Exploring the Bone-Marrow-Fat Paradigm
What is it?
- Research into osteoporosis has to date concentrated on measurement of bone tissue (e.g. DXA assessment of BMD) or molecular pathways (e.g. RANKL). Although the precursors of cells involved in bone remodelling are located with it, Bone Marrow has received little attention, it has become the Forgotten Organ.
- Our Hypothesis is that quantitative assessment of bone marrow will provide a reliable means of predicting remodelling behaviour of bone including its response to treatment.
- Pathophysiology of Bone Marrow (more info)
- Bone, marrow and fat are all interlinked, although the nature of the relationships is complex and has not been clarified to date.
- Bone and marrow function as a single physiological unit, their blood supply being directly connected.
- The stem cell precursors of both osteoclasts and osteoblasts are within bone marrow and exert an important regulatory role on both their own development and on their inter-linked remodelling process.
- There is evidence that the rate of bone turnover is higher at cancellous bone sites perfused with red haematopoietic marrow than where fatty marrow predominates.
- Thought that with increasing age, more adipocytes and fewer osteoblasts formed from mesenchymal stem cells.
- Hypothesis: that marrow composition may predict rate of bone loss and treatment response associated with osteoporosis.