Micropetrosis – Occlusion of Osteocyte Lacunae

Abstract

This article summarizes the current knowledge on micropetrosis – osteocyte lacunar occlusion, while focusing on the latest data on osteocyte viability and diabetic bone disease. The lacunae are fluid-filled ellipsoid spaces where osteocytes reside within the mineralized matrix. During osteocyte lifetime, the lacunar space is kept in a non-mineralized state. However, a dying osteocyte appears to enable the initiation of lacunar mineralization – creating a fossil within the living tissue. Elevated frequencies of micropetrosis are observed with advanced age, but also type 1 diabetes mellitus. The latter is a common health threat to our society with rising numbers of patients suffering from the disease associated symptoms including a secondary type of osteoporosis with an elevated risk of fragility fractures. While the underlying mechanism of diabetic bone disease is not entirely understood, more evidence is pointing towards a combinatory effect of loss of bone mass and an impaired overall bone quality. The high number of micropetrotic osteocyte lacunae leads to a more brittle bone tissue prone to microcracking. Further investigations are required to determine the implications of elevated micropetrosis as a reliable target of bone fragility.

Zusammenfassung

Mikropetrose, die Okklusion der Osteozytenlakunen, stellt eine besondere Art der Mineralisation innerhalb des Knochens dar. In ihrem Verlauf werden Osteozyten-behauste Lakunen stufenweise komplett ausmineralisiert. Somit entstehen lokale Unterbrechungen des mechanoregulatorischen Osteozyten Netzwerkes, welches Knochenumbauprozesse im Knochen steuert. Die Sprödigkeit der Knochenmatrix wird durch die lokale Anhäufung der mineralisierten Lakunen erhöht, Stressdissipationsmechanismen fehlen, und es kann zur Anhäufung von Mikrocracks kommen. Die beiden letzteren Faktoren können zu einer erhöhten Brüchigkeit der Knochenmatrix beitragen. Mikropetrose wurde zuerst in Knochenproben alternder Individuen detektiert. Ein erhöhtes Vorkommen mikropetrotischer Lakunen findet sich in osteoporotischen Patienten, sowohl mit altersbedingter, als auch mit sekundärer Diabetes Mellitus-bedingter Osteoporose. Diabetes mellitus geht mit einem erhöhten Frakturrisiko einher, wobei bei Typ 1 Diabetes Mellitus das Frakturrisiko um das 7-fache erhöht sein kann. Mechanistische Untersuchungen, welche die ursächlichen Zusammenhänge der brüchigen Knochenmatrix mit Typ 1 Diabetes Mellitus erklären sind noch rar, weisen jedoch auf eine Kombination aus Knochenmasseverlust und beeinträchtigter Knochenqualität hin. Unsere Untersuchungen an Typ 1 Diabetes Mellitus kortikalen Knochenproben konnten zeigen, dass es lokal zu einer erhöhten Bildung mikropetrotischer Osteozytenlakunen kommt. Diese lokalen Okklusionen befinden sich in der relativ jüngeren Knochenmatrix – dem periostalen Bereich, spezifischer in den osteonalen Knochenumbaueinheiten dieses Bereiches und nicht in der lokal älteren interstitialen Knochenmatrix. Daraus ergibt sich unsere Arbeitshypothese, dass Typ 1 Diabetes Mellitus zu einer pathologischen Knochenalterung einhergehend mit gehäuftem Osteozyten-Zelltod, Mikropetrose und Mikrocrack-Ansammlung führt. Die Bedeutung des lebenden Osteozytennetzwerkes für den Erhalt der physiologischen Knochenmatrixqualität sollte durch die spezifische Charakterisierung der Mikropetrose, dem fossilen Osteozytennetzwerk, erweitert werden. Zukünftige Studien zur Verbesserung der pharmakologischen Behandlung von Knochenpathologien sollten Osteozytenparameter miteinbeziehen.

Keywords

micropetrosis - osteocyte lacunar mineralization - osteocytes - diabetes mellitus - osteoporosis

Schlüsselwörter

Mikropetrose - Osteozytenlakunen Mineralisierung - Osteozyten - Diabetes mellitus - Osteoporose

Publication History

Received: 18 August 2022

Accepted: 09 October 2022

Article published online:
14 December 2022

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