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

Assembling expert panel for prevention, diagnosis, and treatment of osteoporosis National Institute of Health (NIH) 2000

Entering Selective estrogen receptor modulators (SERMs) in Market 1998

Using T-score to classify and define bone mineral density (BMD) world health organization (WHO) 1994

Discovering specific cytokines that influence osteoclasts activity 1990's

Publicizing osteoporosis National Institute of Health (NIH) 1984

Discovering bisphosponates Herbert Fleisch, Switzerland physiologist 1960's

Developing bone densitometers Norman, American researcher 1950

Defining postmenopausal bone loss Fuller Albright, American endocrinologist 1940's

Treating postmenopausal osteoporosis with estrogen Fuller Albright, American endocrinologist 1940's

Defining age-related bone loss Astley Cooper, English surgeon 1830's

Naming osteoporosis Jean Lobstein, French pathologist 1830's

First discovery of osteoporosis John Hunter, British surgeon 1800's

Dowager's hump in Egyptian mummies 4000 years ago

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.

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.

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.

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.

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.

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

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.

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.