ASBMR Three Year Pre-Meeting Symposia - The American Society for Bone and Mineral Research (ASBMR), the largest professional, scientific and medical society established to bring together clinical and laboratory-based scientists who are involved in the study of bone, mineral and musculoskeletal science, has had a successful history of conducting annual topical meetings funded by single year NIH R13 grants since 2002. More recently, ASBMR received two, three-year R13 grants to cover pre-meeting symposia programs for 2016-2018 and 2019-2021. The current application seeks funding for a three-year R13 grant to advance the field of musculoskeletal diseases by focusing on three specific areas of scientific research in 2022, 2023 and 2024: 1) “Rare Diseases: From Molecules and Mechanisms to Therapeutics”; 2) “Osteocytes in Bone Health and Disease and as Therapeutic Target Cells”; 3) “Energy Metabolism in Skeletal Development and Disease”. These three symposia cover highly relevant areas of musculoskeletal research that has recently undergone rapid evolution in scientific knowledge and collectively contribute to major clinical morbidity disability and mortality. The overall objective of this R13 is to stimulate further advances that will result in improved patient care for musculoskeletal diseases by bringing together the best researchers for each of the three symposia. The symposia will review the state of the art in each topic area, exchanging ideas with attendees, and stimulating the interaction between young and established researchers. Symposia attendees will be encouraged to attend the subsequent ASBMR Annual Meetings for additional opportunities to interact with musculoskeletal researchers. Programs for all three symposia were developed by an organizing committee, and all speakers for the first two symposia have confirmed their participation. Presenters include established and young investigators, women and men, and, since about half of ASBMR membership is from outside the US, a number of key international speakers have also been invited. Poster sessions, young investigator award presentations, and at the end of each meeting a “dine-around” evening are planned to promote direct interaction between young investigators and more senior speakers. In 2022, the symposium will gather international experts in rare bone diseases to discuss the latest advances on underlying mechanisms and therapies, provide guidance to clinicians on how to recognize them, and lessons learnt from rare diseases that have direct application to more common bone diseases such as osteoporosis. In 2023, the symposium will review the advances in basic, translational and clinical research on the role of osteocytes in the biology and pathophysiology of bone, and how to target osteocytes with therapeutic goals. The osteocyte role in mechanobiology, hormone actions, cancer in bone and osteocyte endocrine actions will be discussed. The 2024 symposium will discuss the recent advances on the role of energy metabolism in skeletal development and disease; including the role of hypoxia and mitochondria-mediated mechanisms, and its involvement in the response of bone to anabolic therapies and metabolic diseases such as diabetes.