Dynamics of Bone and Cartilage Metabolism: Principals and Clinical Applications

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9780126348408: Dynamics of Bone and Cartilage Metabolism: Principals and Clinical Applications

Dynamics of Bone and Cartilage Metabolism is a comprehensive treatise that spans the complete range from basic biochemistry of bone and cartilage components to the clinical evaluation of disease markers in bone and joint disorders.
Part I of the book provides an up-to-date account of current knowledge of the structure, biosynthesis and molecular biology of the major tissue components, including the important regulators such as cytokines, growth factors, and proteases.
The second part of the book covers the organizational structure and cellular metabolism of bone and cartilage. As with the first part, there are separate sections on bone and cartilage addressing their specific and unique functions. For bone, questions on mineralization, remodeling and hormonal regulation are covered as well as the derivation of products of metabolism: for cartilage, the physiology and pathology are reviewed in relation to the products of metabolism, together with recent data from animal and in vitro models. The first two parts of the book serve to contextualize all of the biochemical markers for assessing bone and cartilage metabolism.
Part III deals with the utility of components specific to bone and cartilage as biomarkers of health and disease, both in experimental and clinical settings. A wide range of disorders affecting bone and cartilage metabolism is covered, including different forms of osteoporosis, metastatic bone disease and arthritic diseases, as well as some of the less common growth and degenerative abnormalities. This application-oriented part of the book is complemented by an initial section detailing the methodological and technical aspects of the various biochemical and genetic markers of disease and their measurements.
With contributions from over 75 international experts, this book will be indispensable reading for those involved in skeletal research as well as for rheumatologists, endocrinologists, clinical biochemists, and other clinical disciplines participating in the management of the patient with bone and cartilage diseases.

Key Features
* Comprehensive and complete guide to bone and cartilage biochemistry and metabolism
* Covers both aspects of skeletal integrity, bone and cartilage
* Spans the interests of both research and clinical disciplines
* Authoritative accounts from more than 75 experts in their respective fields
* Provides clear biochemical bases for disease markers
* Provides state-of-the-art accounts on genetic markers of bone and joint disease
* Provides objective evaluations of the clinical applicability of disease markers

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About the Author:

Dr. Bilezikian, Professor of Medicine and Pharmacology at the College of Physicians and Surgeons, Columbia University is the Chief of the Division of Endocrinology and Director of the Metabolic Bone Diseases Program at Columbia-Presbyterian Medical Center. He also serves as Associate Chair, Department of Medicine. Dr. Bilezikian received his undergraduate training at Harvard College and his medical training at the College of Physicians and Surgeons. He completed four years of house staff training (internship and residency) including the Chief Medical Residency of the Medical Service at Columbia Presbyterian Medical Center. Dr. Bilezikian received his training in Metabolic Bone Diseases and in Endocrinology at the NIH where he served as a Clinical Associate in the Mineral Metabolism Branch under the tutelage of Dr. Gerald Aurbach. Dr. Bilezikian belongs to a number of professional societies, including the American Society for Bone and Mineral Research, of which he served as President in 1996. He is a member of the Endocrine Society, the American Federation for Clinical Research, the American Society for Clinical Investigation, the Association of American Physicians, the American Association of Clinical Endocrinologists, the American Society for Pharmacology and Experimental Therapeutics, and the International Society of Clinical Densitometry, of which he is President. He is Editor-in-Chief of the Journal of Clinical Endocrinology and Metabolism. His books include Editor-in-Chief of The Parathyroids (1994), and co-editor of Principles of Bone Biology (1996), The Aging Skeleton (1999), and Dynamics of Bone and Cartilage Metabolism (1999). He has been on numerous panels, including serving as Chair of the NIH Consensus Development Panel on Optimal Calcium Intake, and the Food and Nutrition Board of the National Academy of Sciences. He is a major national and international spokesperson for the field of metabolic bone diseases. Dr. Bilezikian's major research inte

Markus J. Seibel completed a medical degree and a doctoral degree in 1984 from the University of Mainz, Germany and the University of Pennsylvania, Philadelphia. Since 1996, he has been the head of the Endocrine Laboratories at Heidelberg University, Germany and a consultant in Endocrinology. Since 1997, he has been an Associate Professor and Member of the Faculty of Medicine at the University of Heidelberg and as of 1999, he will be Associate to the Director of the Department of Endocrinology and Metabolism. His research interests include bone and cartilage metabolism, treatment of osteoporosis, and thyroid carcinoma.

From The New England Journal of Medicine:

The close developmental and spatial relation between bone and cartilage is self-evident, yet these two issues are often considered as separate entities. The approach taken in this book -- to consider the structural, functional, metabolic, and pathologic aspects of bone and cartilage in parallel -- is a welcome departure and provides the reader with an unusual and interesting range of topics. In part I, the composition of the organic extracellular matrix of bone and cartilage is described; part II covers the cellular and molecular characteristics of these tissues; and part III is devoted to the technical and clinical aspects of biochemical markers of bone and cartilage metabolism. In all, there are 46 chapters, each approximately 10 to 15 pages long and most with comprehensive references. The book is generally well illustrated, although almost exclusively in black and white. There is broad coverage of the basic scientific and clinical aspects of this field, thus supporting the effort, stated in the preface, to appeal both to laboratory researchers and to the wide range of clinical specialists who may encounter disorders of bone and cartilage.

The first 10 chapters, which constitute part I, are an excellent background to the rest of the book. They include clear and comprehensive descriptions of collagen biochemistry, noncollagenous proteins in cartilage and bone, and other aspects of bone and cartilage biochemistry. Research on cartilage has lagged significantly behind bone research, and this is evident in several of these initial chapters. For example, a large number of adhesion molecules are expressed in cartilage, but little is known about their role. The following 14 chapters, which constitute part II of the book, cover a variety of topics related to bone and cartilage physiology, including bone remodeling, parathyroid hormone and parathyroid hormone-related peptide, 1,25-dihydroxyvitamin D, sex steroids, and calcium and phosphate homeostasis. The last five chapters in this section are devoted to cartilage and include interesting accounts of the fluid dynamics of the joint space, animal models of cartilage breakdown, and in vitro models of cartilage metabolism.

The third section of the book, "Markers of Bone and Cartilage Metabolism," discusses metabolic bone diseases, primarily osteoporosis but also Paget's disease, osteomalacia and rickets, renal osteodystrophy, primary hyperparathyroidism, and metastatic bone disease. Diseases of cartilage receive less coverage, with one chapter on rheumatoid arthritis and other inflammatory joint diseases and one chapter on osteoarthritis. All these chapters emphasize the use of biochemical markers of bone and cartilage metabolism in the diagnosis and monitoring of disease and, in some cases, as a research tool to understand better the underlying pathophysiologic mechanisms. Genetic markers are also considered in relation to bone and cartilage disorders, and the calculation of biochemical indexes of bone and cartilage homeostasis is described in some technical detail. Markers in bone include not only biochemical markers of bone turnover but also vitamin D metabolites, calcium and phosphate, and parathyroid hormone. In addition, there is a chapter on markers of cartilage metabolism in joint fluid, serum or plasma, and urine. Although the study of cartilage metabolism is in its infancy, there have been promising developments, such as the identification of potential prognostic markers in osteoarthritis, including serum hyaluronan (hyaluronic acid), cartilage oligomeric matrix protein, and C-reactive protein.

Scientists and physicians who wish to cross the divide between bone and cartilage will find this book of considerable interest and value. There is excellent coverage of the structural and physiologic characteristics of these tissues and detailed descriptions of the methods involved in assessing tissue markers of metabolism in body fluids. Inevitably, there are some omissions. The chapters on clinical aspects provide an up-to-date account of the use of markers in diagnosis and disease monitoring, but physicians seeking comprehensive coverage of diseases of bone and cartilage will be disappointed. Many of the clinical chapters, particularly those on secondary forms of osteoporosis, emphasize that data on biochemical markers are currently not sufficient to allow assessment of their value in clinical practice. Nevertheless, there are grounds for optimism that a better understanding of bone and cartilage metabolism will make possible considerable advances in the clinical management of diseases affecting these tissues. This is an important challenge for both scientists and clinicians.

Juliet E. Compston, M.D.
Copyright 2000 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

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