Sympathetic nervous system and bone adaptive response to its mechanical environment.

While bone adaptive response to its mechanical environment was considered to be controlled locally by cytokines and systemic hormones, some recent work suggests that it could also be neuronally regulated. Bone is indeed very densely innervated and many experimental and clinical studies have previously shown the involvement of the nervous system in the control of bone metabolism. The demonstration that the central nervous system regulates bone mass via the sympathetic nervous system (SNS) has prompted recent studies aimed to investigate the role of the SNS in the bone mechano-adaptive response. This review will focus on this work and summarize the evidence for a contribution of the beta-adrenergic signalling in the response of bone cells to mechanical loading. The apparent conflicting results obtained in diverse experimental models of loading and unloading, at different skeletal sites, and in relation to various hormonal levels, will be discussed. While those studies do not support a major influence of the SNS on the bone mechano-adaptive response, there is nevertheless strong evidence that the SNS is part of a complex system which contributes to the metabolic regulation of bone.