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Horm Metab Res 2016; 48(11): 764-770
DOI: 10.1055/s-0042-117721
Review
© Georg Thieme Verlag KG Stuttgart · New York

Effects of Glucocorticoids on Bone: What we can Learn from Pediatric Endogenous Cushing’s Syndrome

L. J. W. Tack
1   Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics and Genetics, Ghent University Hospital, Ghent, Belgium
,
C. Tatsi
2   Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
,
C. A. Stratakis
2   Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
,
M. B. Lodish
2   Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
› Author Affiliations
Further Information

Publication History

received 30 August 2016

accepted 08 September 2016

Publication Date:
11 October 2016 (online)

Also available at
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Abstract

Chronic exposure to supraphysiologic levels of glucocorticoids (GCs) is associated with impaired bone mineral density, an increase in fracture rates, and, in growing children, compromised linear growth. GCs inhibit bone formation in part by decreasing the number of osteoblasts and by increasing bone resorption by stimulating osteoclasts. While GCs are used to treat many chronic diseases, it is difficult to isolate the effects of the steroids on the bone from the effects of the underlying disease itself. Investigation into the effects of GC exposure on the bone in endogenous Cushing syndrome have contributed to our understanding of bone microarchitecture, growth, healing, and regeneration. We now know that GCs negatively impact bone marrow derived-mesenchymal stromal cells. In children with Cushing syndrome, the potential reversibility of deleterious effects of chronic GC exposure on bone provides insight into the pathophysiology behind pure GC excess.

Key words

glucocorticoids - Cushing’s syndrome - stem cells - glucocorticoid-induced osteoporosis - pediatrics
 

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