Abstract
Osteoporosis is a degenerative bone disease that causes significant morbidity and
mortality in multiple sclerosis (MS) patients; the pathogenesis of this disease being
poorly understood in the context of MS. Osteoporosis is seen more frequently in MS
patients than in healthy controls matched for age and sex. Extensively studied factors,
including impaired ambulation and the use of steroids, do not appear to completely
account for the phenomenon. This review summarizes common risk factors, physiologic
and genetic, that may contribute to the etiology and progression of osteoporosis in
MS patients as well as providing insight into nervous system control of bone metabolism
and homeostasis.
Keywords
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References
- Estimation of the prevalence of low bone density in Canadian women and men using a population-specific DXA reference standard: the Canadian Multicentre Osteoporosis Study (CaMos).Osteoporos Int. 2000; 11: 897-904
- Skeletal tissue response to cytokines.Clin Orthop Relat Res. 1990; 258: 245
- Markers of bone remodeling predict rate of bone loss in multiple sclerosis patients treated with low dose glucocorticoids.Clin Chim Acta. 2004; 348: 147-154
- Risk of bone loss in men with multiple sclerosis.Mult Scler. 2004; 10: 170-175
- Intramuscular interferon beta-1a therapy initiated during a first demyelinating event in multiple sclerosis.N Engl J Med. 2000; 343: 898-904
- The influence of smoking on vitamin D status and calcium metabolism.Eur J Clin Nutr. 1999; 53: 920
- Predictors and prevalence of low bone mineral density in fully ambulatory persons with multiple sclerosis.J Neurol. 2010; 257: 410-418
- Bone status in multiple sclerosis: beyond corticosteroids.Mult Scler. 2003; 9: 600-604
- Bone health in ambulatory individuals with multiple sclerosis: impact of physical activity, glucocorticoid use, and body composition.J Rehabil Res Dev. 2008; 45: 851-861
- A phase I/II dose-escalation trial of vitamin D3 and calcium in multiple sclerosis.Neurology. 2010; 74: 1852-1859
- Risk factors for low bone mineral density and the 6-year rate of bone loss among premenopausal and perimenopausal women.Osteoporos Int. 2004; 15: 439-446
- Long‐term effects of intravenous high dose methylprednisolone pulses on bone mineral density in patients with multiple sclerosis.Eur J Neurol. 2005; 12: 550-556
- Regulatory T cells: back to the future.Neth J Med. 2006; 64: 4-9
- The healthy immune system vs the MS immune system.Neurology. 2010; 74: S2-S8
- Bone and cytokines: beyond IL-1, IL-6 and TNF-a.Calcif Tissue Int. 1999; 64: 1-7
- The role of osteopontin: a shared pathway in the pathogenesis of multiple sclerosis and osteoporosis?.J Neurol Sci. 2009; 276: 41-44
- Osteopontin: a bridge between bone and the immune system.J Clin Invest. 2003; 112: 147-148
- Increased osteopontin plasma levels in multiple sclerosis patients correlate with bone-specific markers.Mult Scler. 2010; 16: 443-449
- 1, 25-dihydroxyvitamin D3 prevents the in vivo induction of murine experimental autoimmune encephalomyelitis.J Clin Invest. 1991; 87: 1103
- Vitamin D intake and incidence of multiple sclerosis.Neurology. 2004; 62: 60-65
- Expression of 1,25-dihydroxyvitamin D3 receptor in the immune system.Arch Biochem Biophys. 2000; 374: 334-338
- Vitamin D as an immune modulator in multiple sclerosis, a review.J Neuroimmunol. 2008; 194: 7-17
- RANKL maintains bone homeostasis through c-Fos-dependent induction of interferon-β.Nature. 2002; 416: 744-749
- Favorable effect of immunomodulator therapy on bone mineral density in multiple sclerosis.Ir J Med Sci. 2009; 178: 43-45
- Receptor activator of nuclear factor kappaB ligand and osteoprotegerin regulation of bone remodeling in health and disease.Endocr Rev. 2008; 29 ([Epub 2007 Dec 5]): 155-192
- Interferon-β modulates bone-associated cytokines and osteoclast precursor activity in multiple sclerosis patients.Mult Scler. 2006; 12: 541-550
- Annu Rev Physiol. 2000; 62: 413-437
- The weight of leptin in immunity.Nat Rev Immunol. 2004; 4: 371-379
- Leptin neutralization interferes with pathogenic T cell autoreactivity in autoimmune encephalomyelitis.J Clin Invest. 2006; 116: 447
- Requirement for leptin in the induction and progression of autoimmune encephalomyelitis.J Immunol. 2001; 166: 5909
- Regulation of neuronal and glial proteins by leptin: implications for brain development.Endocrinology. 1999; 140: 2755
- Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass.Cell. 2000; 100: 197-207
- Enhanced bone formation in lipodystrophic PPARγ hyp/hyp mice relocates haematopoiesis to the spleen.EMBO Rep. 2004; 5: 1007-1012
- The leptin receptor.J Biol Chem. 1997; 272: 6093
- Leptin regulates bone formation via the sympathetic nervous system.Cell. 2002; 111: 305-317
- Relationship of serum leptin concentration with bone mineral density in the United States population.J Bone Miner Res. 2002; 17: 1896-1903
- Central control of bone remodelling.J Neuroendocrinol. 2008; 20: 802-807
- New treatments for reflex sympathetic dystrophy.N Engl J Med. 2000; 343: 654-656
- Effects of a beta-blocker on bone turnover in normal postmenopausal women: a randomized controlled trial.J Clin Endocrinol Metab. 2005; 90 ([Epub 2005 Jul 5]): 5212-5216
- Signaling through the M3 muscarinic receptor favors bone mass accrual by decreasing sympathetic activity.Cell Metab. 2010; 11: 231-238
- Central control of bone remodeling by neuromedin U.Nat Med. 2007; 13: 1234-1240
- The molecular clock mediates leptin-regulated bone formation.Cell. 2005; 122: 803-815
- NPY and Y receptors: lessons from transgenic and knockout models.Neuropeptides. 2004; 38: 189-200
- Serotonin regulates osteoclast differentiation through its transporter.J Bone Miner Res. 2004; 19: 1420-1431
- A serotonin-dependent mechanism explains the leptin regulation of bone mass, appetite, and energy expenditure.Cell. 2009; 138: 976-989
- Recombinant human interferon-gamma inhibits formation of human osteoclast-like cells.J Immunol. Dec 1 1986; 137: 3544-3549
- Actions of recombinant interleukin 1, interleukin 2, and interferon-gamma on bone resorption in vitro.J Immunol. Apr 1 1986; 136: 2478-2482
- Expression of IL-5 alters bone metabolism and induces ossification of the spleen in transgenic mice.J Clin Invest. Apr 2001; 107: 949-959
- IL-22 promotes osteoclastogenesis in rheumatoid arthritis through induction of RANKL in human synovial fibroblasts.Arthritis Rheum. 2012; 64 ([Electronic publication ahead of print 2011 Oct 27] doi:10.1002/art.33446): 1015-1023
- Fluoxetine promotes remission in acute experimental autoimmune encephalomyelitis in rats.Neuroimmunomodulation. 2012; 19 ([Electronic publication ahead of print 2012 Mar 21]): 201-208
- The immunomodulatory effect of the antidepressant sertraline in an experimental autoimmune encephalomyelitis mouse model of multiple sclerosis.Neuroimmunomodulation. 2011; 18 ([Epub 2010 Nov 17]): 117-122
- Vitamin D has a direct immunomodulatory effect on CD8+ T cells of patients with early multiple sclerosis and healthy control subjects.J Neuroimmunol. Apr 2011; 233 ([Epub 2010 Dec 24]): 240-244
Article info
Publication history
Published online: May 14, 2012
Accepted:
March 29,
2012
Received in revised form:
March 28,
2012
Received:
January 4,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.