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Osteoporosis affects 1 in 3 women and 1 in 12 men at sometime
in their lives. Approximately 300,000 osteoporotic fractures
occur each year in the UK. As the population lives longer
the number of sufferers is likely to increase with more people
at risk of this painful and disabling condition. In all countries
this also represents an increasing burden for healthcare systems
and families of patients. To reverse this trend a greater
understanding is required of the factors the affect bone loss
with aging.
Bone is in a state of constant remodelling with old bone
being replaced by new bone. This cycle is balanced by the
interplay between osteoblasts (bone forming cells) and osteoclasts
(bone resorbing cells). This relationship is regulated by
diet and the intake of vitamins and minerals, and also by
a variety of hormones, growth factors, and inflammatory cytokines.
With age the activity of osteoclasts exceeds that of osteoblasts.
As a result bone density progressively decreases. In women
this is particularly due to the loss of oestrogens after the
menopause. Recent epidemiological studies indicate that it
is a far more complex scenario, which is influenced over the
long term by similar dietary factors to those that put an
individual at risk of heart disease. Perceptive new insights
into the key factors regulating osteoblast and osteoclast
activity are the most likely route to new treatments to prevent
and treat osteoporosis.
Recent research funded by the William Harvey Research Foundation
has shown the important role of the enzyme endothelial nitric
oxide synthase in mediating the actions of oestrogens on osteoblasts
and osteoclasts. In addition, medicines that release nitric
oxide appear to be able to mimic to some extent these actions.
Further research in this area is likely to identify the key
molecular switches that control osteoblast and osteoclast
responses to hormones and growth factors.
The William Harvey Research Foundation seeks further
funding to continue this important area of research.
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