Sclerostin of osteocytes-from expression to clinical use,Sklerostin des Osteozyten-von der Expression zur klinischen Anwendung

Sclerostin is a secreted glycoprotein and a product of the SOST gene, which is primarily expressed in osteocytes. Expression of sclerostin leads to inhibition of osteoblast-induced bone formation and therefore to reduced bone mass. In contrast, the loss-of-function deletion of the SOST gene induces a high bone mass bone phenotype. Furthermore, sclerostin may act on the osteocyte itself which leads to an increased osteoclast-induced bone resorption and supports osteocytic osteolysis. Sclerostin expression can be influenced by different mechanisms and represents a potential treatment option based on the anabolic action in bone formation. The sclerostin antibody Romosozumab is available since the beginning of 2019 in Japan and the US and first studies have shown positive effects on fracture risk and BMD in postmenopausal women. Other studies present data on sclerostin serum values in correlation with fractures and diseases such as diabetes mellitus type 2 which leave the unanswered question whether sclerostin is a possible biomarker for fracture risk diagnostics.