文献类型：期刊文献

中文题名：中药单体调控成骨相关信号通路治疗激素性股骨头坏死的研究进展

英文题名：Active Components in Chinese Medicinal Herbs Regulate Osteogenic Signaling Pathway in Treatment of Steroid-induced Osteonecrosis of Femoral Head:A Review

作者：尚征亚[1];曹林忠[1,2];张翼[3];马成祥[1];胡康一[1];杨浩东[1];孙金宁[1];张勇杰[1];杨小瑞[1]

第一作者：尚征亚

机构：[1]甘肃中医药大学,兰州730000;[2]甘肃中医药大学附属医院,兰州730000;[3]解放军总医院第八医学中心,北京100080

第一机构：甘肃中医药大学

年份：2023

卷号：29

期号：18

起止页码：229

中文期刊名：中国实验方剂学杂志

外文期刊名：Chinese Journal of Experimental Traditional Medical Formulae

收录：CSTPCD;;北大核心:【北大核心2020】；CSCD:【CSCD2023_2024】；

基金：国家自然科学基金项目(81860859,82160915)。

语种：中文

中文关键词：中药单体;调控;激素性股骨头坏死;研究进展

外文关键词：active components in Chinese medicinal herbs;regulation;steroid-induced osteonecrosis of femoral head necrosis;review

摘要：激素性股骨头坏死是一种主要由糖皮质激素诱导的多种因素共同作用而造成的骨科常见疾病,其具有治愈难度大、愈后效果差等特点。而且其具体发病机制至今仍未明确。成骨相关信号通路对骨形成的影响至关重要,糖皮质激素诱导的成骨相关信号通路异常激活及转运所导致的骨髓间充质干细胞分化异常、骨代谢功能紊乱、成骨形成障碍等因素或是造成激素性股骨头坏死发生和发展的主要原因。骨骼的形成、重塑能力都离不开骨髓间充质干细胞的参与,其是一种拥有不断自我更新和分化能力的干细胞,更好地强化骨骼重塑能力关键就在于提高其成骨分化能力,并且这是抑制骨吸收,阻止破骨细胞分化的重点。传统中药对骨坏死的治疗在古时已有应用,《本草汇言》记载:“凡下焦之虚,非杜仲不补……足胫之酸,非杜仲不去;腰膝之痛,非杜仲不除……补肝益肾,诚为要药。”这表明古代医家早已开始运用杜仲补益肝肾,强健筋骨的功效对骨坏死进行有效治疗。随着国家支持中医药发展的力度加大,传统中医药在防治激素性股骨头坏死方面的研究不断增加,多项研究都发现中药通过影响靶向信号分子可以对骨髓间充质干细胞的分化产生积极的作用,促进成骨及骨缺损修复,进而对抗激素性股骨头坏死的发生及发展。中药调控成骨相关信号通路防治激素性股骨头坏死已成为当今研究的热点。现就中药单体通过调控成骨相关信号通路防治激素性股骨头坏死的研究进展做一综述,挖掘探究促进骨髓间充质干细胞向成骨细胞分化、抑制破骨细胞分化、促进骨形成的机制,以期为中药治疗激素性股骨头坏死的更深层次研究提供参考。
As a threat to human health,steroid-induced osteonecrosis of femur head is a common refractory orthopedic disease mainly caused by glucocorticoids,with poor prognosis and unclear pathogenesis.Osteogenesis-associated signaling pathways play an important role in bone formation.Glucocorticoid-induced abnormal activation and transport of these signaling pathways lead to abnormal differentiation of bone marrow mesenchymal stem cells,dysfunction of bone metabolism,and osteogenesis disorders,which may be the main reasons for the occurrence and development of steroid-induced osteonecrosis of femur head.Bone formation and remodeling need the participation of bone marrow mesenchymal stem cells,which are stem cells characterized by continuous self-renewal and differentiation.The key to strengthening bone remodeling is to improve the osteogenic differentiation capacity,which is the key point to inhibit bone resorption and prevent bone marrow mesenchymal stem cells from differentiating into osteoclasts.Traditional Chinese medicine(TCM)has been used in the treatment of osteonecrosis in ancient times.It is recorded in the Treasury of Words on Materia Medica(《本草汇编》)that"The deficiency in the lower energizer cannot be tonified without Eucommiae Cortexz.The soreness in lower legs cannot be alleviated without Eucommiae Cortex...The pain in the waist and knee cannot be relieved without Eucommiae Cortex...Tonifying liver and invigorating kidney,Eucommiae Cortex is an essential medicine."This indicates that ancient physicians have already begun to use the liver-tonifying,kidneyinvigorating,and sinew-bone-strengthening effects of Eucommiae Cortex for the treatment of osteonecrosis.As the national support for the development of TCM strengthens,increasing studies have been conducted on the TCM prevention and treatment of steroid-induced osteonecrosis of femur head.Studies have suggested that Chinese medicinal herbs can exert a positive effect on the differentiation of bone marrow mesenchymal stem cells by affecting targeted signaling molecules,and promote osteogenesis and bone defect repair,thus combating the occurrence and development of steroid-induced osteonecrosis of femur head.The regulation of osteogenic signaling pathway by Chinese medicines to prevent steroid-induced osteonecrosis of femoral head has become a hot research topic.This article reviews the studies about the prevention and treatment of steroid-induced osteonecrosis of femur head with the active components in Chinese medicinal herbs by regulating osteogenic signaling pathways.We then explore the mechanism of the active components in promoting the differentiation of bone marrow mesenchymal stem cells into osteoblasts and inhibiting their differentiation into osteoclasts to facilitate bone formation,aiming to provide a reference for the further study of treating steroid-induced osteonecrosis of femoral head with Chinese medicinal herbs.