Impaired Bone Physiology in Rheumatoid Arthritis: Can the Wnt Pathway be the Connecting Link Between the Synovium and the Bone?

IF 2.1 Q4 Medicine

Mediterranean Journal of Rheumatology Pub Date : 2026-04-21 eCollection Date: 2026-09-01 DOI:10.31138/mjr.140925.eri

Michail I Krikelis, Dimitra Moschou, Konstantina Zoupidou, Evangelia Mole, Konstantinos Makris, Simeon Tournis, Sousana Gazi, Vassilios Nikolaou, Clio Mavragani, Efstathios Chronopoulos

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Abstract

Introduction and methods: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterised by bone loss. A Medline/PubMed search was conducted in September 2025 using the keywords "rheumatoid arthritis" AND "bone loss." The search was restricted to recently published review or systematic review articles (2020-2025). In total, 24 articles were thoroughly reviewed.

Results: Inflammation-induced accelerated bone resorption both at the systemic level and in juxta-articular bone is typical to rheumatoid arthritis. Bone formation and bone biomechanics are also impaired due to inflammation, prolonged or repeated corticosteroid treatment, and muscle wasting.

Conclusions: Aberrant bone loss and impaired bone formation are hallmarks of rheumatoid arthritis. The underlying pathophysiological mechanisms differ between early and refractory disease, suggesting a potential central role of the highly conserved Wnt pathway in the bone impairment observed in established RA.

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类风湿关节炎的骨生理受损：Wnt通路是滑膜与骨之间的连接纽带吗？

类风湿性关节炎（RA）是一种以骨质流失为特征的慢性炎症性疾病。Medline/PubMed检索于2025年9月进行，关键词为“类风湿关节炎”和“骨质流失”。检索仅限于近期发表的综述或系统综述文章（2020-2025）。总共有24篇文章被彻底审查。结果：炎症诱导的骨吸收加速在全身水平和关节旁骨是典型的类风湿关节炎。由于炎症、长期或反复的皮质类固醇治疗和肌肉萎缩，骨形成和骨生物力学也会受损。结论：异常骨丢失和骨形成受损是类风湿关节炎的标志。早期和难治性疾病的潜在病理生理机制不同，提示高度保守的Wnt通路在已建立的RA中观察到的骨损伤中可能起核心作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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