Can Hypoxic Conditioning Improve Bone Metabolism? A Systematic Review

Abstract

Abstract: Among other functions, hypoxia-inducible factor plays a critical role in bone–vascular coupling and bone formation. Studies have suggested that hypoxic conditioning could be a potential nonpharmacological strategy for treating skeletal diseases. However, there is no clear consensus regarding the bone metabolism response to hypoxia. Therefore, this review aims to examine the impact of di erent modes of hypoxia conditioning on bone metabolism. The PubMed andWeb of Science databases were searched for experimental studies written in English that investigated the e ects of modification of ambient oxygen on bone remodelling parameters of healthy organisms. Thirty-nine studies analysed the e ect of sustained or cyclic hypoxia exposure on genetic and protein expression and mineralisation capacity of di erent cell models; three studies carried out in animal models implemented sustained or cyclic hypoxia; ten studies examined the e ect of sustained, intermittent or cyclic hypoxia on bone health and hormonal responses in humans. Di erent modes of hypoxic conditioning may have di erent impacts on bone metabolism both in vivo and in vitro. Additional research is necessary to establish the optimal cyclical dose of oxygen concentration and exposure time.