In November 1999 the Wellcome Trust sponsored a meeting to address the etiology of postmenopausal osteoporosis. Originally, we had thought to report our findings through a consensus document but, in our hands, the drafts grew in size and faded in focus. Therefore, we took the liberty of extracting a theme from our own thoughts stimulated by the meeting and by the contributions of the participants expressed there. This article is a personal extract of the proceedings. None of the views expressed should be attributed to the participants other than ourselves.
Perspective: Postmenopausal Osteoporosis as a Failure of Bone's Adaptation to Functional Loading: A Hypothesis*
Article first published online: 1 NOV 2001
Copyright © 2001 ASBMR
Journal of Bone and Mineral Research
Volume 16, Issue 11, pages 1937–1947, November 2001
How to Cite
Lanyon, L. and Skerry, T. (2001), Perspective: Postmenopausal Osteoporosis as a Failure of Bone's Adaptation to Functional Loading: A Hypothesis. J Bone Miner Res, 16: 1937–1947. doi: 10.1359/jbmr.2001.16.11.1937
- Issue published online: 2 DEC 2009
- Article first published online: 1 NOV 2001
- estrogen receptor
There is substantial evidence that bones' ability to withstand functional loading without damage depends on the processes of bone modeling and remodeling, which are responsible for establishing and maintaining bone architecture, being influenced by a feedback mechanism related to the control of functional strains. It is probably useful to consider the diminished ability to maintain bone strength in postmenopausal osteoporosis as a failure of this mechanism. Acceptance of this approach would not only increase understanding of the etiology of postmenopausal osteoporosis but also significantly influence the ways in which it is investigated and treated. This would not mean that the many other factors affecting bone mass and bone cell activity will be ignored, but rather these factors will be put in perspective. Research to prevent or treat osteoporosis could be directed usefully to understanding how osteoblasts, lining cells, and osteocytes respond to mechanically derived information and how these responses are converted into stimuli controlling structurally appropriate modeling and remodeling. Evidence suggesting that early strain-related responses of bone cells in males and females involve the estrogen receptor (ER) could explain decreased effectiveness of this pathway when ER levels are low.