Bone, Inflammation, and Inflammatory Bowel Disease

Current Osteoporosis Reports - Tập 9 - Trang 251-257 - 2011
Manasi Agrawal1, Shitij Arora2, Jianjun Li1, Rabin Rahmani1, Li Sun3, Adam F. Steinlauf4, Jeffrey I. Mechanick3, Mone Zaidi3
1Department of Gastroenterology, Maimonides Medical Center, Brooklyn, USA
2Department of Internal Medicine, Wyckoff Heights Medical Center, affiliate of Weill Cornell Medical College, Brooklyn, USA
3The Mount Sinai Bone Program, Department of Medicine, Mount Sinai School of Medicine, New York, USA
4Department of Gastroenterology, Mount Sinai School of Medicine, New York, USA

Tóm tắt

Osteoporosis is a leading cause of morbidity in patients with inflammatory bowel disease (IBD). Bone loss is an early systemic process and occurs even before clinical disease manifests. Bone disease is attributed to vitamin D deficiency, steroid use, and/or systemic inflammation. In this review, we discuss the molecular pathways of bone loss mediated by inflammatory cytokines and other mediators. Further research will hopefully clarify the mechanisms of inflammation-induced bone loss in IBD and guide effective treatment modalities.

Tài liệu tham khảo

•• Oostlander AE et al. Dutch Initiative on Crohn and Colitis (ICC). Histomorphometric analysis reveals reduced bone mass and bone formation in patients with quiescent Crohn’s disease. Gastroenterology. 2011;140(1): 116–23. This study identifies that bone loss occurs even before clinically significant bowel disease has occurred, implicating chronic inflammation as the earliest cause for metabolic bone disease in IBD.

•• Miheller P et al. Changes of OPG and RANKL concentrations in Crohn’s disease after infliximab therapy. Inflamm Bowel Dis. 2007;13(11):1379–84. This study demonstrates that IBD treatment targeted at inflammatory cytokines can alter bone metabolism favorably, thereby establishing inflammation as a cause for bone loss.

• Bernstein M, Irwin S, Greenberg GR. Maintenance infliximab treatment is associated with improved bone mineral density in Crohn's disease. Am J Gastroenterol. 2005;100(9):2031–5. This study corroborates inflammation as a major cause of bone disease in IBD, and its reversal with blocking TNF-α with infliximab.