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The NOD\u2010like receptor family pyrin domain\u2010containing 3 (NLRP3) inflammasome, a multi\u2010subunit protein complex involved in bone homeostasis, mediates inflammatory cascades in response to external stimuli and pathological conditions. This process triggers pyroptosis in various bone\u2010related cells, disrupting bone repair and remodelling. Oestrogen deficiency and aging lead to the overactivation of the NLRP3 inflammasome, stimulate bone immunity, metabolism and other abnormalities and disrupt angiogenesis\u2013osteogenesis coupling. These factors contribute significantly to the pathological progression of OP. However, the precise mechanisms remain poorly understood and are lacking clinical validation. Therefore, this review summarises the mechanisms of NLRP3 inflammasome in response to bone immune signals, external stress and intercellular communication, as well as its role in metabolic regulation, including reprogramming and post\u2010translational modification, thereby influencing pyroptosis in macrophages, endothelial cells, mesenchymal stem cells and osteoblasts. It explores potential therapeutic strategies that target NLRP3 activation, including exosome (Exos)\u2010based interventions and traditional Chinese medicine components, which may modulate its differential expression and affect angiogenesis\u2013osteogenesis differentiation. These approaches offer promising avenues for the prevention and treatment of OP.<\/jats:p>","DOI":"10.1111\/jcmm.70798","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T16:41:32Z","timestamp":1756140092000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["<scp>NLRP3<\/scp> Inflammasome\u2010Mediated Pyroptosis in Osteoporosis: Osteoimmune Mechanisms and Therapeutic Targeting"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9668-9301","authenticated-orcid":false,"given":"Jiaxuan","family":"Fan","sequence":"first","affiliation":[{"name":"Clinical College of Traditional Chinese Medicine Gansu University of Chinese Medicine  Lanzhou Gansu P. R. 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