Bone Remodeling Dynamics

This podcast episode explores the intricate cellular and molecular pathways regulating normal bone remodeling and their disruption in osteoporotic states. Listeners will review the fundamental roles of the rank, rank ligand, osteoprotegerin axis, and canonical wnt beta catenin signaling, including endogenous regulation by sclerostin. The discussion details the pathophysiology behind estrogen deficiency, age related senescence, and glucocorticoid excess. Finally, the episode breaks down the comparative pharmacology of antiresorptive therapies like bisphosphonates and denosumab versus anabolic and dual action agents like teriparatide and romosozumab, emphasizing evidence based sequencing strategies and critical transition protocols for clinicians managing severe metabolic bone disease.