Abstract
Bone mineral density, a bone matrix parameter frequently used to predict fracture risk, is not the only one to affect bone fragility. Other factors, including the extracellular matrix (ECM) composition and microarchitecture, are of paramount relevance in this process. The bone ECM is a noncellular three-dimensional structure secreted by cells into the extracellular space, which comprises inorganic and organic compounds. The main inorganic components of the ECM are calcium-deficient apatite and trace elements, while the organic ECM consists of collagen type I and noncollagenous proteins. Bone ECM dynamically interacts with osteoblasts and osteoclasts to regulate the formation of new bone during regeneration. Thus, the composition and structure of inorganic and organic bone matrix may directly affect bone quality. Moreover, proteins that compose ECM, beyond their structural role have other crucial biological functions, thanks to their ability to bind multiple interacting partners like other ECM proteins, growth factors, signal receptors and adhesion molecules. Thus, ECM proteins provide a complex network of biochemical and physiological signals. Herein, we summarize different ECM factors that are essential to bone strength besides, discussing how these parameters are altered in pathological conditions related with bone fragility.
Highlights
The bone mineralized extracellular matrix (ECM) is predominantly responsible for bone’s resistance to fracture, defined as bone strength
The skeleton derives its resistance to fracture from multiple components regulated across several levels of hierarchical organization
These results suggests that changes in the microarchitecture cause a proportional decrease in the mechanical stimuli that may drastically affect the mechanoregulation of bone regeneration, promote microcracks and accelerate osteoporosis
Summary
The bone mineralized extracellular matrix (ECM) is predominantly responsible for bone’s resistance to fracture, defined as bone strength. Bone formation or internal reconstruction will determine the spatial structure of the tissue but its mechanical properties. Bone mass has been used as a predictor of bone fragility; it is only a partial correspondent. The skeleton derives its resistance to fracture from multiple components regulated across several levels of hierarchical organization. The relative composition, organization, and maturity of the mineral and organic matrix have a paramount relevance on how bones respond to mechanical demand
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