Molecular Classification
Other
Other Names
Bone tissue, Osseous tissue
Disease Roles
OsteoporosisFractureOsteogenesis imperfecta

Bone Overview

Bone is a specialized mineralized connective tissue composed of a dense extracellular matrix predominantly consisting of type I collagen and hydroxyapatite crystals, which together provide mechanical strength and rigidity[1][3][7]. It contains four main cell types: osteoblasts (bone-forming), osteocytes (mature, matrix-embedded), osteoclasts (bone-resorbing), and bone lining cells, all coordinating bone remodeling and homeostasis[1][7]. Bone serves structural, protective, metabolic, and hematopoietic functions, and its dynamic remodeling is tightly regulated by local and systemic factors, including various hormones, cytokines, and growth factors[1][7][9]. In clinical medicine, bone is a tissue system rather than a molecular or protein target; therapies for bone diseases commonly target molecular mediators (such as RANKL, parathyroid hormone receptor, sclerostin) or pathways involved in bone cell activity and matrix regulation, rather than "bone" as a discrete target in the sense of a single molecular entity[2][4].

Mechanism of Action

Bisphosphonates: Inhibit osteoclast-mediated bone resorption Denosumab: RANKL inhibitor, reduces osteoclast formation/function Parathyroid hormone analogs: Intermittent stimulation of bone formation (anabolic effect) Romosozumab: Sclerostin inhibitor, increases bone formation and reduces resorption Calcitonin: Directly inhibits osteoclast activity

Biological Functions

Mechanical support
Mineral storage (especially calcium and phosphate)
Hematopoiesis (blood cell formation in bone marrow)
Endocrine regulation (via cells and matrix factors)
Protection of internal organs

Disease Associations

Osteoporosis
Fracture
Osteogenesis imperfecta
Bone cancers (e.g., osteosarcoma, bone metastases)
Paget's disease
Osteomyelitis
Other metabolic bone diseases

Safety Considerations

  • Osteonecrosis of the jaw (bisphosphonates, denosumab)
  • Atypical femoral fractures (bisphosphonates)
  • Hypercalcemia (parathyroid hormone analogs)
  • Hypocalcemia (denosumab)
  • Increased risk of osteosarcoma (teriparatide, in preclinical models)
  • Cardiovascular risks (romosozumab)
  • General mineral metabolism disturbances

Interacting Drugs

Bisphosphonates (e.g., alendronate, zoledronic acid)
Parathyroid hormone analogs (teriparatide, abaloparatide)
Denosumab
Romosozumab
Calcium and vitamin D supplements
Calcitonin

Associated Biomarkers

Biomarker
Bone mineral density (BMD)
Serum calcium and phosphate
Alkaline phosphatase (bone-specific isoform)
Telopeptides (e.g., CTX, NTX) as markers of bone turnover
Osteocalcin
Sclerostin