The role of estrogen and androgen receptors in bone health and disease

作者:Manolagas Stavros C*; O' Brien Charles A; Almeida Maria
来源:Nature Reviews Endocrinology, 2013, 9(12): 699-712.
DOI:10.1038/nrendo.2013.179

摘要

Mouse models with cell-specific deletion of the estrogen receptor (ER) alpha, the androgen receptor (AR) or the receptor activator of nuclear factor KB ligand (RANKL), as well as cascade-selective estrogenic compounds have provided novel insights into the function and signalling of ERa and AR. The studies reveal that the effects of estrogens on trabecular versus cortical bone mass are mediated by direct effects on osteoclasts and osteoblasts, respectively. The protection of cortical bone mass by estrogens is mediated via ER alpha, using a non-nucleus-initiated mechanism. By contrast, the AR of mature osteoblasts is indispensable for the maintenance of trabecular bone mass in male mammals, but not required for the anabolic effects of androgens on cortical bone. Most unexpectedly, and independently of estrogens, ERa in osteoblast progenitors stimulates Wnt signalling and periosteal bone accrual in response to mechanical strain. RANKL expression in B lymphocytes, but not T lymphocytes, contributes to the loss of trabecular bone caused by estrogen deficiency. In this Review, we summarize this evidence and discuss its implications for understanding the regulation of trabecular and cortical bone mass; the integration of hormonal and mechanical signals; the relative importance of estrogens versus androgens in the male skeleton; and, finally, the pathogenesis and treatment of osteoporosis.

  • 出版日期2013-12