Current Osteoporosis Reports最新文献

{"title":"Time-Lapse HR-pQCT: an in Vivo Imaging-Based Assessment of Bone Remodeling Dynamics.","authors":"Minhao Zhou, Thomas L Nickolas, Joachim H Ix, Galateia J Kazakia","doi":"10.1007/s11914-026-00973-2","DOIUrl":"10.1007/s11914-026-00973-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Osteoporosis remains a pressing worldwide health concern. Understanding disease progression and evaluating treatment responses requires comprehensive skeletal assessment. This review presents a novel skeletal assessment - time-lapse high-resolution peripheral quantitative computed tomography (time-lapse HR-pQCT) - and highlights its capability in assessing bone formation and resorption.</p><p><strong>Recent findings: </strong>Time-lapse analysis was validated for in vivo bone remodeling assessment in micro-CT-based preclinical studies two decades ago. Recently, clinical time-lapse HR-pQCT research has demonstrated its feasibility in assessing bone turnover in patients with chronic kidney disease, and in characterizing the spatial distribution of long-term bone gain and loss in response to medications, mechanical loading, disease, and injury. Moving forward, time-lapse HR-pQCT requires validation against the gold standard bone biopsy with quantitative histomorphometry. Time-lapse HR-pQCT is a skeletal assessment capable of evaluating and longitudinally monitoring changes in bone density, microarchitecture, and remodeling dynamics. Rigorous validation and application to clinical imaging modalities will enable its broader implementation.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cone Beam Computed Tomography of Bonejaws in Patients With Primary Osteoporosis: A Systematic Review.","authors":"Irene Frassineti, Lorenzo Cinci, Andrea Magnini, Maria Pisano, Luigi Barbato, Francesco Cairo, Luisella Cianferotti, Cosimo Nardi","doi":"10.1007/s11914-026-00972-3","DOIUrl":"10.1007/s11914-026-00972-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>This study aimed to investigate the potential of Cone Beam Computed Tomography (CBCT) parameters to identify primary osteoporosis in jawbones.</p><p><strong>Recent findings: </strong>Early diagnosis of osteoporosis is crucial but challenging. Dual X-ray Absorptiometry (DXA) is the gold standard to measure bone density, nevertheless it has limitations including cost, radiation dose, and 2D imaging. CBCT is a volumetric imaging technique commonly used in dentistry that showed promise as an alternative tool due to its high spatial resolution and excellent analysis of bone structures. Mandibular and maxillary CBCT indices showed a strong correlation with Bone Mineral Density (BMD) assessed by DXA. Regional indices (Anterior, Molar, and Posterior), quantitative indices (Computed Tomography Mandibular Index, Computed Tomography Index Superior and Inferior), Radiographic Density, Fractal Dimension, and the qualitative index named Computed Tomography Cortical Index seemed appropriate for the detection of primary osteoporosis. Morphometric parameters for trabecular bone did not show differences between osteoporotic and non-osteoporotic patients. Future studies should assess diagnostic accuracy of such CBCT indices and formulate standardized measurement protocols.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testosterone and Bone Health in Men.","authors":"Hussein Kafel, Shehzad Basaria","doi":"10.1007/s11914-026-00971-4","DOIUrl":"10.1007/s11914-026-00971-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>To elucidate the association between testosterone and skeletal health in men. In this review, i) we discuss the influence of testosterone on bone metabolism, ii) review population studies demonstrating the relationship between sex steroid concentrations and bone mineral density (BMD) and bone quality, and iii) summarize data from seminal trials of testosterone therapy and its effects on bone density and fracture risk.</p><p><strong>Recent findings: </strong>In population studies, low testosterone (and estradiol) levels in men are associated with reduced bone mass and a higher risk of fracture. Clinical studies of testosterone replacement in men with organic hypogonadism show robust improvement in BMD. To the contrary, clinical trials of testosterone therapy in middle aged and older men with age-related low testosterone have shown modest increases in BMD (mainly vertebral BMD). Results of the TRAVERSE trial unexpectedly showed higher fracture rates in men randomized to testosterone therapy. Testosterone plays an important role in the maintenance of male skeleton. Most studies of testosterone therapy have demonstrated some degree of improvement in BMD, However, considering that testosterone treatment has not demonstrated reduction in fracture rates, we recommend that hypogonadal men who are at high risk for fracture receive treatment with agents that have proven anti-fracture efficacy.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stimulant Medications and Bone Health.","authors":"Christine M Swanson, Julie H Wolfe, Chadi A Calarge","doi":"10.1007/s11914-026-00965-2","DOIUrl":"10.1007/s11914-026-00965-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes the potential impact of stimulant medications on bone health, to raise awareness and optimize their safe use.</p><p><strong>Recent findings: </strong>Stimulant medications can impair bone health through inadequate nutrient/calorie intake and stimulation of the sympathetic nervous system, which regulates bone metabolism. However, their use decreases fracture risk in younger populations ([Formula: see text]25 years old) with attention deficit/hyperactivity disorder (ADHD), likely through reductions in impulsivity and injury. Special care may be needed when fractures occur while using these medications, as recent data suggest psychostimulants are associated with impaired fracture healing. Prescription and non-prescription use of psychostimulants have increased. Their ultimate effect on bone health may be a balance between effective behavioral modification and adverse effects on bone metabolism related to nutrition and sympathetic activation. Future research should investigate how psychostimulants affect acquisition of peak bone mass, stability of bone mineral density (BMD) when used through mid/late-life, and fracture healing.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Innate and Adaptive Immune Functions of Osteoblast-Lineage Cells.","authors":"Mohammad A Hossain, Plinio R Hurtado, Gerald J Atkins","doi":"10.1007/s11914-026-00970-5","DOIUrl":"10.1007/s11914-026-00970-5","url":null,"abstract":"<p><strong>Purpose of the review: </strong>The osteoblast lineage has traditionally been viewed through a structural and metabolic lens, yet growing evidence indicates that these cells possess diverse functions, including roles in innate and adaptive immune responses. To establish a coherent mechanistic framework, we performed a systematic review of the literature concerning immune signalling, antigen presentation, and pathogen responses across the osteoblast lineage.</p><p><strong>Recent findings: </strong>We identified 463 unique studies, with 43 meeting the inclusion criteria. Our synthesis reveals a stage-specialised immune continuum. Osteoprogenitors appear to initiate early inflammatory signalling while mature osteoblasts operate as microbial sensors and conditional antigen-presenting cells via inducible expression of cell membrane and cytosolic pattern recognition receptors, and a functional major histocompatibility complex class II apparatus. Osteocytes, the most abundant and long-lived bone cell type, are also capable of detecting microbial danger and activate extensive interferon, chemokine and cytokine programmes within the lacunocanalicular network. Together, these properties define a stromal immune system that coordinates both innate and adaptive immunity across bone surfaces and the mineralised matrix. This osteoblast lineage-integrated immune architecture provides a conceptual basis for understanding osteomyelitis incidence and persistence, biomaterial-immune interactions, as well as inflammatory bone remodelling, reframing this lineage as a previously underappreciated regulator of skeletal and systemic immunity.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain-bone Crosstalk after Neurotrauma: Dual Effects of Traumatic Brain Injury on Skeletal Remodeling.","authors":"Vetriganesh Maduraiveeran, Shivum Lal, Carlos Isales, Krishnan Dhandapani, Sadanand Fulzele","doi":"10.1007/s11914-026-00968-z","DOIUrl":"10.1007/s11914-026-00968-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Traumatic brain injury (TBI) is increasingly recognized as a systemic disorder with significant effects on skeletal biology. This review summarizes current evidence describing how TBI impacts fracture healing, heterotopic ossification, and long-term bone remodeling.</p><p><strong>Recent findings: </strong>Clinical observations and experimental models demonstrate that TBI can accelerate early fracture callus formation and increase the risk of heterotopic ossification, suggesting a transient pro-osteogenic state following injury. Proposed mechanisms include neuroinflammatory cytokine release, sympathetic nervous system activation, neuroendocrine dysregulation, and mobilization of osteoprogenitor cells. Conversely, persistent neuroinflammation, hypothalamic-pituitary axis dysfunction, oxidative stress, and altered autonomic signaling are associated with impaired fracture remodeling, increased bone resorption, and progressive bone loss. Emerging data implicate extracellular vesicle-mediated signaling as a key pathway linking brain injury to skeletal outcomes. TBI induces a contextual, biphasic skeletal response with both osteogenic and degenerative consequences. Understanding this duality is essential for optimizing fracture care and preserving bone health after neurotrauma.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteopetrosis: Pathogenesis, Clinical Management, and Emerging Therapies.","authors":"Simone Donati, Cinzia Aurilia, Gaia Palmini, Irene Falsetti, Francesca Marini, Francesca Giusti, Roberto Zonefrati, Francesco Ranaldi, Teresa Iantomasi, Maria Luisa Brandi","doi":"10.1007/s11914-026-00969-y","DOIUrl":"10.1007/s11914-026-00969-y","url":null,"abstract":"<p><strong>Purpose of the review: </strong>Osteopetrosis is a heterogeneous group of bone diseases with increased bone density as a result of defective osteoclast function or differentiation. The clinical presentations range from the early, often lethal, infantile malignant forms to the mild autosomal dominant forms. This review provides recent updates in preclinical findings regarding molecular genetics, diagnosis, and novel therapeutic approaches in osteopetrosis.</p><p><strong>Recent findings: </strong>The diagnosis is radiologic, supported by biochemical and genetic examination to identify mutations in the key genes involved in osteoclasts, TCIRG1, CLCN7, OSTM1, SNX10, RANK, and RANKL. Treatment is at present largely the management of complications and includes vitamin D and calcium supplements, IFN-γ therapy, and hematopoietic stem cell transplantation (HSCT), the latter being the treatment of choice for most forms of osteopetrosis. Two gene therapy- and iPSCs-derived strategies, based on reconstituting the function of osteoclasts, have been recently developed for the management of this hereditary bone disease. Furthermore, emerging findings suggest the possible involvement of epigenetic mechanisms, such as non-coding RNAs (ncRNAs), in osteopetrosis pathophysiology, paving the way for potential novel diagnostic biomarkers and tailored molecular treatments. The aim of this review is to provide an overview of recent progress in molecular genetics, diagnosis, and novel therapeutic strategies in osteopetrosis and to illustrate conceivable scenarios in regenerative and gene-based therapy.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential Versus Step-Therapy Approaches for Osteoporosis Management in Orthopedic Subspecialties.","authors":"Samer G Salman, Rohan Phadke, James Burnett, Jonathan Walsh","doi":"10.1007/s11914-026-00967-0","DOIUrl":"10.1007/s11914-026-00967-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Osteoporosis affects more than 53 million Americans and contributes to nearly 2 million fragility fractures each year, yet most patients who sustain fractures never receive guideline-recommended pharmacotherapy. Traditional step-therapy typically begins with bisphosphonates and reserves anabolic agents for later-line use, whereas sequential therapy prioritizes anabolic treatment followed by antiresorptive consolidation. This review synthesizes the evidence comparing these treatment paradigms and examines their relevance to orthopedic populations, in whom bone quality directly influences fracture healing, fixation, fusion, and implant-related outcomes.</p><p><strong>Recent findings: </strong>Among 37 studies meeting PRISMA-ScR inclusion criteria, anabolic-first sequential therapy generally produced greater gains in bone mineral density and greater fracture risk reduction than step-therapy or antiresorptive monotherapy. In one representative trial, romosozumab followed by denosumab achieved a 16.8% increase in lumbar spine bone mineral density versus 7.5% with monotherapy, and 92% versus 47% of patients reached treatment targets. In ARCH, anabolic-first therapy was associated with 48% lower vertebral fracture risk and 38% lower hip fracture risk. In orthopedic settings, emerging evidence suggests that sequential protocols may improve postoperative bone mineral density after hip fracture, support spinal fusion, and mitigate periprosthetic bone loss after arthroplasty. Prior antiresorptive exposure appeared to attenuate subsequent anabolic response, particularly at the hip, supporting the rationale for earlier anabolic use. Economic analyses also suggest that, despite higher upfront drug costs, sequential therapy may be cost-effective in patients at high fracture risk. Current evidence supports anabolic-first sequential therapy as a more effective strategy than step-therapy for improving bone mineral density and reducing fracture risk in appropriately selected high-risk patients. For orthopedic populations, the available data suggest meaningful potential benefits in hip fracture care, spinal reconstruction, and arthroplasty, although subspecialty-specific evidence remains more limited than the broader osteoporosis literature. These findings support reconsideration of formulary and treatment policies that delay anabolic therapy in patients most likely to benefit.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Statistical Shape and Appearance Modelling for Predicting Osteoporotic Fracture Risk.","authors":"Edward M Chu, Cheryl E Quenneville","doi":"10.1007/s11914-026-00966-1","DOIUrl":"10.1007/s11914-026-00966-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Osteoporotic fractures remain a major cause of morbidity and mortality worldwide. Current clinical assessment metrics (e.g., bone mineral density) are limited in their ability to identify fracture risk and bone strength. Statistical Shape and Appearance Modelling (SSAM) offers a method to quantify anatomical geometry and density patterns. This review examines advancements in SSAM for osteoporosis research.</p><p><strong>Recent findings: </strong>Recent literature demonstrates that SSAM can capture detailed bone geometry and internal density distribution. Increasingly, these models are combined with computational analytics, including finite element analysis and machine learning, to assess the mechanical and structural behavior of bone. SSAM provides a robust quantitative framework for bone research. Notably, SSAM is used to reconstruct 3D subjects from clinical 2D images for biomechanical evaluation. Although clinical adoption remains limited by generalizability, the advancement of deep learning and complex SSAM pipelines supports its potential for osteoporosis screening and fracture risk prediction.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PHEWAS, TWAS, Mendelian Randomization in Osteoporosis Research: the good, the bad, and the ugly.","authors":"Siwen Li, Katerina Trajanoska","doi":"10.1007/s11914-026-00962-5","DOIUrl":"10.1007/s11914-026-00962-5","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: While GWAS has identified many loci associated with bone mineral density (BMD), translating these findings into functional insights and treatments remains challenging. Post-GWAS methods such as Transcriptome-Wide Association Study (TWAS), Phenome-Wide Association Study (PheWAS), and Mendelian Randomization (MR) provide complementary strategies to prioritize genes and causal risk factors. This review summarizes findings from these studies. RECENT FINDINGS: TWASs have identified many potential causal genes for BMD, but only a few, such as PPP6R3, have been confirmed through functional validation. Several MR studies have provided increasing evidence of causal relationships between inflammatory bowel disease, NAFLD, COPD, and lower BMD, along with a higher risk of osteoporosis. PheWAS and MR also identify bone marrow fat as a risk factor for decreased BMD. It is essential to bridge the critical gap between statistical discovery and biological validation. Moreover, the lack of bone-specific transcriptomic data remains a significant limitation, underscoring the need to generate such datasets. At the same time, all MR evidence should be corroborated with other sources to strengthen causal conclusions. </p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}