骨骼系统是脊椎体组成的基础，提供肌肉附着稳定位置、保护重要器官、储存矿物离子、为造血系统提供场所，并参与复杂的内分泌和免疫系统。不出所料，骨骼在生理条件下不断被吸收、形成和重塑。一旦骨代谢平衡被打破（包括炎症、肿瘤、骨折和骨代谢疾病），身体便迅速启动骨再生以保持骨组织的结构和质量。自噬（宏噬）是真核细胞的一种重要代谢过程，它通过控制分子降解和细胞器更新来维持代谢能量平衡，并在骨再生中扮演重要角色。一个相对较新的发现是，间充质细胞、成骨细胞、破骨细胞、骨细胞、软骨细胞和血管化过程表现出自噬，正在探索和更新参与其中的分子机制和靶点。自噬在退行性疾病（椎间盘退化症、骨关节炎等）和骨代谢疾病（骨质疏松症、病理性骨折、骨硬化等）中的作用也逐渐显现。调节自噬的调节剂，包括MTOR（雷帕霉素素机械靶点）抑制剂、AMPK激活剂和新兴植物化学物质，已经受益于骨再生。利用生物材料（特别是纳米材料）诱导自噬也是一个有吸引力的研究方向，可以根据载荷分子/药物的材料性质，如形状、粗糙度和表面化学性质等，产生卓越的治疗性能。所有这些都有重要的临床意义，未来在自噬相关信号、通路、机制和治疗在骨疾病中的发现方面。

The skeletal system is the basis of the vertebral body composition, which affords stabilization sites for muscle attachment, protects vital organs, stores mineral ions, supplies places to the hematopoietic system, and participates in complex endocrine and immune system. Not surprisingly, bones are constantly reabsorbed, formed, and remodeled under physiological conditions. Once bone metabolic homeostasis is interrupted (including inflammation, tumors, fractures, and bone metabolic diseases), the body rapidly initiates bone regeneration to maintain bone tissue structure and quality. Macroautophagy/autophagy is an essential metabolic process in eukaryotic cells, which maintains metabolic energy homeostasis and plays a vital role in bone regeneration by controlling molecular degradation and organelle renewal. One relatively new observation is that mesenchymal cells, osteoblasts, osteoclasts, osteocytes, chondrocytes, and vascularization process exhibit autophagy, and the molecular mechanisms and targets involved are being explored and updated. The role of autophagy is also emerging in degenerative diseases (intervertebral disc degeneration [IVDD], osteoarthritis [OA], etc.) and bone metabolic diseases (osteoporosis [OP], osteitis deformans, osteosclerosis). The use of autophagy regulators to modulate autophagy has benefited bone regeneration, including MTOR (mechanistic target of rapamycin kinase) inhibitors, AMPK activators, and emerging phytochemicals. The application of biomaterials (especially nanomaterials) to trigger autophagy is also an attractive research direction, which can exert superior therapeutic properties from the material-loaded molecules/drugs or the material's properties such as shape, roughness, surface chemistry, etc. All of these have essential clinical significance with the discovery of autophagy associated signals, pathways, mechanisms, and treatments in bone diseases in the future.