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Abstract：
Osteoporosis is a systemic skeletal disease caused by an imbalance between bone resorption and formation. Current treatments primarily involve systemic medication and hormone therapy. However, these systemic treatments lack directionality and are often ineffective for locally severe osteoporosis, with the potential for complex adverse reactions. Consequently, treatment strategies using bioactive materials or external interventions have emerged as the most promising approaches. This review proposes twelve microenvironmental treatment targets for osteoporosis-related pathological changes, including local accumulation of inflammatory factors and reactive oxygen species (ROS), imbalance of mitochondrial dynamics, insulin resistance, disruption of bone cell autophagy, imbalance of bone cell apoptosis, changes in neural secretions, aging of bone cells, increased local bone tissue vascular destruction, and decreased regeneration. Additionally, this review examines the current research status of effective or potential biophysical and biochemical stimuli based on these microenvironmental treatment targets and summarizes the advantages and optimal parameters of different bioengineering stimuli to support preclinical and clinical research on osteoporosis treatment and bone regeneration. Finally, the review addresses ongoing challenges and future research prospects.
摘要：
骨质疏松症是由骨吸收和骨形成之间的不平衡引起的全身性骨骼疾病。目前的治疗主要涉及全身药物和激素治疗。然而,这些系统治疗缺乏方向性，对局部严重的骨质疏松症通常无效。具有复杂不良反应的可能性。因此,使用生物活性材料或外部干预的治疗策略已成为最有前途的方法.这篇综述提出了12个骨质疏松症相关病理变化的微环境治疗目标，包括炎症因子和活性氧（ROS）的局部积累，线粒体动力学失衡，胰岛素抵抗，破坏骨细胞自噬，骨细胞凋亡失衡，神经分泌物的变化,骨细胞的老化，增加局部骨组织血管破坏，减少再生。此外,本文综述了基于这些微环境治疗目标的有效或潜在的生物物理和生化刺激的研究现状，并总结了不同生物工程刺激的优势和最佳参数，以支持骨质疏松症治疗和骨再生的临床前和临床研究。最后,该综述解决了当前的挑战和未来的研究前景。
