骨硬化蛋白与骨质疏松:治疗的新方向

Sclerostin: a new hope for the treatment of osteoporosis

背景:骨硬化蛋白的研究为骨质疏松的治疗提供了一个新的方向,通过促进骨生成,抑制骨吸收改善骨质疏松。目的:系统梳理骨硬化蛋白与骨质疏松相关文献,为进一步研究和促进骨硬化蛋白应用于骨质疏松的临床治疗和预防提供理论支持,提高骨质疏松的诊断和治疗效果。方法:以"Osteoporosis,Sclerostin,Sclerosteosis,Wnt/β-catenin,LRP5/6,Sclerostin antibody,Sclerostin and life style,Romosozumab、Blosozumab"为英文检索词,检索Pub Med数据库相关文献,经过筛选对其中的58篇文献进行分析探讨。结果与结论:(1)骨硬化蛋白的缺失或合成减少能促进骨的生成,骨硬化蛋白抗体在动物实验和临床试验中表现良好,能很好的促进骨生成,抑制骨吸收;(2)临床Ⅲ期试验结果支持前期试验所表现出的骨硬化蛋白单克隆抗体在骨代谢中的双重作用,表现出较好的治疗骨质疏松的应用前景;(3)研究发现血清骨硬化蛋白水平与生活方式关系密切,具体的对应关系还需进一步的验证;(4)大量的实验结果支持骨硬化蛋白应用于临床,骨硬化蛋白的研究为骨质疏松的预防和治疗提供一个新的方向。

BACKGROUND:Sclerostin has been shown to promote bone formation and decrease bone resorption,which provides a new idea for the treatment of osteoporosis.OBJECTIVE:To review the literatures related to sclerostin and osteoporosis,thereby providing theoretical basis for sclerostin applied in the treatment and prevention of osteoporosis,so as to improve the diagnosis and curative efficacy of osteoporosis.METHODS:PubMed database was searched using the keywords of“osteoporosis,sclerostin,sclerosteosis,Wnt/β-catenin,LRP5/6,sclerostin antibody,sclerostin and expertise,romosozumab,blosozumab”.Finally,58pertinent articles were enrolled for analysis.RESULTS AND CONCLUSION:Sclerostin inhibits bone formation,so anti-sclerostin antibody is utilized,and animal experiments and clinical trials have shown that it can promote bone formation and inhibit bone reaorption.PhaseIII trial results potentially signify a significant step in achieving market approval,which support the preclinical and clinical emergence of sclerostin antibody therapies for both osteoporosis and alternative applications.The serum level of sclerostin is found to be closely related to lifestyle,but still need to be studied in depth.Increasing trial results show that sclerostin is the promising therapeutic candidate,which provides a new direction in the prevention and treatment of osteoporosis.