Rickets and Osteomalacia, from Genes to Nutrition

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About this Research Topic

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Background

Rickets in children and osteomalacia in adults can be genetic or acquired. The progress in genetics allows the in-depth study of genetic forms of rickets (calciopenic or phosphopenic) and the development of new treatments. On the other hand, nutritional rickets has reappeared globally. It is a public health emergency and it is totally preventable and treatable.
There are still many unanswered questions, for instance on the best treatment for the genetic calciopenic types, the effect of burosumab in the phosphopenic types, proposals for a transition plan, and also lifestyle data on nutrition and exercise.

As for nutritional rickets, it has many aspects; medical, social, and political. Are the existing guidelines being applied? What are the hurdles in doing so? What is the outcome of adults with osteomalacia, including pregnant and lactating women? What is the true incidence in older adults and after bariatric surgery? Can non-invasive biomarkers replace bone biopsy? Finally, the interaction between genetics and epigenetics in nutritional rickets is an equally important topic.

We aim to translate research into everyday life, thus we welcome articles on genetic and nutritional rickets which are expected to have an impact on the wellbeing of our patients, i.e. with implications on clinical practice. All relevant disciplines (e.g. endocrinologists, paediatricians, nutritionists, radiologists, orthopaedic surgeons, dentists) are invited to contribute and to highlight the holistic approach needed for these complex cases.
We also aim to raise awareness and to educate the readers through the presentation of challenging cases, clinical quizzes and interesting radiological images.
Another important goal is to cover gaps in knowledge and generate new, vivid discussions on new areas of research.
Finally, the public health impact of nutritional rickets should not be overlooked. The recent refugee crisis is a humanitarian issue of utmost importance and the health illiteracy and increased mobility of these vulnerable groups pose unique challenges and dilemmas in surveillance, management and follow up. We aim to highlight this topic as well, possibly through the contribution of a sociologist or a political scientist with experience on the subject.

This research topic aims at gathering reviews and research articles on, but not limited to, the following themes:
Genetic rickets (calciopenic and phosphopenic), children and adults
• Advice on nutrition, exercise (rehabilitation) and dental care
• Treatment protocols for calciopenic types
• Experience with new treatments in phosphopenic types
• Transition
• Challenging cases/radiological images/clinical quizzes

Nutritional rickets, children and adults
• Vitamin D polymorphisms and epigenetics
• Feedback on the application of global consensus for nutritional rickets
• Nutrition: Vitamin K and D3 (there are many vitamin D supplements that also contain vitK2; what is the evidence?)
• Osteomalacia in pregnancy and lactation
• Public health initiatives on vitamin D, targeted screening of populations (and families) at risk, dental care
• Rickets/osteomalacia reporting in mobile populations, communication difficulties, social aspects


COI: Dr. Laurent has received consultancy and lecture fees from Alexion, Amgen, Daiichi Sankyo, Kyowa Kirin, Menarini, Sandoz, Takeda, UCB, and Will-Pharma.

Keywords: Rickets, bone, vitamin D, osteomalacia, genetic, phosphorus, calcium

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