1 Immuno-Rheumatology Outpatient Unit, Division of Internal Medicine, “Maggiore della Carità Hospital”, Novara, Italy
2 Interdisciplinary Research Center of Autoimmune Diseases, Novara, Italy
3 Division of Internal Medicine, “Sant’Andrea Hospital”, Vercelli, Italy
Patients with Rheumatoid Arthritis (RA) commonly develop osteoporosis and fragility fractures. This fact cannot be explained only with the use of glucocorticoids, known to be detrimental for bone health. RA is characterized by a chronic inflammation caused by the continuous activation of innate and adaptive immunity with proinflammatory cytokines overproduction. This process is detrimental for several organs and physiological processes, including the impairment of bone remodeling. We will briefly review the pathogenesis of inflammation-related bone loss in RA, describing well-known and new molecular pathways and focusing on vitamin D and Parathyroid Hormone role.
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