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Review
. 2024 Apr 2:15:1370900.
doi: 10.3389/fphar.2024.1370900. eCollection 2024.

Traditional Chinese medicine in osteoporosis: from pathogenesis to potential activity

Gang Cao #  1   2 , ShaoQi Hu #  2 , Yan Ning #  2 , Xinyue Dou  2 , Chuan Ding  2 , Lu Wang  2 , Zeping Wang  2 , Xianan Sang  2 , Qiao Yang  2 , Jiangnan Shi  2 , Min Hao  2 , Xin Han  2
Affiliations
Review

Traditional Chinese medicine in osteoporosis: from pathogenesis to potential activity

Gang Cao et al. Front Pharmacol. .

Abstract

Osteoporosis characterized by decreased bone density and mass, is a systemic bone disease with the destruction of microstructure and increase in fragility. Osteoporosis is attributed to multiple causes, including aging, inflammation, diabetes mellitus, and other factors induced by the adverse effects of medications. Without treatment, osteoporosis will further progress and bring great trouble to human life. Due to the various causes, the treatment of osteoporosis is mainly aimed at improving bone metabolism, inhibiting bone resorption, and promoting bone formation. Although the currently approved drugs can reduce the risk of fragility fractures in individuals, a single drug has limitations in terms of safety and effectiveness. By contrast, traditional Chinese medicine (TCM), a characteristic discipline in China, including syndrome differentiation, Chinese medicine prescription, and active ingredients, shows unique advantages in the treatment of osteoporosis and has received attention all over the world. Therefore, this review summarized the pathogenic factors, pathogenesis, therapy limitations, and advantages of TCM, aiming at providing new ideas for the prevention and treatment of OP.

Keywords: osteoporosis; pathogenesis; pathogenic factors; traditional Chinese medicine; treatment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Pathogenic factors of osteoporosis, such as aging, inflammation, and diabetes mellitus, could contribute to the development of osteoporosis.
FIGURE 2
FIGURE 2
Main single herbs for treating osteoporosis.
FIGURE 3
FIGURE 3
Role of the Wnt/β-catenin signaling pathway in osteoporosis. Interleukin, IL; insulin-like growth factor-1, IGF-1; lipoprotein receptor-related protein, LRP; disheveled, DVL; glycogen synthase kinase-3β, GSK-3β; DNA methyltransferase 3B, Dnmt3b; runt-related transcription factor 2, Runx2; forkhead box O, FoxO; dickkopf-1, DKK1; disheveled binding antagonist of beta-catenin 1, DACT1; and transforming growth factor-beta, TGF-β.
FIGURE 4
FIGURE 4
Role of the TGF-β/BMP signaling pathway in osteoporosis. Transforming growth factor-beta, TGF-β; TGF-β type I receptor, TβR; runt-related transcription factor 2, Runx2; histone deacetylases, HDACs; mitogen-activated protein kinase, MAPK; bone morphogenetic protein, BMP; tumor necrosis factor-α, TNF-α; and nuclear factor-κB, NF-κB.
FIGURE 5
FIGURE 5
Role of the MAPK signaling pathway in osteoporosis. Advanced glycation end products, AGEs; runt-related transcription factor 2, Runx2; SAPK/Erk kinase 1, SEK1; Jun N-terminal kinase, JNK; mitogen-activated protein kinase kinase, MEK; mitogen-activated protein kinase kinase kinase, MEKK1; extracellular signal-regulated kinases, ERK; transforming growth factor-β-activated kinase 1, TAK1; MAP kinase kinase-3, MKK3; C-terminal telopeptide of type I collagen, CTX1; tartrate-resistant acid phosphatase isoform 5b, TRAP5b; dickkopf-1, Dkk1; anti-human t-lymphocyte globulin 1, ATG1; nuclear factor of activated T-cells 1, NFATC1; and interleukin, IL.
FIGURE 6
FIGURE 6
Role of the RANK/NF-κB (RANKL)/OPG signaling pathway in osteoporosis. Nuclear factor-κB, NF-κB; nuclear factor kappa B, RANK; nuclear factor-κB ligand, RANKL; inhibitor of NF-κB α, IκBα; osteoprotegerin, OPG; interleukin, IL; glycogen synthase kinase-3β, GSK-3β; nuclear factor of activated T-cells 1, NFATC1; forkhead box O, FoxO; reactive oxygen species, ROS; and macrophage colony-stimulating factor, MCSF.
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