Advances in Enhancing Bone Micro- and Nanoarchitecture in Osteoporosis and Fragility Fractures

Osteoporosis is one of the most prevalent endocrine and metabolic bone disorders worldwide, characterized by reduced bone strength and an increased risk of fragility fractures. While bone mineral density (BMD) remains the clinical standard for diagnosis and risk assessment, it captures only one aspect of skeletal integrity. Bone strength is also determined by the quality of its micro- and nanoarchitecture, including trabecular connectivity, cortical porosity, collagen organization, mineral composition, and the hierarchical interactions between bone cells and the extracellular matrix. These structural features are tightly regulated by genetic and epigenetic factors and by endocrine pathways involving parathyroid hormone, sex steroids, vitamin D, glucocorticoids, thyroid hormones, and emerging endocrine regulators such as osteokines and muscle-derived factors. Recent advances in high-resolution imaging, biomaterials, tissue engineering, and molecular biology are providing unprecedented insight into the mechanisms governing skeletal architecture and offering new opportunities to restore bone quality beyond increasing bone mass alone.Despite major progress in osteoporosis therapies, many patients continue to sustain fractures despite stable or improved BMD, highlighting the need to better understand the biological determinants of bone quality. Improving bone micro- and nanoarchitecture has emerged as a promising strategy for enhancing skeletal strength, promoting fracture healing, and developing next-generation anabolic and regenerative therapies. This Research Topic aims to bring together basic, translational, and clinical research exploring the genetic, endocrine, cellular, and biomechanical mechanisms that regulate bone architecture across multiple spatial scales. By integrating advances in bone biology, genetics, imaging, biomaterials, regenerative medicine, and therapeutic development, this collection seeks to identify novel strategies to preserve and restore skeletal integrity in osteoporosis and other metabolic bone disorders.We welcome contributions addressing, but not limited to, the following themes:• Endocrine regulation of bone micro- and nanoarchitecture in health and disease • Genetic and epigenetic determinants of bone micro- and nanoarchitecture, including molecular mechanisms and genetic variants affecting bone quality • Rare and monogenic skeletal disorders as models for understanding the biological determinants of bone quality and architecture • Osteocyte, osteoblast, and osteoclast interactions linked to measurable changes in skeletal microstructure • Microarchitectural deterioration in osteoporosis, aging, and endocrine disorders • Effects of muscle, mechanical loading, energy metabolism, and the bone–muscle axis on skeletal quality and strength • Novel anabolic therapies and their effects on bone quality beyond BMD • Biomaterials, tissue engineering, and regenerative strategies for restoring bone architecture • Advanced imaging technologies for assessing bone micro- and nanoarchitecture • Collagen organization, mineralization, and nanoscale determinants of bone strength • Microarchitectural and biomechanical determinants of fragility fractures and fracture healing • Biomarkers validated against imaging, histomorphometric, or biomechanical measures of bone architecture • Translational and clinical approaches to improving bone strength and reducing fracture risk Topic editors: Ali Ghasem-Zadeh, Danielle Whittier, Ram Naresh Yadav Source: https://www.frontiersin.org/research-topics/85190/advances-in-enhancing-bone-micro--and-nanoarchitecture-in-osteoporosis-and-fragility-fractures