Beyond Bone Loss: A Biology Perspective on Osteoporosis Pathogenesis, Multi-Omics Approaches, and Interconnected Mechanisms

Osteoporosis is a systemic bone disorder characterized by decreased bone mass and deteriorated microarchitecture, leading to an increased risk of fractures. Recent studies have revealed that its pathogenesis involves complex biological processes beyond bone remodeling, including oxidative stress, ch...

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Main Authors: Yixin Zhao, Jihan Wang, Lijuan Xu, Haofeng Xu, Yu Yan, Heping Zhao, Yuzhu Yan
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/6/1443
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author Yixin Zhao
Jihan Wang
Lijuan Xu
Haofeng Xu
Yu Yan
Heping Zhao
Yuzhu Yan
author_facet Yixin Zhao
Jihan Wang
Lijuan Xu
Haofeng Xu
Yu Yan
Heping Zhao
Yuzhu Yan
author_sort Yixin Zhao
collection DOAJ
description Osteoporosis is a systemic bone disorder characterized by decreased bone mass and deteriorated microarchitecture, leading to an increased risk of fractures. Recent studies have revealed that its pathogenesis involves complex biological processes beyond bone remodeling, including oxidative stress, chronic inflammation, cellular senescence, osteoimmunology, gut microbiota alterations, and epigenetic modifications. Oxidative stress disrupts bone homeostasis by promoting excessive free radical production and osteoclast activity. Chronic inflammation and the accumulation of senescent cells impair skeletal repair mechanisms. Advances in osteoimmunology have highlighted the critical role of immune–bone crosstalk in regulating bone resorption and formation. Moreover, the gut–bone axis, mediated by microbial metabolites, influences bone metabolism through immune and endocrine pathways. Epigenetic changes, such as DNA methylation and histone modification, contribute to gene–environment interactions, affecting disease progression. Multi-omics approaches (genomics, proteomics, and metabolomics) systematically identify molecular networks and comorbid links with diabetes/cardiovascular diseases, revealing pathological feedback loops that exacerbate bone loss. In conclusion, osteoporosis pathogenesis extends beyond bone remodeling to encompass systemic inflammation, immunometabolic dysregulation, and gut microbiota–host interactions. Future research should focus on integrating multi-omics biomarkers with targeted therapies to advance precision medicine strategies for osteoporosis prevention and treatment.
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spelling doaj-art-db5d9c19afaa4d93a53c8008b83c28052025-06-25T13:32:00ZengMDPI AGBiomedicines2227-90592025-06-01136144310.3390/biomedicines13061443Beyond Bone Loss: A Biology Perspective on Osteoporosis Pathogenesis, Multi-Omics Approaches, and Interconnected MechanismsYixin Zhao0Jihan Wang1Lijuan Xu2Haofeng Xu3Yu Yan4Heping Zhao5Yuzhu Yan6Clinical Laboratory of Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, ChinaYan’an Medical College, Yan’an University, Yan’an 716000, ChinaClinical Laboratory of Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, ChinaClinical Laboratory of Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, ChinaClinical Laboratory of Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, ChinaClinical Laboratory of Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, ChinaClinical Laboratory of Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, ChinaOsteoporosis is a systemic bone disorder characterized by decreased bone mass and deteriorated microarchitecture, leading to an increased risk of fractures. Recent studies have revealed that its pathogenesis involves complex biological processes beyond bone remodeling, including oxidative stress, chronic inflammation, cellular senescence, osteoimmunology, gut microbiota alterations, and epigenetic modifications. Oxidative stress disrupts bone homeostasis by promoting excessive free radical production and osteoclast activity. Chronic inflammation and the accumulation of senescent cells impair skeletal repair mechanisms. Advances in osteoimmunology have highlighted the critical role of immune–bone crosstalk in regulating bone resorption and formation. Moreover, the gut–bone axis, mediated by microbial metabolites, influences bone metabolism through immune and endocrine pathways. Epigenetic changes, such as DNA methylation and histone modification, contribute to gene–environment interactions, affecting disease progression. Multi-omics approaches (genomics, proteomics, and metabolomics) systematically identify molecular networks and comorbid links with diabetes/cardiovascular diseases, revealing pathological feedback loops that exacerbate bone loss. In conclusion, osteoporosis pathogenesis extends beyond bone remodeling to encompass systemic inflammation, immunometabolic dysregulation, and gut microbiota–host interactions. Future research should focus on integrating multi-omics biomarkers with targeted therapies to advance precision medicine strategies for osteoporosis prevention and treatment.https://www.mdpi.com/2227-9059/13/6/1443osteoporosis pathogenesisbone remodelingosteoimmunologyepigeneticsmulti-omics
spellingShingle Yixin Zhao
Jihan Wang
Lijuan Xu
Haofeng Xu
Yu Yan
Heping Zhao
Yuzhu Yan
Beyond Bone Loss: A Biology Perspective on Osteoporosis Pathogenesis, Multi-Omics Approaches, and Interconnected Mechanisms
Biomedicines
osteoporosis pathogenesis
bone remodeling
osteoimmunology
epigenetics
multi-omics
title Beyond Bone Loss: A Biology Perspective on Osteoporosis Pathogenesis, Multi-Omics Approaches, and Interconnected Mechanisms
title_full Beyond Bone Loss: A Biology Perspective on Osteoporosis Pathogenesis, Multi-Omics Approaches, and Interconnected Mechanisms
title_fullStr Beyond Bone Loss: A Biology Perspective on Osteoporosis Pathogenesis, Multi-Omics Approaches, and Interconnected Mechanisms
title_full_unstemmed Beyond Bone Loss: A Biology Perspective on Osteoporosis Pathogenesis, Multi-Omics Approaches, and Interconnected Mechanisms
title_short Beyond Bone Loss: A Biology Perspective on Osteoporosis Pathogenesis, Multi-Omics Approaches, and Interconnected Mechanisms
title_sort beyond bone loss a biology perspective on osteoporosis pathogenesis multi omics approaches and interconnected mechanisms
topic osteoporosis pathogenesis
bone remodeling
osteoimmunology
epigenetics
multi-omics
url https://www.mdpi.com/2227-9059/13/6/1443
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