Osteocytes: mechanosensors of bone and orchestrators of mechanical adaptation

Significant progress has been made in the field of mechanotransduction in bone cells. The knowledge about the role of osteocytes as the professional mechanosensor cells of bone as well as the lacuno-canalicular porosity as the structure that mediates mechanosensing is increasing. New insights might result in a paradigm for understanding the bone formation response to mechanical loading, and the bone resorption response to disuse. Under physiological loading conditions the strain-derived flow of interstitial fluid through the lacuno-canalicular porosity seems to mechanically activate the osteocytes, which subsequently alter the bone remodeling activity of osteoblasts and/or osteoclasts. Fatigue loading results in local microdamage, disruption of normal flow patterns, and osteocyte apoptosis. Apoptotic osteocytes likely attract osteoclasts to resorb the damaged bone. This concept allows explanation of local bone gain and loss, as well as remodeling in response to fatigue damage, as processes supervised by mechanosensitive osteocytes. Uncovering the cellular and mechanical basis of the osteocyte’s response to loading would greatly contribute to our understanding of the cellular basis for bone remodeling, and could contribute to the discovery of new treatment modalities for bone mass disorders, such as osteoporosis