NYC Gazette

Researchers at the Hospital for Special Surgery (HSS) have identified a cellular target that may improve the diagnosis and treatment of osteoporosis and other metabolic bone diseases. Published in JCI Insight, the study highlights the role of circulating osteoclast precursor cells (cOCPs) in bone loss. This research is pioneering in linking cellular biomarkers with osteoporosis, potentially enabling earlier detection and more effective therapies.

"This is a new approach to understanding how we might maintain bone strength by affecting the committed precursor cells that are responsible for a lot of the damage and destruction that happens in bone, either in joints or generally in osteoporosis," said Richard Bockman, MD, PhD, endocrinologist at HSS and co-author of the study. "This study also revealed a new target for managing bone health in metabolic bone and many orthopedic disorders."

Osteoporosis affects about 10 million Americans aged 50 and older. Known as a "silent disease," it often goes undetected until fractures occur. "People don’t usually find out until they experience a fracture, at which point the bone is already gone," said Kyung Hyun Park-Min, PhD, scientist at HSS's Arthritis and Tissue Degeneration Program and lead author of the paper.

Bone health involves remodeling through resorption by osteoclasts and formation by osteoblasts. Bone weakens when resorption surpasses formation. cOCPs worsen this by traveling to bones through blood vessels to fuse with resident osteoclasts.

In collaboration with HSS Endocrinology & Metabolic Bone Service, Drs. Park-Min and Bockman studied 44 postmenopausal women—16 with untreated osteoporosis—to measure cOCP levels via blood tests. Results showed significantly higher cOCP levels in women with osteoporosis compared to those with normal bone density.

While acknowledging the small sample size from one center, researchers see implications for screening and treating osteoporosis. Current methods like DEXA scans are costly and infrequent.

"The advantage of determining cOCPs is that it may identify individuals at high risk who may not yet have osteoporosis but have low bone density," says Dr. Park-Min. "If we can identify these individuals before they suffer a fracture, we can recommend treatment options to promote healthy bones."

The study also suggests significance for joint replacement surgery outcomes regarding cOCPs.

"One potential complication of joint replacements is subsidence or aseptic loosening," Dr. Bockman said.

Dr. Park-Min’s team collaborates with HSS's Complex Joint Reconstruction Center to research cOCP association with aseptic loosening incidence. "High osteoclast activity is one of the main factors contributing to aseptic loosening," Dr. Park-Min noted.