleton consists of two temporally and spatially coupled phases, resorption by osteoclasts, and new bone deposition by osteoblasts [1–5].”
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Effect of phenolic extracts from different extra-virgin olive oil varieties on osteoblast-like cells
Melguizo‐Rodríguez, L., Ramos‐Torrecillas, J., Manzano‐Moreno, F. J., Montes, R. I., Rivas, A., Ruíz, C., Luna‐Bertos, E. D., & García‐Martínez, O. (2018) · PLoS ONE · doi:10.1371/journal.pone.0196530 · Cited by 12
The Extract of Ramalina litoralis Inhibits Osteoclast Differentiation
Lee, Y., Jeong, M., Kim, K., Baek, S.-H., Hur, J., & Son, Y. (2018) · Biotechnology and Bioprocess Engineering · doi:10.1007/s12257-018-0407-1 · Cited by 11
Yao, L., Huang, C., & Dai, J. (2023) · Molecular Biology Reports · doi:10.1007/s11033-023-08900-9 · Cited by 11
“Bone formation is a dynamic physiological process regulated by osteoclasts (mediators of bone resorption) and osteoblasts (mediators of bone formation) [17].”
BackgroundDancr-BRG1 regulates Nfatc1 transcription and Pgc1β-dependent metabolic shifts in osteoclastogenesis
Zhang, Z., Meng, Y., Lin, T., Zhang, Z., Tao, Z., Yin, H.-Z., Yang, F., & Zhou, X. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2313656121 · Cited by 11
“Human bone undergoes constant remodeling maintained by osteoblast - mediated bone formation and osteoclast - mediated bone resorption (1).”
BackgroundXu, C., Wei, Z., Dong, X., Xing, J., Meng, X., Qiu, Y., Zhou, H., Zheng, W., Xu, Z., Huang, S., et al. (2024) · Biochemical Pharmacology · doi:10.1016/j.bcp.2024.116391 · Cited by 11
Imbalanced Skeletal Muscle Mitochondrial Proteostasis Causes Bone Loss
Jin, Z., Mao, Y., Guo, Q., Yin, Y., Kiram, A., Zhou, D., Yang, J., Zhou, Z., Xue, J., Feng, Z., et al. (2024) · Research · doi:10.34133/research.0465 · Cited by 13
“Osteoporosis, a degenerative disorder associated with aging, manifests as reduced bone mass, micro-architectural degradation, and an increased susceptibility to hip fractures [1].”
BackgroundHuang, P., Li, W., Guan, J., Jia, Y., Wang, D., Chen, Y., Xiao, N., Ou, S., Wang, Y., & Yang, B. (2025) · Journal of Functional Biomaterials · doi:10.3390/jfb16010025 · Cited by 12
“Bone restoration and regeneration are dynamic processes that repair minor bone defects or reunite minor fracture parts [225].”
De, L., Altamura, D., Sibillano, T., Siliqi, D., Filograsso, G., Bunk, O., & Giannini, C. (2013) · Journal of Applied Crystallography · doi:10.1107/s002188981300770x · Cited by 11
“…progressive hearing loss and kidney problems (Kashtan, 1993), osteoporosis, characterized by bone loss and increased risk of fracture (Shuster, 2005; Feng & McDonald, 2011), and Knobloch syndrome, where retina degeneration causes extreme nearsightedness (high myopia) (Mahajan et al., 2010), to…”
BackgroundGuo, Q., Cao, Z., Wu, B., Chen, F., Tickner, J. C., Wang, Z., Qiu, H., Wang, C., Chen, K., Tan, R. X., et al. (2018) · Journal of Cellular Physiology · doi:10.1002/jcp.26893 · Cited by 11
“Currently, several antiresorption drugs which inhibit the osteoclast‐mediated bone resorption are widely used in the clinic; however, limitations to the treatment of osteoporosis still exist (X. Feng & McDonald, 2011; Knopp‐Sihota, Cummings, Homik, & Voaklander, 2013; T. Wang et al., 2017).”
BackgroundCho, E., Lee, J., Lee, J., Chen, Z., Ahn, S. H., Kim, N. D., Kook, M.-S., Min, S. H., Park, B., & Lee, T. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19113436 · Cited by 11
“However, bone loss occurs due to imbalance of osteoblast and osteoclast activity, which causes osteoporosis and increases the risk of fracture [30,31].”
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“The skeleton provides mechanical support for stature and locomotion, protects vital organs, controls homeostasis of minerals and must be maintained by constant bone modeling to carry out these important functions throughout life [1].”
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Benzofuran-pyran hybrids: A new class of potential bone anabolic agents
Gupta, S., Adhikary, S., Modukuri, R. K., Choudhary, D., Trivedi, R., & Sashidhara, K. V. (2018) · Bioorganic & Medicinal Chemistry Letters · doi:10.1016/j.bmcl.2018.04.041 · Cited by 11
Neotuberostemonine inhibits osteoclastogenesis via blockade of NF-κB pathway
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Comparison of Bone Turnover Markers between Young Adult Male Smokers and Nonsmokers
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“Osteopenia is a condition that acts as an early indicator for a decrease in bone mass; it is asymptomatic, but if not managed early may deteriorate to osteoporosis [1].”
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Dosage Forms - Innovation and Future Perspectives
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Bone Balance within a Cortical BMU: Local Controls of Bone Resorption and Formation
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Targeting Ferroptosis: Emerging Insights into Osteoporosis Mechanisms
Yang, H., Ru, K., Liu, S., Zhu, C., Qian, A., & Chen, Z. (2025) · Biology · doi:10.3390/biology14081062 · Cited by 11
“The RANK/RANKL/OPG signaling pathway is central to regulating osteoclast differentiation and activation [12].”
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Metadata
- Authors
- Feng, X., & McDonald, J. M.
- Affiliations
- University of Alabama at Birmingham (US)
- ORCID
- Feng, Xu
- Venue
- Annual Review of Pathology: Mechanisms of Disease
- Publisher
- Annual Reviews
- Published
- 2011-02-28
- Volume
- 6
- Issue
- 1
- Pages
- 121-145
- ISSN
- 1553-4006 (ISSN-L)
- 1553-4014
- PMC
- PMC3571087
- OpenAlex
- W2166266977
- Cited by
- 1,272
- References
- 171
- Citations by year
- 2026: 59 · 2025: 109 · 2024: 102 · 2023: 124 · 2022: 135 · 2021: 142 · 2020: 107 · 2019: 117 · 2018: 86 · 2017: 68 · 2016: 59 · 2015: 47 · 2014: 36 · 2013: 37 · 2012: 29
- FWCI
- 3.28
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Annual Review of Pathology Mechanisms of Disease (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (R01CA109119)
- National Institute of Neurological Disorders and Stroke (R21NS061677, NS061677)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (5P30 AR0406031, R01AR047830, AR 47830, R01AR050235)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Oncology › Bone health and treatments
- Keywords
- bone remodeling, bone resorption, bone formation, osteoclasts, osteoblasts, bone disease, menopause, hormonal changes, age-related bone loss, physical activity, drug-induced bone loss, mineral homeostasis, pathophysiology
- MeSH terms
- Animals, Bone Diseases, Humans, Bone Remodeling
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