Mecanismos celulares e moleculares do estrógeno na reabsorção óssea
Cellular and molecular mechanisms of the estrogen in the bone resorption
Faloni, A.P.S.; Cerri, P.S.
Rev. odontol. UNESP, vol.36, n2, p.181-188, 2007
Resumo
O osso é um tecido conjuntivo mineralizado cuja homeostase está sob a influência de diversos fatores sistêmicos e locais. Entre os fatores sistêmicos, sabe-se que o estrógeno é um hormônio que inibe a reabsorção óssea e, por essa razão, tem sido amplamente utilizado no tratamento e na prevenção da osteoporose. Os mecanismos de ação do estrógeno na reabsorção óssea não estão completamente esclarecidos. Assim, nesta revisão, está descrito o papel do estrógeno no tecido ósseo, enfocando alguns mecanismos celulares e moleculares de ação desse hormônio. Informações clínicas a respeito da possível relação entre osteoporose, homeostase dos ossos maxilares e tratamentos dentários foram também incluídas nesta revisão. De acordo com os dados da literatura, o estrógeno atua na via RANK/RANKL/OPG, inibindo a formação de osteoclastos. Também tem sido mostrado que o estrógeno promove a apoptose de osteoclastos e, assim, diminui a reabsorção óssea. Esse hormônio também reduz a reabsorção óssea inibindo proteases produzidas por osteoclastos. Se o estrógeno age diretamente em osteoclastos, ou indiretamente por meio dos osteoblastos, ainda é controverso. Porém, pode-se concluir que o estrógeno inibe a reabsorção óssea agindo em vias relacionadas à formação, à atividade e à sobrevivência dos osteoclastos. Considerando-se que tem sido observada uma correlação entre osteoporose e perda óssea nos maxilares, o conhecimento dos mecanismos do estrógeno na reabsorção óssea, pelo cirurgião-dentista, pode contribuir para o sucesso de diversos tratamentos dentários. Além disso, o cirurgião-dentista pode contribuir para o diagnóstico dessa patologia, bem como encaminhar o paciente para um tratamento especializado.
Palavras-chave
Estradiol, osteoclastos, reabsorção óssea, homeostase, osteoporose, odontologia.
Abstract
Bone is a mineralized connective tissue that depends upon numerous interacting systemic and local factors for its homeostasis. Among systemic factors, it is known that estrogen is a hormone, which exerts an inhibitory function on bone resorption and, for this reason, it has been widely used in the treatment and prevention of osteoporosis. The mechanisms of action of the estrogen on bone resorption are not completely understood. Thus, in this review, we described the role of the estrogen in the bone, focusing on some cellular and molecular mechanisms of action of this hormone. Clinical information concerning possible association among osteoporosis, oral bone homeostasis and dental treatments were also included in this review. According to literature, estrogen acts on the RANK/RANKL/OPG system, inhibiting osteoclastogenesis. It has also been shown that estrogen promotes osteoclasts apoptosis and thereby decreases bone resorption. Moreover, estrogen reduces bone resorption by inhibiting proteases produced by osteoclasts. Whether estrogen acts directly on osteoclasts, or indirectly through osteoblasts, is still controversial. However, we may conclude that estrogen inhibits bone resorption by acting on pathways associated with the formation, activity and survival of osteoclasts. Since a relationship between osteoporosis and oral bone loss has been observed, the knowledge of the mechanisms of the estrogen on bone resorption by the dentist may contribute to the prognosis and success of several dental treatments. Besides, the dentist can contribute to diagnosis of the osteoporosis and to indicate the pacient to an specialized treatment.
Keywords
Estradiol, osteoclasts, bone resorption, homeostasis, osteoporosis, dentistry
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