[New pathophysological relevant metabolic pathways in osteoporosis. Future innovative therapies?].

Osteoporosis is characterized by low bone mass and by changes in the microarchitecture of the bone. This leads to reduced bone stability and altered suscebtibility to fractures. Bone remodelling in healthy persons is characterized by a balance between bone resorption and bone formation. At the cellular level, bone remodelling is regulated by osteoclast and osteoblast activity. During bone loss, there is an imbalance, osteoclast activity being more pronounced. Therefore, the influende of estrogens, Wnt and the RANK/ RANKL/OPG system on osteoclastogenesis and osteoclast activity has been investigated. The RANK/RANKL/OPG-System is actively involved in the differentiation and function of osteoclasts and seems to play a central part in most pathophysiological mechanisms that are active in osteoporosis.