移植治疗骨质疏松研究进展

Research progress in the treatment of osteoporosis with transplantation

随着人口老龄化,我国已居世界骨质疏松症患者数量的首位。目前针对原发性骨质疏松的治疗大部分是通过药物改善症状,尚没有研究出快速而确切的疗法。本文综述了近十年来对于骨质疏松发病机制和新的治疗方法探索的新进展。其中,从细胞水平对骨质疏松的发病机制研究表明,骨质疏松的发生与干细胞机能紊乱密切相关。干细胞以及骨髓基质机能紊乱以及功能不足,导致多种促进成骨的因子生成不足,引起成骨细胞生成障碍、破骨细胞和脂肪细胞生成活跃,进而导致骨量减少、骨组织显微结构的异常形成骨质疏松。对于骨质疏松细胞水平发病机制的研究,促使了包括骨髓移植、干细胞移植、成骨细胞移植在内的应对骨质疏松新策略的产生。研究者尝试补充功能结构完整的骨髓、骨髓基质、干细胞、成骨细胞等进入骨质疏松者体内,从而调节机能紊乱、补足功能和成骨诱导生长因子的不足,以此达到预防和治疗骨质疏松的目的。

With the ageing of the population, in our country we have the most osteoporosis patients in the world. By now, mostly we have used medicines to alleviate symptoms related to the primary osteoporosis. No rapid and efficient therapy have been developed. This paper reviews new development in the pathogenesis and treatment of osteoporosis. Among others, researches at the cellular level demonstrate that the occurrence of osteoporosis is related with the disordered function of the stem cell. The disordered function of the stem cell and the bone marrow stroma cause the deficiency of factors related to bone formation, leading to the impaired formation of osteoblasts, active proliferation of osteoclasts and fat cells. All of these result to bone loss, abnormal bone microstructure, and the occurrence of osteoporosis. Investigations of pathogenesis of osteoporosis at the cellular level promote the development of new stretigies for treating osteoporosis, including transplantation of bone marrow, stem ceils, and osteoblasts. The researchers try to transplant the normal bone marrow, or bone matrix, or stem cells, or osteoblasts to patients with osteoporosis, in order to regulate the disordered function, and supply the factors that can stimulate bone growth, and finally to prevent and cure osteoporosis.