Is osteoporosis an autoimmune mediated disorder?

The last two decades have marked a growing understanding of the interaction occurring between bone and immune cells. The chronic inflammation and immune system dysfunction commonly observed to occur during the ageing process and as part of a range of other pathological conditions, commonly associated with osteoporosis has led to the recognition of these processes as important determinants of bone disease. This is further supported by the recognition that the immune and bone systems in fact share regulatory mechanisms and progenitor molecules. Research into this complex synergy has provided a better understanding of the immunopathogenesis underlying bone diseases such as osteoporosis. However, existing research has largely focussed on delineating the role played by inflammation in pathogenic bone destruction, despite increasing evidence implicating autoantibodies as important drivers of osteoporosis. This review shall attempt to provide a comprehensive overview of existing research examining the role played by autoantibodies in osteoporosis in order to determine the potential for further research in this area. Autoantibodies represent promising targets for the improved treatment and diagnosis of inflammatory bone loss.
Highlights • Immune and bone systems recognised to share regulatory mechanisms and progenitor molecules. • Osteoclasts and osteoblasts are continuously controlled by a variety of cells of the immune system. • Altered bone composition often observed to occur alongside diseases characterised by immune dysfunction. • Immune disturbance linked to pathogenic bone loss through the action of inflammatory markers and autoantibodies.