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I got a question from a textbook <<Seeley's Anatomy & Physiology Twelfth Edition>> that does not have an answer at the back of the book (only odd numbered questions do have an answer and this question is even):

In addition to targeting the bacteria for death, what is one theoretical medical approach that could help reduce the amount of bone loss during osteomyelitis?

I found a paper that suggests 3 methods:

  1. Antibiotics targeting the bacteria (but that is targeting the bacteria for death
  2. Surgical debridement of dead tissue (including sequestrum) or biofilm produced by the bacteria
  3. Hyperbaric oxygen treatment, which puts patient in a high pressure pure oxygen environment will result in immunomodulation, reduction in pro-inflammatory mediators. This is helpful because bone loss in osteomyelitis is also caused largely by host's inflammatory chemical damaging the bone.

Another paper only suggest antibiotics and surgical methods. I look through a few other and there seemed to be no other methods to help reduce bone loss during osteomyelitis.

However, i am not sure if there is any other ways to reduce bone loss during osteomyelitis. Please help me by suggesting other methods that i may have missed out.

Thank you

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    Paraphrasing my comment on your question prior to migration... the question in your textbook is asking you to think critically about the mechanisms of this condition. They're not asking you to find what other people have proposed or what treatments are available, they want you to think about what you've read. They ask "theoretical", not "research existing methods". Asking this question here kind of misses the point of the learning that the question is meant to evoke. Sep 29 '21 at 22:36
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You could address bone metabolism.

Bone contains osteoclasts and osteoblasts. Osteoclasts break down and resorb bone. Osteoblasts lay down new bone.

If osteoclasts are inhibited, bone resorbtion is inhibited. This is how bisphosphates and RANK-ligand inhibitors work. Both categories of drug are used to inhibit bone loss due to cancer or to osteoporosis. In theory, these drugs could inhibit bone loss due to osteomyelitis also.

If osteoblasts are stimulated, they will lay down more new bone. Bone Morphogentic Protein stimulates osteoblasts and has been used clinically to accelerate and augment orthopedic surgeries. In theory, BMP could stimulate osteoblasts associated with infected bone to lay down new bone and counter bone loss.

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  • PTH like drugs also help? Sep 30 '21 at 10:04
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    @greenonion You might want to scroll up and read Bryan's comment. I think you're missing the point of the question.
    – Carey Gregory
    Oct 1 '21 at 5:08
  • @greenonion - I think not PTHlike drugs. PTH regulates calcium levels by stimulating osteoclasts to break down bone which is not what you want. Possibly a drug to block PTH? Those exist.
    – Willk
    Oct 1 '21 at 23:35
  • Are they called PTH inhibitors? Oct 2 '21 at 23:34

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