Osteoporosis historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2], Charmaine Patel, M.D. [3]

Overview

Osteoporosis was first discovered by John Hunter, British surgeon, in 1800's. He found that bones in human body are turning over, continuously; when some old or dysfunctioned bone tissue become eroded and eliminated, the new fully functioned one being substituted. Nowadays, the process is called remodeling, the most important issue in osteoporosis pathophysiology. Jean Lobstein, a French pathologist of 1830's, found that there are normal holes in every bones; but some people's bones from specific age and diseases may have larger holes than normal ones. He eventually named theses kinds of bones as porous; thus the disease became called osteoporosis.

Osteoporosis historical Perspective

 
 
 
Dowager's hump in Egyptian mummies
4000 years ago
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
First discovery of osteoporosis
John Hunter, British surgeon
1800's
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Naming osteoporosis
Jean Lobstein, French pathologist
1830's
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Defining age-related bone loss
Astley Cooper, English surgeon
1830's
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Defining postmenopausal bone loss
Fuller Albright, American endocrinologist
1940's
 
 
 
Treating postmenopausal osteoporosis with estrogen
Fuller Albright, American endocrinologist
1940's
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Developing bone densitometers
Norman, American researcher
1950
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Discovering bisphosponates
Herbert Fleisch, Switzerland physiologist
1960's
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Publicizing osteoporosis
National Institute of Health (NIH)
1984
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Discovering specific cytokines that influence osteoclasts activity
1990's
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Using T-score to classify and define bone mineral density (BMD)
world health organization (WHO)
1994
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Entering Selective estrogen receptor modulators (SERMs) in Market
1998
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Assembling expert panel for prevention, diagnosis, and treatment of osteoporosis
National Institute of Health (NIH)
2000
 
 
 


Osteoporosis was first discovered by John Hunter, British surgeon, in 1800's. He found that bones in human body are turning over, continuously; when some old or dysfunctioned bone tissue become eroded and eliminated, the new fully functioned one being substituted. Nowadays, the process is called remodeling, the most important issue in osteoporosis pathophysiology. Jean Lobstein, a French pathologist of 1830's, found that there are normal holes in every bones; but some people's bones from specific age and diseases may have larger holes than normal ones. He eventually named theses kinds of bones as porous; thus the disease became called osteoporosis.[1]

Bone with holes, osteoporosis, is seen in over 4000 years old Egyptian mummies; showed the revealing sign of osteoporosis called "Dowager's hump".

Many developments have been made in the treatment and prevention of osteoporosis over the years; however, osteoporosis remains a significant challenge within the field of medicine.

The link between age-related reductions in bone density and fracture risk goes back to Astley Cooper; and the term "osteoporosis", recognition of its pathological appearance in the 1830's is generally attributed to the French pathologist, Lobstein.[2]

The American endocrinologist, Fuller Albright from Massachusetts General Hospital, linked osteoporosis with the postmenopausal state. Thus, in the 1940's, he started to treat menopausal women with estrogen in order to prevent further bone loss.[3]

In the 1960's, researchers developed more sensitive methods to detect early bone loss; such as bone densitometers.

Bisphosponates which inhibit bone resorption, and revolutionized the treatment of osteoporosis; were discovered in the 1960s by Herbert Fleisch.[4]

In 1984, the National Institute of Health (NIH) publicized this disease, and brought attention to osteoporosis as a significant threat to health; with the emphasis that bone loss could be reduced by estrogen therapy, calcium supplementation, good nutrition, and exercise.[5]

In the 1980's and 1990's researchers discovered the specific cytokines which influence the activity of osteoclasts, the components that cause bone breakdown.[6]

Selective estrogen receptor modulators (SERMs), such as raloxifene, entered the market around 1998. They also have been found to treat breast tumors and to stimulate the growth of uterine cells.[7]

World Health Organization (WHO) first used T-scores as a measure for classification and definition of various amounts of bone mineral density (BMD), in 1994. The T-score was determined as the standard deviation of the BMD for a single patient in contrast with a standard population sample. The population sample is always a young, healthy person, matched for sex and race.[8]

References

  1. "History of Osteoporosis".
  2. Lobstein JGCFM. Lehrbuch der pathologischen Anatomie. Stuttgart: Bd II, 1835.
  3. Albright F, Bloomberg E, Smith PH (1940). "Postmenopausal osteoporosis". Trans. Assoc. Am. Physicians. 55: 298–305.
  4. Patlak M (2001). "Bone builders: the discoveries behind preventing and treating osteoporosis". FASEB J. 15 (10): 1677E–E. PMID 11481214.
  5. "The National Institutes of Health (NIH) Consensus Development Program: Osteoporosis".
  6. Pagliari D, Ciro Tamburrelli F, Zirio G, Newton EE, Cianci R (2015). "The role of "bone immunological niche" for a new pathogenetic paradigm of osteoporosis". Anal Cell Pathol (Amst). 2015: 434389. doi:10.1155/2015/434389. PMC 4605147. PMID 26491648.
  7. Macor, John (2008). Annual reports in medicinal chemistry. London, UK: Elsevier/Academic Press. ISBN 9780123743442.
  8. "Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group". World Health Organ Tech Rep Ser. 843: 1–129. 1994. PMID 7941614.

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