Glucocorticoid-induced osteoporosis: summary of a workshop.

Bone remodeling is regulated by systemic and local factors, and glucocorticoids are hormones with a significant impact on the skeleton. Bone remodeling is tightly regulated, and bone formation occurs in areas of previously resorbed bone. Bone is continuously regenerated, a process that is carried out by basic multicellular units. These units are comprised by teams of juxtaposed osteoclasts and osteoblasts. These bone-resorbing and -forming cells maintain bone remodeling in an orderly fashion, and osteoclastogenesis is dependent on the genesis and presence of osteoblasts. The number of bone-forming and bone-resorbing cells present in the basic multicellular units is also dependent on an orderly cellular death or apoptosis. Therefore, cell genesis and death are critical for the maintenance of bone homeostasis. The genesis of osteoblasts and osteoclasts is governed by specific genes, local regulatory factors, and various systemic hormones, including glucocorticoids (1).