Pathophysiology and therapeutic advances in myeloma bone disease

Q1 Medicine
Fujing Zhang, Junling Zhuang
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引用次数: 2

Abstract

Bone disease is the most common complication in patients with multiple myeloma (MM), and it may lead to skeletal-related events (SREs) such as bone pain, pathological fractures, and spinal cord compression, which impair a patients' quality of life and survival. The pathogenesis of myeloma bone disease (MBD) involves disruption of bone reconstitution balance including excessive activation of osteoclasts, inhibition of osteoblasts, and participation of osteocytes and bone marrow stromal cells. Various factors, such as the receptor activator of nuclear factor-κB ligand (RANKL)/osteoprotegerin (OPG), dickkopf-1 (DKK-1), sclerostin, and activin-A, are involved in the development of MBD. Bisphosphonates and the anti-RANKL antibody denosumab are currently the main treatment options for MBD, delaying the onset of SREs. Denosumab is preferred in patients with MM and renal dysfunction. Although effective drugs have been approved, antimyeloma therapy is the most important method for controlling bone disease.

Abstract Image

骨髓瘤骨病的病理生理学和治疗进展
骨病是多发性骨髓瘤(MM)患者最常见的并发症,可导致骨痛、病理性骨折、脊髓受压等骨骼相关事件(SREs),影响患者的生活质量和生存。骨髓瘤骨病(MBD)的发病机制涉及骨重建平衡的破坏,包括破骨细胞的过度激活、成骨细胞的抑制以及骨细胞和骨髓基质细胞的参与。核因子-κB配体受体激活因子(RANKL)/骨保护素(OPG)、dickkopf-1 (DKK-1)、硬化蛋白(sclerostin)、活化素- a等多种因子参与MBD的发生。双膦酸盐和抗rankl抗体denosumab目前是MBD的主要治疗选择,可以延缓SREs的发作。Denosumab是MM和肾功能不全患者的首选。虽然有效的药物已经被批准,但抗骨髓瘤治疗是控制骨病最重要的方法。
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来源期刊
CiteScore
6.70
自引率
0.00%
发文量
195
审稿时长
35 weeks
期刊介绍: This journal aims to promote progress from basic research to clinical practice and to provide a forum for communication among basic, translational, and clinical research practitioners and physicians from all relevant disciplines. Chronic diseases such as cardiovascular diseases, cancer, diabetes, stroke, chronic respiratory diseases (such as asthma and COPD), chronic kidney diseases, and related translational research. Topics of interest for Chronic Diseases and Translational Medicine include Research and commentary on models of chronic diseases with significant implications for disease diagnosis and treatment Investigative studies of human biology with an emphasis on disease Perspectives and reviews on research topics that discuss the implications of findings from the viewpoints of basic science and clinical practic.
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