Phloretin inhibits osteoclast differentiation and alleviates disuse osteoporosis through the PI3K/AKT/NF-κB pathway

  • Eur J Pharmacol. 2026 May 28:1025:178925. doi: 10.1016/j.ejphar.2026.178925.
Fanhao Wei  1 Bin Yang  2 Binjia Ruan  3 Liyong Zhang  4 Chaoyong Wang  3 Jun Cai  2 Jingcheng Wang  5 Hongwei Wang  6 Yongxiang Wang  7
Affiliations
  • 1. Department of Graduate School, Dalian Medical University, No.9 of West Section of Lushun South Road, Dalian, 116044, China; Department of Orthopedics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, Yangzhou, 225001, China.
  • 2. Department of Orthopedics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, Yangzhou, 225001, China.
  • 3. Clinical Medical College, Nanjing University Medical School, 22 Hankou Road, Nanjing, 210093, China.
  • 4. Yangzhou Hospital of Traditional Chinese Medicine, 577 Wenchang Middle Road, Yangzhou, 225001, China.
  • 5. Department of Graduate School, Dalian Medical University, No.9 of West Section of Lushun South Road, Dalian, 116044, China; Department of Orthopedics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, Yangzhou, 225001, China. Electronic address: [email protected].
  • 6. Nanjing University Medical School, Jiangsu Key Lab of Molecular Medicine, 22 Hankou Road, Nanjing, 210093, China. Electronic address: [email protected].
  • 7. Department of Graduate School, Dalian Medical University, No.9 of West Section of Lushun South Road, Dalian, 116044, China; Department of Orthopedics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 West Nantong Road, Yangzhou, 225001, China. Electronic address: [email protected].
Abstract

Mechanical unloading that results from aging, prolonged bed rest, or spaceflight leads to disuse osteoporosis (DOP), a significant public health concern. However, the mechanisms underlying this condition, as well as effective therapeutic strategies, remain incompletely defined. In this study, significant bone deterioration, increased osteoclast activation, and upregulation of the PI3K/Akt/NF-κB signaling cascade were observed in femoral specimens from hindlimb suspension (HLS) mice, a well-established DOP model. Phloretin, a naturally occurring flavonoid with notable antioxidant and anti-inflammatory activities, has shown anti-osteoclastogenic effects in chemically induced models. Nevertheless, its therapeutic efficacy and direct molecular targets in mechanical unloading-induced bone loss, a condition characterized by a distinct pathophysiology, remain largely undefined. Herein, we demonstrated that phloretin markedly suppressed osteoclastogenesis, attenuated excessive bone resorption and effectively counteracted bone loss in the hindlimb-unloading murine model. Complementing these in vivo findings, primary osteoclast cultures revealed that phloretin reduced osteoclast formation and activity by inhibiting the PI3K/Akt/NF-κB signaling axis. Importantly, pharmacological activation of the PI3K pathway with 740 Y-P significantly reduced Phloretin's inhibitory effects on osteoclast differentiation and bone protection, confirming that this pathway is the primary regulatory target. Unlike general anti-resorptive agents, phloretin specifically addresses the PI3K-mediated signaling activation triggered by mechanical unloading. Our findings provide robust evidence for the application of phloretin as a targeted therapy for disuse-related skeletal disorders.

Keywords
Hindlimb suspension; Osteoclast; PI3K/AKT/NF-κB; Phloretin.
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