A 73-year-old female patient is currently being treated with bisphosphonate medication for osteoporosis. She takes this medication along with a vitamin D supplement in the morning, then a calcium supplement in the late afternoon. Bisphosphonates inhibit osteoclast activity and encourage their apoptosis. Osteoclasts decalcify the bone matrix by:
- Degrading the collagen of the matrix, releasing the mineral components of the bone
- Pumping out protons to create an acidic microenvironment that dissolves the mineral components of the bone.
- Releasing matrix metalloproteinases, which act on the mineral components of the bone.
- Releasing carbon dioxide, which combines with water in the bone to form carbonic acid.
- Secreting small matrix vesicles which absorb the mineral components from the bone matrix