Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Tumour necrosis factor blockade and the risk of osteoporosis: back to the future. | Available online http content 9 4 107 Editorial Tumour necrosis factor blockade and the risk of osteoporosis back to the future Philip Sambrook Kolling Institute University of Sydney Sydney Australia Corresponding author Philip Sambrook sambrook@ Published 30 August 2007 This article is online at http eontent 9 4 107 2007 BioMed Central Ltd Arthritis Research Therapy 2007 9 107 doi ar2277 See related research article by Marotte et al. http eontent 9 3 R61 Abstract Osteoporosis is a common clinical problem especially in patients with rheumatoid arthritis RA . A reduction in bone mineral density BMD of the axial and appendicular skeleton ranging from 7 to 15 has been reported in RA in studies employing a variety of densitometrie techniques. Reports consistent with a beneficial effect of tumour necrosis factor blockade on BMD have begun to emerge in recent years and in Arthritis Research and Therapy a case control study reports that patients treated with infliximab for RA had preservation of BMD in the lumbar spine and femoral neck compared to those treated with methotrexate. Generalised osteoporosis is just one of three bony manifestations of rheumatoid arthritis RA which also include erosions and localised juxta-articular bone loss of affected joints. Although a number of causes for this generalised osteoporosis have been proposed 1 2 increasing evidence suggests a common mechanism for all three bone manifestations. Control of inflammation appears to be the most important strategy for prevention of bone loss in RA 3 . The discovery of the receptor activator of nuclear factor kB RANK ligand RANKL pathway a transmembrane protein belonging to the tumour necrosis factor TNF superfamily and its inhibition by osteoprotogerin OPG has had important implications for bone physiology as well as inflammation research. RANK and its decoy receptor OPG are key regulators of osteoclastic .
