porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo10127porozendo-10127Research ArticleНаучный обзорReviewАнтитела к склеростину как новая анаболическая терапия остеопорозаSclerostin antibodies as novel anabolic therapy for osteoporosishttps://orcid.org/0000-0002-9783-3599МамедоваЕлизавета ОктаевнаMamedovaElizaveta O.

к.м.н.

MD, PhD

lilybet@mail.ruhttps://orcid.org/0000-0003-1413-1549ГребенниковаТатьяна АлексеевнаGrebennikovaTatiana A.

к.м.н.

MD, PhD

grebennikova@hotmail.comhttps://orcid.org/0000-0002-6674-6441БелаяЖанна ЕвгеньевнаBelayaZhanna E.

д.м.н.

MD, PhD

jannabelaya@gmail.comhttps://orcid.org/0000-0001-7041-0732РожинскаяЛюдмила ЯковлевнаRozhinskayaLiudmila Y.

д.м.н., профессор

MD, PhD, professor

lrozhinskaya@gmail.com<p>ФГБУ "НМИЦ эндокринологии" Минздрава России</p>Россия<p>Endocrinology Research Centre</p>Russian Federation2018080420192132129Copyright &#x00A9; Мамедова Е.О., Гребенникова Т.А., Белая Ж.Е., Рожинская Л.Я., 20182018Мамедова Е.О., Гребенникова Т.А., Белая Ж.Е., Рожинская Л.Я.Mamedova E.O., Grebennikova T.A., Belaya Z.E., Rozhinskaya L.Y.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/10127

Препараты для лечения остеопороза можно условно разделить на две группы: препараты, подавляющие костную резорбцию, и, соответственно, костеобразование (бисфосфонаты, деносумаб) и препараты, стимулирующие костеобразование, т.е. обладающие анаболическим действием. К последним относят терипаратид, паратгормон 1-84 и абалопаратид, которые, помимо стимуляции костеобразования, также стимулируют и костную резорбцию, что лимитирует их анаболический эффект.

Открытие склеростина – ключевого ингибитора костеобразования – привело к разработке концепций по ингибированию этого белка с целью усиления костеобразования. Ромосозумаб – человеческое моноклональное антитело к склеростину, которое, связываясь со склеростином, позволяет лигандам Wnt-сигнального пути взаимодействовать с их ко-рецепторами, что, в свою очередь, приводит к усилению костеобразования и повышению минеральной плотности кости. В отличие от классических анаболических препаратов для лечения остеопороза, ромосозумаб не только стимулирует костеобразование, но и подавляет костную резорбцию. В клинических исследованиях ромосозумаб продемонстрировал выраженный прирост минеральной плотности кости в позвоночнике и бедре. В статье представлены данные о доклинических и клинических исследованиях ромосозумаба.

Osteoporosis medications are divided into two groups: those inhibiting bone resorption and formation (bisphosphonates and denosumab), and those stimulating bone formation i.e. having an anabolic effect. The latter include teriparatide, parathyroid hormone 1-84 and abaloparatide, all of which stimulate bone resorption as well as bone formation, which limits their anabolic effect.

The discovery of sclerostin – the key inhibitor of bone formation – has led to development of the concept that inhibition of this protein could stimulate bone formation. Romosozumab is a human monoclonal antibody to sclerostin that binds to sclerostin and enables Wnt-signaling pathway ligands and their co-receptors to interact with each other, which, in turn, leads to increased bone formation and bone mineral density. Unlike classical anabolic drugs in osteoporosis treatment, romosozumab stimulates bone formation and inhibits bone resorption. In clinical trials, romosozumab showed marked increase in lumbar spine and hip bone mineral density. Presented article contains information about pre-clinical and clinical studies of romosozumab.

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The authors declare that there are no conflicts of interest present.