Journal
CURRENT OSTEOPOROSIS REPORTS
Volume 15, Issue 6, Pages 542-554Publisher
SPRINGER
DOI: 10.1007/s11914-017-0405-9
Keywords
Chronic non-bacterial osteomyelitis; CNO; Chronic recurrent multifocal osteomyelitis; CRMO; Treatment; Inflammation; Cytokine; Bone; Biomarkers
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Funding
- German Research Foundation (DFG) [KFO249, TP2, HO4510/1-2]
- Thyssen Foundation
- intramural MeDDrive program of TU Dresden
- Else Kroner Foundation
- Foundation for Therapeutic Research
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Chronic non-bacterial osteomyelitis (CNO) with its most severe form chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disorder. We summarize the clinical presentation, diagnostic approaches, most recent advances in understanding the pathophysiology, and available treatment options and outcomes in CNO/CRMO. Though the exact molecular pathophysiology of CNO/CRMO remains somewhat elusive, it appears likely that variable defects in the TLR4/MAPK/inflammasome signaling cascade result in an imbalance between pro- and anti-inflammatory cytokine expressions in monocytes from CNO/CRMO patients. In this context, we present previously unpublished data on cytokine and chemokine expression in monocytes and tissues. CNO/CRMO is an autoinflammatory bone disorder resulting from imbalanced cytokine expression from innate immune cells. Though the exact molecular pathophysiology remains unclear, variable molecular defects appear to result in inflammasome activation and pro-inflammatory cytokine expression in monocytes from CNO/CRMO patients. Recent advances suggest signaling pathways and single molecules as biomarkers for CNO/CRMO as well as future treatment targets.
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