What is the role of osteoimmunology in the pathogenesis of osteoporosis?

Updated: Jan 20, 2021
  • Author: Rachel Elizabeth Whitaker Elam, MD, MSc; Chief Editor: Herbert S Diamond, MD  more...
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Answer

The term osteoimmunology is defined as the interaction between the skeletal system and the immune system. Osteoclastogenic proinflammatory cytokine in particularly TNF, IL-1, 1L-6, or IL-7 is increased in the first ten years in postmenopausal osteoporotic patients. Of note, Crohn's and rheumatoid arthritis are inflammatory conditions that promote osteoporosis. [27]

T cells are considered to play a role and were found to produce more TNF in postmenopausal women with osteoporotic fracture. [27] Recently, a mechanism was promoted whereby the loss of estrogen results in rapid bone loss by activating low-grade inflammation resulting in osteoporosis in the acute phase of bone catabolic activity in ovariectomized mice. [27] It was found that ovariectomy in mice results in increased dendritic cells which express IL-7 and IL-15  inducing antigen-independent production of IL-17A and TNFα in a subset of memory T cells. The study found that ovariectomized mice with T- cell ablation of IL15RA result in no 1L-17A and TNFα expression and no increase in bone resorption or bone loss. [28]

B lymphocytes play a role in osteoporosis by producing RANKL and OPG which regulates the RANK/ RANKL/OPG axis. Production of RANKL by B-lymphocyte is increased in postmenopausal women. The ablation of RANKL in B cells in mice resulted in partial protection from trabecular bone loss post ovariectomy. [27]


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