More than 43 million Americans have osteoporosis or osteopenia, low bone density that is a marker for risk of fracture. That number is expected to increase to 61 million by 2020. Bone mineral accretion during growth and development in childhood is a critical determinant of the risk for osteoporosis later in life. Failure to achieve optimal bone density during childhood and adolescence results in suboptimal peak bone mass, which contributes to the risk for osteoporosis later in life. The NICHD conducts and supports research on bones and bone health as a way to understand healthy development and the origins of health and disease.
Some Institute research is aimed at understanding the factors and mechanisms of normal bone growth, including the cellular, molecular, and genetic mechanisms involved with bone growth in children, as well as the factors that influence this growth, such as ethnicity and sex. The Institute's portfolio also includes studies of bone composition, including calcium, vitamin D, and other minerals, and ways to improve bone health, including weight-bearing physical activity and nutritional supplements.
Much of this research is supported through the NICHD's Pediatric Growth and Nutrition Branch (PGNB), which examines the developmental origins of health and disease to better understand and prevent chronic disease in adulthood. Branch-supported research includes (but is not limited to):
Within the Section on Growth and Development, part of the NICHD Division of Intramural Research (DIR), studies focus on the cellular and molecular mechanisms of longitudinal bone growth in childhood, including research on chondrocytes, cells that produce cartilage, and growth factors.
Other Institute research focuses on understanding abnormal bone and other tissue growth and development. In some cases, this abnormal growth results from genetic diseases that affect bone and other tissues directly. In other cases, a certain aspect of a disease or the interventions used to treat a disease lead to abnormal bone growth.
The Bone and Extracellular Matrix Branch within the DIR focuses on studies of osteogenesis imperfecta (OI)—a genetic disease that results in severe osteoporosis and lifelong disability—and other diseases that result from a defective extracellular matrix in bone, such as Ehlers-Danlos syndrome. Laboratory studies are aimed at understanding their genetic etiology and molecular and cellular mechanisms, and will yield insight into normal skeletal functioning. Clinical protocols of the Branch focus on improved clinical diagnosis and treatments. Branch research has identified the genes involved with different types of OI and with response to treatments for OI.
Some diseases, such as autism spectrum disorders (ASDs), and medications used to treat different conditions, such as HIV/AIDS, can also affect bone health, growth, and strength. The Institute supports research to understand how these effects occur and ways to ameliorate them. For example:
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