How osteoporosis drugs cause disruptions in vital communication between bone cells

Our bones are maintained by a continuous cycle of remodeling. Specialized cells called osteoblasts and osteoclasts are responsible for creating new bone and resorbing old bone, respectively.

A scientific study has shed new light on how these cells work, revealing robust and complex layers of communication between these types of cells. Today we’ll listen to the conversations our cells have about our bones, and we’ll consider how osteoporosis drugs disrupt that natural communication to the detriment of our bone health.

What did the osteoblast say to the osteoclast?

A study published in the journal Cells offers us a rare insight into the mechanisms by which our bone cells communicate. Researchers in New York and Massachusetts have compiled and reviewed current knowledge about how osteoblasts and osteoclasts communicate with each other.

Osteoblasts are cells that build new bone mass. Osteoclasts are cells responsible for dissolving and resorbing old bone mass. Together they complete the cycle of bone remodeling, replacing old bone with new bone.

Researchers have revealed that the impulse for the body to activate or deactivate one cell type originates in another. Osteoblasts and osteoclasts communicate with each other about their activity level and about the amount of each cell type.¹

This communication takes place in different ways. The study identifies eight compounds derived from osteoblasts that promote or suppress osteoclasts and seven derived from osteoblasts that affect osteoclasts. These compounds move between cells either by direct cell-to-cell contact or by secretion into the fluid surrounding the cells.

Some compounds inhibit the production of new osteoclasts or osteoblasts or conversely promote their new production. Some of them affect the survival of precursors necessary for the formation of new cells, or they influence which type of cell becomes a developing cell.¹

The communication between osteoblasts and osteoclasts allows them to balance the processes of bone remodeling and achieve homeostasis in which healthy bone mass is maintained.

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A study published in the journal Cells gathered information about the compounds released by osteoclasts and osteoblasts to communicate with each other. These compounds, released by one cell type, cause the promotion or suppression of the other type. This helps maintain a balanced bone remodeling cycle.

Disruptions in mobile communications

Many of the physical changes that naturally accompany aging affect the balance of osteoblasts and osteoclasts in favor of osteoclasts. This results in bone loss, as old bone is resorbed more quickly than replaced.

Furthermore, many behaviors can reinforce the changes that throw our bone remodeling process out of balance. For example, increases in the stress hormone cortisol and chronic inflammation have been shown to suppress osteoblasts and activate osteoclasts.² These stressors disrupt communication between our bone cells, which could otherwise keep them in balance.

Fortunately, it is possible to counteract the forces that disrupt bone remodeling at the source. The Osteoporosis Reversal Program recommends making beneficial changes in diet, physical activity and lifestyle to create the right conditions for bone remodeling.

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The aging process can cause an imbalance between osteoblasts and osteoclasts, as well as certain behaviors. For example, increased stress and inflammation hinder osteoblasts and increase the number of osteoclasts. You can counteract these disruptions through changes in your diet, exercise and lifestyle, as described in the Osteoporosis Reversal Program.

Artificial manipulation causes communication breakdowns

Over the past thirty years we have witnessed the rise of osteoporosis medications, which take a limited approach. Most of these drugs attempt to force a change in the number or activity of osteoclasts by introducing synthetic replicas of factors that inhibit them.

However, research into cellular communication has shown that osteoclasts are responsible for providing instructions to osteoblasts. As a result, any change in any part of the system has a ripple effect. In their report, the researchers describe this chain of disruptions caused by anti-osteoporosis drugs.

“…interactions between osteoblasts and osteoclasts have played a powerful role in shaping the actions of all currently approved drugs that act on the skeleton, often imposing limitations on the activities of these agents. Most antiresorptive agents that inhibit osteoclast formation and activity simultaneously suppress bone formation, while the activity of anabolic agents that induce bone formation is similarly dampened by simultaneously increasing bone resorption.”¹

This demonstrates one of the fundamental dysfunctions of osteoporosis drugs. You cannot artificially change part of the process without it leading to a change in the rest of the system. The result is medications that have no effect and are accompanied by unwanted – and often distressing – side effects.

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Because osteoclasts and osteoblasts require instructions from each other to maintain healthy bone remodeling, osteoporosis medications that force a decrease in the number of osteoclasts also impact osteoblasts. This limits the ability of osteoporosis drugs to be useful, effective and safe.

What this means for you

Communication is the cornerstone of any relationship – and that includes our bone cells! Avoiding fractures is a goal you can pursue in many ways. One of those ways is to support healthy communication between your osteoblasts and osteoclasts.

The recommendations in the Osteoporosis Reversal Program are designed to achieve just that – through diet, exercise and lifestyle changes. One of the simplest ways to support bone cell communication is by choosing a drug-free approach to prevent fractures.

References

¹ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564526/

² https://www.ncbi.nlm.nih.gov/pubmed/10487665