A literature review of the mechanism of osteolysis in osteosarcoma / 中华骨科杂志

ABSTRACT

Osteosarcomas are the most common primary malignant bone tumors in children and adolescents. Osteolysis is a common feature of all osteosarcomas (traditional, intramedullary, and periosteum). However, the specific mechanism of osteolysis is unknown and many researchers have studied it from different perspectives. Osteolysis is a process in which physiological bone remodeling is disrupted and excessive bone resorption occurs. Osteoclasts, the only cells with bone resorption function in the human body, play a key role in the pathological process of osteolysis in osteosarcomas. Osteoclasts play a leading role in osteolysis by secreting a high concentration of acid and collagenase, and they also mediate the occurrence and development of osteolysis in osteosarcoma through synergistic interaction with osteosarcoma cells. At the same time, osteolysis is an essential part of the pathological process of osteosarcoma, which can promote the occurrence and development of osteosarcoma and form a vicious cycle. Inhibiting osteolysis is of great significance to break this cycle and prevent the occurrence and development of osteosarcoma. However, the specific regulatory mechanism between osteosarcoma cells and osteoclasts and whether other cells in osteosarcoma are also involved in this pathological process remain unclear. Currently, bisphosphonates, small molecule inhibitors and natural compounds are the main drugs used to treat osteolysis of osteosarcoma. However, their efficacy and mechanism are still in the early stage of research. Previous studies on neoplastic osteolysis have mostly focused on metastatic bone tumors. Recently, studies on osteolysis of osteosarcoma have attracted more and more attention. The mechanism of osteoclasts and osteosarcoma cells in tumor-mediated osteolysis and the status of drug therapy of these two cell types as therapeutic targets are reviewed and analyzed. A deeper understanding of the role of osteolysis in the initiation and development of osteosarcoma will provide a theoretical basis and direction for the treatment of osteolysis in the context of osteosarcoma.