photograph by Paul Fetters

Editor's Letter

When my brother was small, he jumped off the back of our living room sofa, in some superhero-inspired game, and fractured his leg. Broken bones are a rite of passage for many kids, but he stands out in the history of our family—the only one of four siblings to ever wear a cast. His junior by three years, I was so impressed by the event that I have always steered clear of ski slopes. The thrill of shushing downhill never outweighed the prospect of hobbling on crutches.

Most of the time, we take our bones for granted—until something goes wrong. Our cover story highlights the work of researchers trying to understand the mechanisms behind normal bone buildup and breakdown and what happens when that process goes awry. What they are learning about bone repair, genetic bone disease, and cancers of the bone tells us that the pathways involved are much more complicated than once thought.

These days my family is keenly aware of the effects of aging on bones. My mother, now 89, was diagnosed with osteoporosis several years ago. Initial treatment with the drug Fosamax proved disappointing, due to side effects. After careful assessment of other available options by her doctor and my sister, a bone genetics researcher, my mother is now facing her second treatment with the once-a-year drug Reclast. Time—and her next bone density test—will tell if the drug is doing its intended job of slowing bone loss.

My father is not exempt. At 92, he’s dealing with weakening and compression of his spinal vertebrae. Two of his sisters have experienced the same fates, both of them developing noticeable “dowager’s humps”—a forward curvature of the upper back due to osteoporosis—in their later years.

Genetic odds say that I will face a similar destiny. My first bone density test, which I had last year, showed mild bone loss. Ever since, with almost religious zeal, I’ve taken a calcium plus vitamin D supplement at breakfast, chased by a bowl of yogurt. I’m hoping this daily routine will at least postpone further bone loss. Like missing out on the thrill of skiing, it’s a small concession I’m happy to make for the health of my bones.

Meanwhile, I will count on researchers like my sister and the ones described in this issue to continue making headway in understanding bone biology, which will no doubt lead to better treatments for all types of skeletal flaws. I hope you find the work as fascinating as I do. And for those of you with iPads, be sure to download the free Bulletin app for a deeper dive into the topic as well as a fun twist on the story’s design.

Mary Beth Gardiner
Editor, HHMI Bulletin