Oxidative Stress and Natural Antioxidants in Osteoporosis: Novel Preventive and Therapeutic Approaches

This review reports in detail the cellular and molecular mechanisms which regulate the bone remodeling process in relation to oxidative stress (OS), inflammatory factors, and estrogen deficiency. OS is considered an important pathogenic factor of osteoporosis, inducing osteocyte apoptosis and varying levels of specific factors, such as receptor activator kappa B ligand (RANKL), sclerostin, and, according to recent evidence, fibroblast growth factor 23, with consequent impairment of bone remodeling and high bone resorption. Bone loss increases the risk of fragility fractures, and the most commonly used treatments are antiresorptive drugs, followed by anabolic drugs or those with a double effect. In addition, recent data show that natural antioxidants contained in the diet are efficient in preventing and reducing the negative effects of OS on bone remodeling and osteocytes through the involvement of sirtuin type 1 enzyme. Indeed, osteocytes and some of their molecular factors are considered potential biological targets on which antioxidants can act to prevent and reduce bone loss, as well as to promote bone anabolic and regenerative processes by restoring physiological bone remodeling. Several data suggest including antioxidants in novel therapeutic approaches to develop better management strategies for the prevention and treatment of osteoporosis and OS-related bone diseases. In particular, anthocyanins, as well as resveratrol, lycopene, oleuropein, some vitamins, and thiol antioxidants, could have protective and therapeutic anti-osteoporotic effects.

Automated summary

This review provides a detailed report on the cellular and molecular mechanisms involved in bone remodeling, specifically in relation to oxidative stress, inflammatory factors, and estrogen deficiency. Oxidative stress is a key factor in the development of osteoporosis, leading to osteocyte apoptosis and impaired bone remodeling and resorption. Recent studies have shown that natural antioxidants found in the diet can effectively prevent and reduce the negative effects of oxidative stress on bone health. These antioxidants target osteocytes and their molecular factors, promoting bone regeneration and preventing bone loss. This suggests that incorporating antioxidants into therapeutic approaches may improve the prevention and treatment of osteoporosis and related bone diseases.