Molecular Aspects of Bone Resorption in B-Thalassemia Major

B-thalassemia is the most common single gene disorder worldwide, in which hemoglobinb-chain production is decreased. today, the life expectancy of thalassemic patients isincreased because of a variety of treatment methods; however treatment related complicationshave also increased. the most common side effect is osteoporosis, which usuallyoccurs in early adulthood as a consequence of increased bone resorption. increased boneresorption mainly results from factors such as delayed puberty, diabetes mellitus, hypothyroidism,ineffective hematopoiesis as well as hyperplasia of the bone marrow, parathyroidgland dysfunction, toxic effect of iron on osteoblasts, growth hormone (gh) andinsulin-like growth factor-1 (igf-1) deficiency. these factors disrupt the balance betweenosteoblasts and osteoclasts by interfering with various molecular mechanisms and resultin decreased bone density.given the high prevalence of osteopenia and osteoporosis in thalassemic patients andcomplexity of their development process, the goal of this review is to evaluate the molecularaspects involved in osteopenia and osteoporosis in thalassemic patients, which maybe useful for therapeutic purposes.