The coordination between bone resorption and bone formation plays an essential role in keeping the mass and microstructure integrity of the bone in a steady state. However, this balance can be disturbed in many pathological conditions of the bone. Nowadays, the classical modalities for treating bone-related disorders are being challenged by severe obstacles owing to low tissue selectivity and considerable safety concerns. Moreover, as a highly mineralized tissue, the bone shows innate rigidity, low permeability, and reduced blood flow, features that further hinder the effective treatment of bone diseases. With the development of bone biology and precision medicine, one novel concept of bone-targeted therapy appears to be promising, with improved therapeutic efficacy and minimized systematic toxicity. Here we focus on the recent advances in bone-targeted treatment based on the unique biology of bone tissues. We summarize commonly used bone-targeting moieties, with an emphasis on bisphosphonates, tetracyclines, and biomimetic bone-targeting moieties. We also introduce potential bone-targeting strategies aimed at the bone matrix and major cell types in the bone. Based on these bone-targeting moieties and strategies, we discuss the potential applications of targeted therapy to treat bone diseases. We expect that this review will put together useful insights to help with the search for therapeutic efficacy in bone-related conditions.

中文翻译：

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骨靶向治疗的最新进展。

骨吸收与骨形成之间的协调在保持骨骼的质量和微结构完整性处于稳定状态中起着至关重要的作用。但是，这种平衡在骨骼的许多病理状况下会受到干扰。如今，由于低的组织选择性和相当大的安全隐患，治疗骨相关疾病的经典方法正受到严重障碍的挑战。此外，作为高度矿化的组织，骨骼显示出先天的刚度，低渗透性和血流减少，这些特征进一步阻碍了骨骼疾病的有效治疗。随着骨骼生物学和精密医学的发展，一种针对骨的疗法的新概念似乎很有希望，它具有改善的治疗效果和最小的系统毒性。在这里，我们基于骨骼组织独特的生物学特性，着眼于骨骼靶向治疗的最新进展。我们总结了常用的骨靶向部分，重点介绍了双膦酸酯，四环素和仿生骨靶向部分。我们还介绍了针对骨基质和骨中主要细胞类型的潜在骨靶向策略。基于这些骨靶向部分和策略，我们讨论了靶向疗法在治疗骨疾病中的潜在应用。我们希望这次审查将汇集有用的见解，以帮助寻找在骨相关疾病中的治疗功效。我们还介绍了针对骨基质和骨中主要细胞类型的潜在骨靶向策略。基于这些骨靶向部分和策略，我们讨论了靶向疗法在治疗骨疾病中的潜在应用。我们希望这次审查将汇集有用的见解，以帮助寻找在骨相关疾病中的治疗功效。我们还介绍了针对骨基质和骨中主要细胞类型的潜在骨靶向策略。基于这些骨靶向部分和策略，我们讨论了靶向疗法在治疗骨疾病中的潜在应用。我们希望这次审查将汇集有用的见解，以帮助寻找在骨相关疾病中的治疗功效。