[PDF][PDF] Bisphosphonates and metastatic bone disease

S Barni, M Mandala, M Cazzaniga, M Cabiddu… - Annals of …, 2006 - researchgate.net
S Barni, M Mandala, M Cazzaniga, M Cabiddu, M Cremonesi
Annals of oncology, 2006researchgate.net
Malignant bone disease is a frequent complication of several common solid tumours
including breast, lung, prostate and renal cancer. A greater understanding of tropic bone
tumour cells, especially the understanding of those properties which lead to their successful
growth within the bone microenvironment is the first step to devise innovative approaches.
Bone metastases are generally characterized as osteolytic, leading to bone destruction, or
osteosclerotic (osteoblastic), leading to new bone formation. The classification of bone …
Malignant bone disease is a frequent complication of several common solid tumours including breast, lung, prostate and renal cancer. A greater understanding of tropic bone tumour cells, especially the understanding of those properties which lead to their successful growth within the bone microenvironment is the first step to devise innovative approaches.
Bone metastases are generally characterized as osteolytic, leading to bone destruction, or osteosclerotic (osteoblastic), leading to new bone formation. The classification of bone metastases as either osteolytic or osteoblastic is the schematic representation of a complex phenomenon wherein both biological scenarios coexist. Breast, lung and renal cancer metastases are usually osteolytic, on the other hand prostate cancer metastases are usually osteoblastic. The type of metastasis is a reflection of the primary mechanism of interference between tumour cells and the bone remodelling system. Hence, the development of osteolytic and osteoblastic lesions results from a functional interaction between tumour cells and osteoclasts or osteoblasts, respectively. Bone is a dynamic organ composed of cells of various embryonic origins; with regards to bone disease two cell types, osteoclasts and osteoblasts regulate bone modelling that occurs during development and bone remodelling that occurs in the adult. Osteoclasts are derived from precursors in the mononuclear-phagocyte lineage and are responsible for bone resorption [1]. Osteoblasts are derived from the stromal cell lineage and are responsible for laying down new bone matrix. A significant factor regulating bone remodelling is the direct interaction between osteoblasts and osteoclasts. The expression of RANK ligand (RANKL) on the surface of osteoblasts engages the receptor, RANK, on osteoclast precursors, leading to their maturation. Hence, osteoclasts release proteases that resorb bone matrix. In addition, a plethora of systemic and locally acting factors deriving from endocrine, immune, and other systems can impact osteoclast and osteoblast function, including the urokinase-type plasminogen activator (uPA), platelet derived growth factor (PDGF), endotheline-1 (ET-1), tumour necrosis factor (TNF-o), Interleukin-1 (IL-1), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-10 (IL-10), paratyroid hormone-related protein (PTHrP), the insulinlike growth factor (IGF) and transphorming growth factor
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