الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Osteoporosis is one or the most common metabolic bone diseases which is characterized by loss of bone mass, along with micro architectural deterioration of ihe skeleton, loading to enhanced bone fragility and increased fractures, Corticosteroids are by far Ihe number one category of bone depleting drills. The long term use of corticosteroids adversely affects bone structure and function that results in osteoporosis and consequently bone fracture in as many as 50% of patients on long term corticosteroid therapy. Corticosteroids can influence bone remodeling in a number of ways at any stage throughout the remodeling cycle. Decreasing bone formation via the direct inhibitory effects on osteoblast function known by the use of ihe bone marker osteocalcin (OC). The increase in osteoblast and oncocyte apoptosis rate and the inhibitory effects on both die synthesis of bene collagen by pre-existing osteoblasts and the conversion of precursor cells (o functioning osteoblasts. Increasing bone restoration via decreasing the expression of osleoprotegrin (OPCi) and so increasing orthoclastic differentiation , while increasing the expression of receptor activator of nuclear factor kappa B legend (KANKL) favoring orthoclastic activity. Corticosteroids can also alter calcium metabolism tluough inhibition of intestinal calcium absorption and increasing urinary calcium loss favoring secondary increase in PTH level and altering vitamin D metabolism (anli -vitamin D action). Different opinions regarding the re visibility of Corticosteroid Induced Osteoporosis .(OOP) were published. However, it is unlikely that ’he large amount of bone loss during high dose corticosteroid therapy can be completely regained wilh full recovery of the mechanical properties of Ihe bone. Tin; liability ol bone regain was negatively correlated with the duration of treatment, as well as unknown host related factors. Bisphosphunates, had shown clinical effectiveness in treating metabolic bone disorders. Up to dale , alendronate and risedionate revealed the greatest benefit in preventing hone loss and decreasing fracture rale. The mechanism of action of bisphospho nates is not fully understood. Experimental and clinical studies showed tliat at The tissue level they inhibit bone restoration and bone turnover without directly suppressing bone formation, resulting in increased bone mass and mineralization. There is a substantial evidence that HMG-CoA reeducate inhibitors (e.g. satins) have an atiabolic effect on bone ilirough a mechanism linked to RANK!., OPG and orthoclastic differentiation modulation. Thus, this could be beneficial as a prophylactic drug in dy slip identical patients on corticosteroid therapy. However, the prophylactic effect of stains on Clops has not yet been established. There is an emerging evidence that niggle sativa seed oil can enhance bane healing confirmed by the increase in serum OC level. To the best of our knowledge in the literature, the effect of niggle sativa on OPG level in steroid induced osteoporosis has not yet been studied .