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. 2023 Dec 4;10:1289144. doi: 10.3389/fmed.2023.1289144

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Copyright © 2023 Tang, Huang, Fang, Tong, Yu, Zheng and Fu.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Schematic working model of OP. In a normal physiological state of healthy bone, BMSC can differentiate into OB, and OB further mature into osteocytes. Meanwhile, OB secretes Collagen I, ALP, OPN, Osteonectin, and other substances to constitute bone matrix. Under pathological state, the upregulation of Notch 2/RANKU/RANK/OPG signaling pathway promoting OC generation and the downregulation of Wnt/β-catenin/TGF-B/BMP-Smad/Hedgehog signaling pathway inhibiting osteogenesis, ultimately lead to OP.