Prof. Xu Cao | Structural Health Monitoring | Best Researcher Award

Lee Riley Profressor, at Johns Hopkins School of Medicine, United States.

Dr. Xu Cao, Ph.D., is an internationally acclaimed musculoskeletal researcher and the Lee Riley Professor at Johns Hopkins University School of Medicine. He is the Director of the Center for Musculoskeletal Research and has dedicated over three decades to unraveling the molecular and cellular mechanisms that underlie bone remodeling and skeletal diseases. Dr. Cao’s pioneering discoveries, particularly on TGF-β’s role in coupled bone remodeling and skeletal interoception, have laid the groundwork for novel therapeutic strategies targeting osteoporosis, osteoarthritis, and spinal disc degeneration. He has consistently translated his basic science findings into preclinical and clinical advancements. Recognized globally, Dr. Cao is among the top 1% of researchers worldwide with Highly Cited Research Awards by Clarivate Analytics. With editorial appointments, numerous awards, and over 150 peer-reviewed publications, Dr. Cao remains a leading voice in orthopedic and bone biology research. He continues to inspire and mentor future scientists while advancing the frontier of skeletal health.

Professional Profile

Scopus

🎓 Education 

Dr. Xu Cao’s academic journey began at Xinjiang University in China, where he received his B.S. in Biology (1978–1982). Driven by a passion for biochemistry and its applications in human health, he pursued his Ph.D. in Chemistry and Biochemistry at the University of South Carolina, completing it in 1991. His doctoral training provided a rigorous foundation in molecular biology and biochemical pathways, which he later applied to the skeletal system. Following his Ph.D., Dr. Cao completed a prestigious five-year postdoctoral fellowship in skeletal diseases at Washington University in St. Louis (1991–1996), where he deepened his research in bone pathology and regenerative biology. These formative years shaped his scientific perspective and laid the groundwork for his future translational work in musculoskeletal disorders. His diverse and interdisciplinary training across continents has enabled him to make groundbreaking contributions at the interface of chemistry, biomedicine, and orthopaedics.

💼 Experience 

Dr. Cao has held esteemed academic appointments throughout his career. He began as an Assistant Professor of Pathology at the University of Alabama at Birmingham (UAB) in 1996, later promoted to Associate Professor (2000–2004), and Professor (2004–2009). In 2009, he joined Johns Hopkins University as the Lee Riley Professor of Orthopaedic Surgery, where he also became the Director of the Center for Musculoskeletal Research. Since 2011, he has directed the Research Division in the Orthopaedic Surgery Department, and in 2014, he was appointed Professor in the Department of Bioengineering and a member of the Institute of Cell Engineering. Dr. Cao is a sought-after advisor and consultant for pharmaceutical firms such as Merck, and an active participant in editorial and peer-review roles for top-tier journals. His extensive leadership roles reflect his commitment to integrating research, education, and innovation in musculoskeletal science.

🔬 Research Interests 

Dr. Xu Cao’s research delves into the molecular and cellular basis of bone biology and skeletal diseases. He is best known for elucidating the role of transforming growth factor-beta (TGF-β) in coupled bone remodeling and its disruption in diseases like osteoporosis and osteoarthritis. His lab uncovered that osteoclast-activated TGF-β not only regulates bone resorption but also recruits mesenchymal stem cells to initiate bone formation—an essential homeostatic mechanism. Dr. Cao’s team also discovered how aberrant TGF-β signaling leads to cartilage degradation and ectopic bone formation. More recently, his research has expanded to neural regulation of the skeleton via skeletal interoception, revealing central nervous system pathways involved in bone and joint disorders. Dr. Cao is actively developing therapies targeting these pathways for conditions such as spinal degeneration, enthesopathy, and osteoarthritis. His translational approach bridges fundamental science with clinical applications to improve skeletal health worldwide.

🏆 Awards 

Dr. Xu Cao has received numerous prestigious awards throughout his illustrious career. He was honored with the 2024 Top 1% Highly Cited Researcher Award by Clarivate Analytics, underscoring his global impact. Earlier in his career, he received the Merck Young Investigator Award and the Sandoz Award from the American Society for Bone and Mineral Research (ASBMR) in 1993, and later, the John Haddad Young Investigator Award in 1999. Dr. Cao has served as President of the International Chinese Musculoskeletal Research Society and was Co-Chair of the 2012 ASBMR Annual Meeting. As Founding Editor of Bone Research and Deputy Editor of Marrow, he continues to shape the direction of scientific publishing in his field. These accolades reflect not only his groundbreaking discoveries but also his mentorship, leadership, and enduring commitment to musculoskeletal science and innovation.

📚 Top Noted Publications 

Dr. Cao has authored over 150 peer-reviewed articles in high-impact journals, several of which are highly cited and considered seminal in bone biology. Recent publications include:

1. Wang Z et al., 2025 – Hypothalamus Regulates Anabolic Metabolism

• Title: Hypothalamus Regulates Anabolic Metabolism of Articular Cartilage Superficial Chondrocytes through PGE₂ Skeletal Interoception​PubMed+8ResearchGate+8CoLab+8

• Authors: Wang Z, Han X, Xu J, Zhang W, Patel K, et al.​AbleSci

• Journal: Advanced Science​

• Publication Date: March 26, 2025​AbleSci

• DOI: 10.1002/advs.202501039​CoLab+2AbleSci+2Wiley Online Library+2

• Summary: This study reveals that skeletal interoception, via prostaglandin E₂ (PGE₂), modulates the hypothalamic sympathetic output, leading to anabolic renewal of the articular cartilage’s superficial zone. Physical activity downregulates hypothalamic norepinephrine, promoting cartilage regeneration. ​Johns Hopkins University+7CoLab+7Wiley Online Library+7PubMed+1CoLab+1

2. Xue P et al., 2024 – Proton-Activated Chloride Channel in Spinal Degeneration

• Title: Proton-Activated Chloride Channel Increases Endplate Porosity and Pain in a Mouse Spine Degeneration Model​PMC+7Johns Hopkins University+7JCI+7

• Authors: Xue P, Zhang W, Shen M, Yang J, Chu J, Wang S, Wan M, Zheng J, Qiu Z, Cao X.​qiulab+2CoLab+2Johns Hopkins University+2

• Journal: Journal of Clinical Investigation​

• Publication Date: August 28, 2024​

• DOI: 10.1172/JCI168155​CoLab+3Johns Hopkins University+3JCI+3

• Summary: The research identifies that activation of the proton-activated chloride (PAC) channel under acidic conditions enhances osteoclast fusion, increasing endplate porosity and contributing to low back pain. Genetic knockout of the PAC gene (Pacc1) reduced these effects without impacting overall bone mass. ​PubMed+1PMC+1

3. Pan D et al., 2024 – Endplate Senescent Osteoclasts and Spine Pain

• Title: Senescence of Endplate Osteoclasts Induces Sensory Innervation and Spinal Pain​eLife+4eLife+4PubMed+4

• Authors: Pan D, et al.​

• Journal: eLife​ScienceDaily+1eLife+1

• Publication Date: June 19, 2024​

• DOI: 10.7554/eLife.92889​eLife

• Summary: This study demonstrates that senescent osteoclasts in vertebral endplates promote sensory nerve innervation, leading to increased spinal pain sensitivity. Treatment with the senolytic drug Navitoclax reduced senescent osteoclast numbers and alleviated spinal pain in animal models. ​

4. Gao F et al., 2024 – Brain Regulates Weight Bearing via PGE₂

• Title: Brain Regulates Weight Bearing Bone through PGE₂ Skeletal Interoception: Implication of Ankle Osteoarthritis and Pain​Semantic Scholar+10JCI+10SciOpen+10

• Authors: Gao F, Hu Q, Chen W, Li J, Qi C, et al.​JCI

• Journal: Bone Research​HEP Journal

• Publication Date: March 2024​

• DOI: 10.1038/s41413-024-00316-w​SciOpen+2HEP Journal+2Nature+2

• Summary: The research uncovers that the hypothalamus senses bone-derived PGE₂ levels in response to mechanical loading, regulating bone remodeling and structure. This brain-bone communication pathway has implications for conditions like ankle osteoarthritis and pain. ​Semantic Scholar+3Nature+3HEP Journal+3

5. Ling Z et al., 2023 – PTH Treatment Reverses Endplate Remodeling

• Title: Parathyroid Hormone Treatment Partially Reverses Endplate Remodeling and Attenuates Low Back Pain in Animal Models of Spine Degeneration​PubMed+4AbleSci+4ResearchGate+4

• Authors: Ling Z, Crane J, Hu H, Chen Y, Wan M, et al.​

• Journal: Science Translational Medicine​

• Publication Date: November 15, 2023​

• DOI: 10.1126/scitranslmed.adg8982​

• Summary: The study indicates that parathyroid hormone (PTH) treatment reduces endplate porosity, increases cartilaginous volume, and improves mechanical properties of vertebral endplates. These structural changes correlate with decreased inflammatory markers and sensory innervation, suggesting PTH’s potential as a disease-modifying therapy for low back pain.

Conclusion

Dr. Xu Cao is exceptionally qualified and highly deserving of the Best Researcher Award.
His work is not only foundational in understanding skeletal diseases but also translational, with direct implications for improving human health. The combination of deep scientific insight, leadership, innovation, and impact makes him an exemplary figure in biomedical research.