Muscle-bone crosstalk via endocrine signals and potential targets for osteosarcopenia-related fracture

Renwang Sheng; Mumin Cao; Mingyuan Song; Mingyue Wang; Yuanwei Zhang; Liu Shi; Tian Xie; Yingjuan Li; Jinyu Wang; Yunfeng Rui

doi:10.1016/j.jot.2023.09.007

Muscle-bone crosstalk via endocrine signals and potential targets for osteosarcopenia-related fracture

J Orthop Translat. 2023 Nov 5:43:36-46. doi: 10.1016/j.jot.2023.09.007. eCollection 2023 Nov.

Authors

Renwang Sheng^{1

2}, Mumin Cao^{1

3

2

4

5}, Mingyuan Song^{1

2}, Mingyue Wang², Yuanwei Zhang^{1

3

2

4

5}, Liu Shi^{1

3

2

4

5}, Tian Xie^{1

3

2

4

5}, Yingjuan Li^{3

6}, Jinyu Wang^{7

3

2}, Yunfeng Rui^{1

3

2

4

5}

Affiliations

¹ Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China.
² School of Medicine, Southeast University, Nanjing, Jiangsu, PR China.
³ Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China.
⁴ Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, PR China.
⁵ Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China.
⁶ Department of Geriatrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China.
⁷ Department of Rehabilitation, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China.

Abstract

Background: Osteosarcopenia is a syndrome coexisting sarcopenia and osteopenia/osteoporosis, with a high fracture risk. Recently, skeletal muscle and bone have been recognized as endocrine organs capable of communication through secreting myokines and osteokines, respectively. With a deeper understanding of the muscle-bone crosstalk, these endocrine signals exhibit an important role in osteosarcopenia development and fracture healing.

Methods: This review summarizes the role of myokines and osteokines in the development and treatment of osteosarcopenia and fracture, and discusses their potential for osteosarcopenia-related fracture treatment.

Results: Several well-defined myokines (myostatin and irisin) and osteokines (RANKL and SOST) are found to not only regulate skeletal muscle and bone metabolism but also influence fracture healing processes. Systemic interventions targeting these biochemical signals has shown promising results in improving the mass and functions of skeletal muscle and bone, as well as accelerating fracture healing processes.

Conclusion: The regulation of muscle-bone crosstalk via biochemical signals presents a novel and promising strategy for treating osteosarcopenia and fracture by simultaneously enhancing bone and muscle anabolism. We propose that myostatin, irisin, RANKL, and SOST may serve as potential targets to treat fracture patients with osteosarcopenia.

The translational potential of this article: Osteosarcopenia is an emerging geriatric syndrome where sarcopenia and osteoporosis coexist, with high fracture risk, delayed fracture healing, and increased mortality. However, no pharmacological agent is available to treat fracture patients with osteosarcopenia. This review summarizes the role of several myokines and osteokines in the development and treatment of osteosacropenia and fracture, as well as discusses their potential as intervention targets for osteosarcopenia-related fracture, which provides a novel and promising strategy for future osteosarcopenia-related fracture treatment.

Keywords: Fracture; Musculoskeletal system; Myokines; Osteokines; Osteosarcopenia.

Publication types

Review