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RESEARCH PAPER / 2026-02-14

Nutritional activation of the Nrf2-Pth1r axis by pyrroloquinoline quinone enhances peak bone mass and potentiates teriparatide in osteoporosis.

Qi Xue, Yueqiang Gu, Jie Li, Ran Qin, Mingying Li, Yiping Li, Zijia Chen, Changhao Li, Jing Zhang, Renlei Yang

Department of Plastic Surgery, Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.Department of Plastic Surgery, Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China. · pubmed

Abstract

Peak bone mass (PBM) critically determines lifelong skeletal health. We showed that dietary supplementation with pyrroloquinoline quinone (PQQ) - a water-soluble bioactive compound that activates nuclear factor erythroid 2-related factor 2 (Nrf2) signaling - during pregnancy or post-weaning enhances PBM acquisition in wild-type mice, subsequently attenuating age-related bone loss and improving mechanical strength. Mechanistically, PQQ-activated Nrf2 binds directly to the parathyroid hormone 1 receptor (Pth1r) promoter, upregulating its transcription and augmenting PTH-induced osteogenesis. Pth1r overexpression rescues the impaired osteogenesis of Nrf2-deficient bone marrow mesenchymal stem cells (BMSCs). Teriparatide's (PTH 1-34) anabolic effects are markedly compromised in Nrf2-deficient mice and human BMSCs, underscoring Nrf2's essential role in PTH-mediated bone formation. Notably, PQQ and PTH 1-34 co-administration synergistically enhances skeletal anabolism in aged mice beyond PTH 1-34 monotherapy. These results establish the PQQ-Nrf2-Pth1r axis as a key regulator of bone mass accrual and suggest PQQ as a promising adjunct to teriparatide for osteoporosis.

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Research summary

Dietary supplementation with pyrroloquinoline quinone enhances peak bone mass and synergizes with teriparatide to improve bone health in osteoporosis. The study addresses mechanisms that could potentially mitigate age-related bone loss, which is a significant aspect of longevity research.

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