What is osteoporosis?
Osteoporosis occurs when the body loses too much bone or does not produce enough of it. Bones become less dense, which makes them weaker and more likely to break. Osteoporosis is very common after the age of 50: approximately one in two women and one in four men over 50 years old will break a bone due to osteoporosis, and in the United States, about 54 million people have osteoporosis.
Osteoporotic bone breaks are serious complications of osteoporosis, often affecting the hip, spine or wrist. These breaks are hard to heal, they cause permanent pain, and can limit mobility. Many patients will need long-term nursing home care after one of these breaks, and in some cases, it may lead to death; about 20% of seniors who break a hip die within one year, from complications related to the broken bone or the surgery to repair it. Every year, osteoporosis causes 2 million broken bones, which amounts to $19 billion in related costs.
What are the risk factors?
Osteoporosis is known for being a silent disease. Often, a person will not know he or she has developed osteoporosis until they break a bone. They may also see other signs, such as losing height or the curving of one’s spine. Many conditions can increase the likelihood of developing osteoporosis, including autoimmune disorders, such as rheumatoid arthritis or multiple sclerosis; gastrointestinal disorders, such as inflammatory bowel disease; cancer; blood disorders, such as leukemia and lymphoma; endocrine disorders, like diabetes, hyperthyroidism, or premature menopause; neurological disorders, including stroke and Parkinson’s disease; and some medical procedures, such as gastrectomy and gastrointestinal bypass procedures. Some drugs can also increase the risk of suffering from osteoporosis, including steroids (such as cortisone), cancer chemotherapeutic drugs, and selective serotonin reuptake inhibitors (like Prozac).
Are there any treatments?
Several medications can help to slow down the loss of bone and control osteoporosis. The treatment most used for this disease are bisphosphonates (such as alendronate or ibandronate), which slow the rate that bone is broken down in our body, maintaining bone density and reducing the risk of fracture. Other medications include hormone treatment such as selective oestrogen receptor modulators (e.g. Raloxifene), which imitate the hormone oestrogen and help maintain bone density; parathyroid hormone, which stimulates osteoblasts to create new bone cells; testosterone treatment, useful when the cause of osteoporosis is a deficit of this hormone; hormone replacement therapy. Calcium and vitamin D supplements, which are needed to make bone, can also be helpful.
All these medications focus on slowing down the process of osteoporosis and controlling the disease, but none of them can reverse the damage already caused. But a new type of approach could do it. Recently, a new alternative was studied: umbilical cord blood mesenchymal stem cells to induce bone regeneration. Korean researchers injected these stem cells in rats suffering from osteoporosis and successfully enhanced bone regeneration. The level of bone regeneration was similar to what can be found in rats that do not suffer from osteoporosis, meaning that the umbilical cord blood mesenchymal stem cells reversed the loss of bone regeneration caused by osteoporosis. This study shows that these stem cells can be a promising alternative for patients with osteoporosis.
Boohwi Hong et al. 2018. Bone regeneration with umbilical cord blood mesenchymal stem cells in femoral defects of ovariectomized rats. Osteoporosis and Sarcopenia. Sep 4(3):95-101
Tella SH, Gallagher JC. 2013. Prevention and treatment of postmenopausal osteoporosis. J Steroid Biochem Mol Biol. 142:155-70.