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Osteoporosis in rheumatoid arthritis: role of the vitamin D/PTH system
- Source :
- Revista Brasileira de Reumatologia (English Edition); 20240101, Issue: Preprints
- Publication Year :
- 2024
-
Abstract
- Osteoporosis is a well-established extra-articular feature of rheumatoid arthritis (RA). Systemic inflammation seems to play a crucial role in causing an alteration of multiple homeostatic systems implied in bone health, such as the RANK/RANKL/Osteoprotegerin and Wnt/β catenin pathways; several other causal factors have been called into question, including the chronic use of corticosteroids. Since vitamin D exerts important immune-regulatory roles, it has been claimed that derangement of the vitamin D/parathyroid hormone (PTH) system, a well-known determinant of bone health, may play a pathogenic role in autoimmunity; animal models and clinical data support this hypothesis. Furthermore, RA patients seem to be relatively refractory to vitamin D-induced PTH suppression. Therefore, the link between RA and osteoporosis might in part be due to alterations in the vitamin D/PTH system. A better understanding of the pathophysiology of this system may be crucial to prevent and cure osteoporosis in patients with inflammatory/autoimmune diseases. A major clinical correlate of the strict cooperation and interdependence between vitamin D and PTH is that correction of the vitamin D deficiency, at least in autoimmune diseases, should be targeted to PTH suppression.
Details
- Language :
- English
- ISSN :
- 22555021
- Issue :
- Preprints
- Database :
- Supplemental Index
- Journal :
- Revista Brasileira de Reumatologia (English Edition)
- Publication Type :
- Periodical
- Accession number :
- ejs34324732
- Full Text :
- https://doi.org/10.1016/j.rbre.2014.10.007