SMAD7-mediated ferroptosis in macrophages drives osteoporosis progression: A multi-omics study

and lipid peroxidation) with bone damage in osteoporosis patients. And we found SMAD7 showing the strongest correlation with trabecular microstructural deterioration. Notably, our findings also confirmed that the SMAD7 inhibitor mongersen effectively attenuated macrophage ferroptosis, suggesting its potential to improve bone microstructural integrity. Our study demonstrates that SMAD7-mediated macrophage ferroptosis is a critical mechanism in osteoporosis pathogenesis, highlighting SMAD7 as a promising therapeutic target.