| Abstract: Sclerostin (Scl) plays an important role in the bone metabolism. A large number of animal experiments and clinical trials have confirmed that inhibiting sclerostin improves bone structure and increases bone mineral density. Romosozumab (ROMO), a monoclonal antibody against sclerostin, has been approved for marketing in the United States and Canada and is currently the only anti-osteoporosis drug that has the dual effect of promoting bone formation and inhibiting bone resorption. However, its side effects and the time dependence during treatment are two major problems at present. Therefore, we are looking forward to developing new osteoporosis drugs with better treatment effects and fewer side effects through sclerostin. In this review, we introduce the current understanding of the structure, expression regulation, and mechanism of sclerotin, and discuss in depth the specific molecular targets in order to provide a new direction for future drug research. We also review the specific effects of sclerostin on different cells in the skeletal system, including osteoclasts (OC), osteoblasts (OB) and adipocytes. Finally, we put forward the research direction in the future. |