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Erschienen in: Calcified Tissue International 2/2018

28.10.2017 | Review

The Proteasome and Myeloma-Associated Bone Disease

verfasst von: Fabrizio Accardi, Denise Toscani, Federica Costa, Franco Aversa, Nicola Giuliani

Erschienen in: Calcified Tissue International | Ausgabe 2/2018

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Abstract

Bone disease is the hallmark of multiple myeloma (MM), a hematological malignancy characterized by osteolytic lesions due to a severe uncoupled and unbalanced bone remodeling with pronounced osteoblast suppression. Bone metastasis is also a frequent complication of solid tumors including advanced breast or prostate cancer. In the past years, the ubiquitin–proteasome pathway has been proved critical in regulating the balance between bone formation and bone resorption. Proteasome inhibitors (PIs) are a new class of drugs, currently used in the treatment of MM, that affect both tumor cells and bone microenvironment. Particularly, PIs stimulate osteoblast differentiation by human mesenchymal stromal cells and increase bone regeneration in mice. Interestingly, in vitro data indicate that PIs block MM-induced osteoblast and osteocyte cell death by targeting both apoptosis and autophagy. The preclinical data are supported by the following effects observed in MM patients treated with PIs: increase of bone alkaline phosphatase levels, normalization of the markers of bone turnover, and reduction of the skeletal-related events. Moreover, the histomorphometric data indicate that the treatment with bortezomib stimulates osteoblast formation and maintains osteocyte viability in MM patients. This review updates the evidence on the effects of PIs on bone remodeling and on cancer-induced bone disease while focusing on MM bone disease.
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Metadaten
Titel
The Proteasome and Myeloma-Associated Bone Disease
verfasst von
Fabrizio Accardi
Denise Toscani
Federica Costa
Franco Aversa
Nicola Giuliani
Publikationsdatum
28.10.2017
Verlag
Springer US
Erschienen in
Calcified Tissue International / Ausgabe 2/2018
Print ISSN: 0171-967X
Elektronische ISSN: 1432-0827
DOI
https://doi.org/10.1007/s00223-017-0349-1

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