The effect of icariin on bone metabolism and its potential clinical application

Review

Abstract

Osteoporosis is a bone disease characterized by reduced bone mass, which leads to increased risk of bone fractures, and poses a significant risk to public health, especially in the elderly population. The traditional Chinese medicinal herb Epimedii has been utilized for centuries to treat bone fracture and bone loss. Icariin is a prenylated flavonol glycoside isolated from Epimedium herb, and has been shown to be the main bioactive component. This review provides a comprehensive survey of previous studies on icariin, including its structure and function, effect on bone metabolism, and potential for clinical application. These studies show that icariin promotes bone formation by stimulating osteogenic differentiation of BMSCs (bone marrow-derived mesenchymal stem cells), while inhibiting osteoclastogenic differentiation and the bone resorption activity of osteoclasts. Furthermore, icariin has been shown to be more potent than other flavonoid compounds in promoting osteogenic differentiation and maturation of osteoblasts. A 24-month randomized double-blind placebo-controlled clinical trial reported that icariin was effective in preventing postmenopausal osteoporosis with relatively low side effects. In conclusion, icariin may represent a class of flavonoids with bone-promoting activity, which could be used as potential treatment of postmenopausal osteoporosis.

Keywords

Bone metabolism Icariin Osteoblasts Osteoclasts Osteoporosis 

Abbreviations

AAPH

2,2′-azobis(2-amidinopropane) dihydrochloride

ALP

alkaline phosphatase

ABCB1

ATP-binding cassette subfamily B member 1

BMP

bone morphogenetic protein

BMSC

bone marrow-derived mesenchymal stem cells

Cebpb

CCAAT/enhancer-binding protein β

CTX

carboxy-terminal collagen cross-links

Col-1

type I collagen

ERs

estrogen receptors

ERK

extracellular signal-regulated kinase

GSK-3β

glycogen synthase kinase-3

Id-1

inhibitor of DNA-binding 1

JNK

c-Jun N terminal kinase

LPS

lipopolysaccharide

MMP

mitochondrial membrane potential

NO

nitric oxide

OC

osteocalcin

ONFH

osteonecrosis of femoral head

OPG

osteoprotegerin

·O2−

superoxide anion

P-gp

P-glycoprotein

ROS

reactive oxygen species

Pparg

peroxisome proliferator-activated receptor γ

Runx2

runt-related transcription factor 2

RANKL

receptor activator of nuclear factor kappa-B ligand

TRAP

tartrate-resistant acid phosphatase

Notes

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2017

Authors and Affiliations

  1. 1.Department of Spine Surgery and Institute of Orthopaedic Research, Shenzhen People’s HospitalJinan University School of MedicineShenzhenChina
  2. 2.Department of Outpatient Clinics, Shenzhen People’s HospitalJinan University School of MedicineShenzhenChina

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