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Sains Malaysiana 48(9)(2019):
2007–2019
http://dx.doi.org/10.17576/jsm-2019-4809-22
Osteoporosis: Possible Pathways
Involved and the Role of Natural Phytoestrogens in Bone Metabolism
(Osteoporosis: Laluan
yang Mungkin Terlibat dan Peranan Fitoestrogen Semula Jadi dalam Metabolisme
Tulang)
ZAR
CHI
THENT1,
SRIJIT
DAS2*,
PASUK
MAHAKKANUKRAUH3
& VIRGINIA LANZOTTI4
1Anatomy
Discipline, Basic Medical Science Cluster, Faculty of Medicine,
Sungai Buloh Campus, Universiti Teknologi MARA, 47000 UiTM Sungai
Buloh, Selangor Darul Ehsan, Malaysia 2Department
of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia
Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras,
Kuala Lumpur, Federal Territory, Malaysia 3Forensic Osteology
Research and Training Centre, Excellence Center of Osteology Research and, Training
Center & Department of Anatomy, Faculty of Medicine, Chiang Mai University,
Chiang Mai 50200, Thailand
4Department of
Agricultural Sciences, Università di Napoli Federico II, Napoli, Italy
Received:
17 May 2019/Accepted: 5 July 2019
ABSTRACT
The incidence of
post-menopausal osteoporosis is increasing globally. In post-menopausal
osteoporosis, there is deficiency in oestrogen level resulting in bone loss and
fractures. Bone formation is under the control of different hormones. In the
present review, we highlight few pathways such as RANKL/RANK,
apoptosis and Wnt/β-catenin signalling pathways and phytoestrogens
involved in the bone metabolism. RANKL/RANK signalling is
responsible for regulating the formation and activation of multinucleated
osteoclasts from their precursors which is responsible for the survival of
normal bone remodelling. Apoptosis regulates the development, growth and
maintains the bone tissues. The Wnt pathway is an important pharmacological
target for bone anabolic drugs and its future discovery. In today’s world,
herbal remedies are used to treat post-menopausal osteoporosis as these
products contain phytoestrogens. These phytoestrogens are oestrogen like
compounds which influence bone metabolism. The phytoestrogens provide better
therapeutic effect in reducing the RANKL, osteoclastogenesis,
inflammatory markers, and increase the osteogenic markers in the bone cells or
osteoblasts. We discuss the mechanism of action of few phytoestrogens such as
genistein, daidzein and equol which are beneficial for improvement of the bone
health. Daidzein enhances osteoblast growth via the upregulation of BMP expression
in primary osteoblast cells and it is a potential antiosteoporotic agent.
Genistein also possesses antioestrogenic property by virtue of its competitive
binding to the same receptors as oestradiol. Equol regulates the bone loss via
hemopoiesis and inflammatory cytokine production. Thus, phytoestrogens could be
efficiently used as osteoprotective agents for the treatment of individuals
with post-menopausal osteoporosis.
Keywords: Fracture;
oestrogen; pharmacology; post-menopausal; treatment
ABSTRAK
Kejadian osteoporosis
selepas menopaus meningkat secara global. Dalam osteoporosis selepas menopaus,
terdapat penurunan aras estrogen yang mengakibatkan kehilangan tulang dan patah
tulang. Pembentukan tulang dikawal oleh hormon yang berbeza. Dalam ulasan
kepustakaan ini, kami menyerlahkan beberapa laluan isyarat seperti RANKL/
RANK, apoptosis dan Wnt/β-catenin serta fitoestrogens yang
terlibat dalam metabolisme tulang. Isyarat RANKL/RANK bertanggungjawab
mengawal pembentukan dan pengaktifan osteoklas multinukleus daripada prekursor
mereka yang terlibat dalam proses pembentukan semula tulang yang normal.
Apoptosis mengawal perkembangan, pertumbuhan dan penyelenggaraan tisu tulang.
Laluan Wnt adalah sasaran farmakologi yang penting untuk ubat anabolik tulang
dan penemuan masa depannya. Di dunia hari ini, banyak ubat-ubatan herba
digunakan untuk merawat osteoporosis Osteoporosis:
Possible menopaus kerana produk ini mengandungi fitoestrogen. Fitoestrogen
mempunyai struktur seperti estrogen yang mempengaruhi metabolisme tulang.
Fitoestrogen memberikan kesan terapeutik yang lebih baik dalam mengurangkan RANKL,
osteoklastogenesis, penanda inflamasi dan meningkatkan penanda osteogenik dalam
sel-sel tulang atau pun osteoblas. Kami membincangkan mekanisme tindakan
beberapa fitoestrogen seperti genistein, daidzein dan equol yang bermanfaat
untuk kesihatan tulang. Daidzein meningkatkan pertumbuhan osteoblas melalui
peningkatan ekspresi BMP dalam sel osteoblas primer dan ia
adalah agen antiosteoporotik yang berpotensi. Genistein juga mempunyai harta
antioestrogenik berdasarkan daya saingnya yang kompetitif kepada reseptor yang
sama seperti oestradiol. Equol mengawal kehilangan tulang melalui hemopoiesis
dan penghasilan sitokin inflamasi. Oleh itu, fitoestrogen boleh digunakan
sebagai agen osteoperlindungan untuk rawatan osteoporosis selepas menopaus.
Kata kunci: Estrogen; farmakologi; patah tulang; selepas menopaus;
rawatan
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*Corresponding author; email: drsrijit@gmail.com
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