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1.甘肃中医药大学,兰州 730000
2.甘肃省第二人民医院,西北民族大学 附属医院,兰州 730030
Received:27 April 2021,
Published Online:27 July 2021,
Published:20 September 2021
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李辉,谢兴文,李宁等.细胞因子在骨质疏松症中的作用及中医药干预研究进展[J].中国实验方剂学杂志,2021,27(18):227-233.
LI Hui,XIE Xing-wen,LI Ning,et al.Role of Cytokines in Osteoporosis and Intervention with Traditional Chinese Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(18):227-233.
李辉,谢兴文,李宁等.细胞因子在骨质疏松症中的作用及中医药干预研究进展[J].中国实验方剂学杂志,2021,27(18):227-233. DOI: 10.13422/j.cnki.syfjx.20211896.
LI Hui,XIE Xing-wen,LI Ning,et al.Role of Cytokines in Osteoporosis and Intervention with Traditional Chinese Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(18):227-233. DOI: 10.13422/j.cnki.syfjx.20211896.
骨质疏松症(OP)是当今世界范围内老年人群中发病率最高的疾病之一。由于世界人口结构的加速变化,对OP的有效防治正日益成为全球关注的健康焦点和临床研究的热点。OP可受遗传、内分泌失调、营养缺乏、不良生活习惯等多种因素影响而发病,由破骨细胞介导的骨吸收与成骨细胞介导的骨形成的偶联平衡被打破致使骨吸收大于骨形成是目前公认的OP发病的主要病理机制。现代医学对OP的研究已经深入到分子免疫学水平,研究发现相关细胞因子在OP的病理机制中扮演着重要角色,通过调节破骨细胞对骨骼的吸收和成骨细胞对骨骼的形成,是调控OP发生和发展的重要转导因子。肿瘤坏死因子-
α
,白细胞介素-1
β
和白细胞介素-6通过刺激破骨形成和抑制成骨细胞功能,在骨破坏中发挥关键作用,而血管内皮生长因子,转化生长因子-
β
,骨形态发生蛋白,骨保护素等细胞因子可通过增强成骨细胞的分化功能、促进骨形成。目前临床多使用降钙素、雌激素及双磷酸盐等西药进行治疗OP,但长期服用患者的依从性差,胃肠道不良反应明显。中医药治疗OP以其整体调节、价廉及不良反应小等优势占据重要治疗作用,并且随着网络药理学和分子生物学等领域研究的深入,发现中医药可通过干预多种细胞因子表达,进而调节骨稳态,发挥治疗OP的作用。该文阐述相关细胞因子在OP发病中的作用,以及中医药调控相关细胞因子的研究成果,以期为OP的中医药防治提供参考依据。
Osteoporosis (OP) is one of the most common diseases in the aged population worldwide. Due to the rapid change in world population structure, the effective prevention and treatment of OP is increasingly becoming the health problem of global concern and also the hot spot of clinical research. OP can be affected by many factors such as heredity, endocrine dyscrasia, nutritional deficiency, and bad living habits. The breakdown of coupling of osteoclast-mediated bone resorption to osteoblast-mediated bone formation leads to stronger bone resorption than bone formation, which is currently recognized as the main pathogenesis of OP. The exploration of OP in modern medicine based on molecular immunology has revealed that related cytokines play an important role in the pathogenesis of OP,and regulating the osteoclast-mediated bone resorption and osteoblast-mediated bone formation is essential for controlling the occurrence and development of OP. Tumor necrosis factor-
α
(TNF-
α
), interleukin-1
β
(IL-1
β
), and interleukin-6 (IL-6) are able to stimulate bone formation and inhibit osteoblast function, thus playing a key role in bone destruction. By contrast, such cytokines as vascular endothelial growth factor (VEGF), transforming growth factor-
β
(TGF-
β
), bone morphogenetic protein (BMP), and osteoprotegerin (OPG) strengthen osteoblast differentiation and promote bone formation. At present, western medicine like calcitonin, estrogen, and bisphosphonate are mostly used for clinical treatment of OP, but a long-term use of these drugs will result in poor compliance and obvious gastrointestinal adverse reactions. Traditional Chinese medicine (TCM) occupies an important position in the treatment of OP due to its advantages of overall regulation, low price, and few side effects. In addition, with the deepening of research on network pharmacology and molecular biology, it has been found that TCM exerts the therapeutic effect against OP by interfering with the expression of various cytokines and adjusting bone homeostasis. This paper has elaborated the role of related cytokines in the pathogenesis of OP and reviewed the research results concerning the regulation of related cytokines by TCM, in order to provide reference for the prevention and treatment of OP with TCM.
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