Journal of Bone Research and Reports

Description

The availability and efficacy of Antiretroviral Therapy (ART) have increased life expectancy for People with Human Immunodeficiency Virus (PLHIV).However, PLHIV patients' quality of life may be compromised as a result of side effects from taking anti-retroviral for an extended period of time and the physiological changes that come with aging. This will also put additional demands on the healthcare system. In the 1990s, Antiretroviral Therapy (ART) was introduced to control HIV replication in people living with HIV. Consequently, PLHIV's life expectancy and quality of life improved, and HIV transmission in the general population decreased significantly. The individual must take ART on a regular basis, which is based on at least three distinct antiretroviral drugs, in order to achieve this therapeutic success. Early initiation of ART also contributes to immune recovery and prevents the occurrence of Acquired Immunodeficiency Syndrome (AIDS).

Antiretroviral Therapy

The Brazilian HIV guidelines recommend that a combination of two nucleoside analog reverse transcriptase inhibitors—lamivudine and tenofovir—along with an integrase inhibitor or non-nucleoside reverse transcriptase inhibitor—efavirenz—should be the first option for treatment. Osteopenia and osteoporosis are metabolic changes that reduce bone microarchitecture, make bones more fragile, and increase the risk of fracture. People living with HIV are more likely to fracture than the general population. In addition, the presence of multiple comorbidities, multiple drug use, peripheral neuropathy, and frailty may be additional risk factors for PLHIV-associated early fracture development. Multiple organs in a child's development are harmed by exposure to ethanol during pregnancy. We investigate the intrauterine programming mechanism and the effects of prenatal exposure to ethanol on postnatal bone mass. We discovered that sustained activation of the local Renin-Angiotensin Systems (RAS) and inhibition of bone formation were accompanied by the induction of bone dysplasia in fetuses and osteopenia in female offspring following prenatal exposure to ethanol.

Enalapril prevented ethanol from inhibiting the osteogenic differentiation of bone marrow mesenchymal stem cells and the formation of mineralized nodules in vitro. By recruiting p300 and directly binding to the ACE promoter region, ethanol also increased early growth response factor 1 expression and nuclear translocation, contributing to ACE histone acetylation and subsequent RAS activation. Rheumatoid arthritis (RA) is characterized most specifically by periarticular osteopenia. It has been discovered that the synovial Renin–Angiotensin System (RAS) plays a role in RA's pathogenesis. This study looked into whether and how periarticular osteopenia in RA is controlled by RAS. In the process of skeletal growth and renewal, key roles are played by bone modeling and remodeling. The process of shaping bone through the independent actions of the osteoblasts and osteoclasts that are not necessarily coupled anatomically or temporally is referred to as bone modeling. Modeling not only helps to define skeletal development and growth but also continues throughout life and contributes to the expansion of the periosteum. The sequential activity of osteoclasts and osteoblasts connected in a remodeling unit is the constant process of bone remodeling in the adult skeleton, and its significance grows with age. After reaching its maximum mass, cancellous bone remains relatively stable until age-related bone loss is triggered by increased resorptive activity and decreased bone formation. Through excessive maternal glucocorticoid, prenatal caffeine activated bone RAS.

Folial osteopenia

In chorioamnionitis and pre-eclampsia, placental insufficiency impeded mineral transfer in utero. Risk factors for OFP have been identified as inadequate calcium and phosphorus supplementation, inadequate vitamin D supplementation, inadequate total enteral nutrition, and prolonged parenteral nutrition. The use of certain medications, such as furosemide, methylxanthine, and corticosteroid, as well as necrotizing enterocolitis, sepsis, cholestasis, and lack of mobilization all contributed to the incidence of OFP. As a result, OFP's etiology demonstrates a multifactorial and intricate origin; However, vitamin D deficiency or mineral calcium and phosphorus deficiency is the primary pathogenesis of OFP.  Preterm infants with OFP benefit from specific therapeutic interventions that are made possible by the identification of risk factors. In a fracture model, the treatment of ovariectomized osteopenic rats with M paradisiaca flower extract and fraction promoted new bone regeneration. The ovariectomy-induced deterioration of trabecular and cortical bone microarchitecture was halted by M paradisiaca flower extract and fraction. Both the extract and the fraction decreased serum CTX, a marker of bone resorption, while simultaneously increasing levels of the marker for bone formation, P1NP.

Out of the four compounds that were isolated, oleracein-E from the M paradisiaca fraction had the strongest osteogenic activity. Vitamin D3 plays a crucial role in preventing osteoporosis and maintaining bone mineral density, but physical activity at an early age doubles this beneficial effect. A sedentary lifestyle is a risk factor for osteoporosis, and those with low vitamin D3 levels and an inactive lifestyle are more likely to have osteopenia or osteoporosis. This chapter aims to emphasize the positive effects of vitamin D3 and exercise on bone mineral density. The activity of osteoblasts and osteoclasts must be balanced precisely for adult bone homeostasis to occur. Because it limits the effectiveness of most anabolic or anti-resorptive treatments for osteoporosis, this osteoblast-osteoclast coupling is important for treatment. The biological aging process is accelerated by postmenopausal conditions, which are characterized by a variety of metabolic disorders, the most common of which results in bone loss and sarcopenia. During pregnancy and lactation, maternal skeletal loss is significant because pre- and post-natal bone development requires calcium from the mother to the fetus. It comes after an anabolic phase around weaning, where the maternal recovery is notable.