重组人甲状旁腺激素(1-34)促成骨作用及在口腔领域的应用

Recombinant human parathyroid hormone(1-34): pro-osteogenic action and application in oral field

背景:重组人甲状旁腺激素(1-34)(recombinant human parathyroid hormone 1-34,rhPTH 1-34),即特立帕肽,为甲状旁腺激素氨基端片段,作为骨合成代谢药,因可以直接刺激新骨形成、增加骨量而成为研究热点,也因其强大的成骨效应引起口腔领域的关注与应用。目的:对特立帕肽的成骨机制、有效性和安全性及其在口腔领域的研究进展进行综述。方法:第一作者检索近20年PubMed数据库、万方数据库收录的相关文章。英文检索词为"rhPTH(1-34),teriparatide,osteoporosis,stomatology,Jaw,implant-osseointegration,periodontal",中文检索词为"重组人甲状旁腺激素(1-34),特立帕肽,骨质疏松,口腔医学,颌骨,种植体-骨结合,牙周"。共选取56篇文献进行综述。结果与结论:特立帕肽可以直接刺激新骨的成骨细胞形成,实现有效的合成代谢,其在口腔领域的研究表现出良好的促进种植体-骨结合、牙周再生、骨缺损愈合及提高正畸稳定性的效果,在口腔领域有良好的应用前景,但仍需要更多更高质量的动物实验及临床研究证实。未来甲状旁腺激素类药物及其类似物可与骨组织工程技术有机结合,更好地促进骨修复,同时也更好地服务于口腔颌面部的修复治疗。

BACKGROUND:Recombinant human parathyroid hormone 1-34(rhPTH 1-34),also known as teriparatide,is the amino terminal fragment of parathyroid hormone.Teriparatide,as a bone anabolic drug,has become a research hotspot because it can directly stimulate new bone formation and increase bone mass.It also attracts attention and application in the oral field due to its strong osteogenesis effect.OBJECTIVE:To review the osteogenic mechanisms,efficacy and safety of teriparatide and its research progress in the oral field.METHODS:The first author searched the Pub Med and Wan Fang databases for relevant literature published over the past two decades.The keywords were"rh PTH(1-34);teriparatide;osteoporosis;stomatology;Jaw;implant-osseointegration;periodontal"in English and Chinese,respectively.Fifty-six eligible articles were finally reviewed.RESULTS AND CONCLUSION:Teriparatide can directly stimulate the formation of osteoblasts in new bone and achieve effective anabolic metabolism.Studies of teriparatide in the oral field have shown good results in promoting implant-osseointegration,periodontal regeneration,bone defect healing and the stability of orthodontics,but increasing high-quality animal experiments and clinical studies are still needed.Future use of parathyroid hormone drugs and their analogues can be combined with bone tissue engineering technology to provide favorable effects in bone repair as well as in oral and maxillofacial repair.