转化生长因子5在发育性髋关节发育不良中的作用研究进展

Progress on Effect of Transforming Growth Factor 5 in Developmental Dysplasia of the Hip

发育性髋关节发育不良(developmental dysplasia of the hip,DDH)是一种主要因髋臼、股骨近端和关节囊等存在结构性畸形而导致的不稳定关节病变,进而发展成为髋关节的脱位。髋关节内软骨发育不良、骨骼及肌腱的异常均可导致髋关节结构的畸形,最终造成DDH。因此,早期预防与诊断是DDH治疗的关键。研究表明,DDH具有遗传基础,其易感基因包括GDF5、HOXD9、COL2AL、PAPPA2等,其中遗传因子转化生长因子5(growth differentiation factor 5,GDF5)对软骨细胞的增殖、分化具有重要作用,是当前研究治疗DDH的热点之一。因而,了解GDF5基因对软骨发育及分化的影响,对于DDH的发病机制和治疗具有重要意义。基于此,综述了国内外近期探讨的GDF5在基因层面上对DDH的影响,以及通过关节内注射重组人GDF5等基于GDF5的DDH治疗方案,以期为DDH的临床治疗提供新的策略。

Developmental dysplasia of the hip(DDH)is an unstable joint disease mainly caused by structural deformities of acetabulum,proximal femur and joint capsule,which develops into dislocation of the hip.Dysplasia of cartilage in the hip joint,abnormal bones and tendons can lead to structural deformity of the hip joint,and eventually lead to DDH.Therefore,early prevention and diagnosis is the key to DDH treatment.Researches show that DDH has genetic basis,and its susceptible genes include GDF5,HOXD9,COL2AL,PAPPA2,etc.Among them,growth differentiation factor 5(GDF5)plays an important role in the proliferation and differentiation of chondrocytes,which is one of the hot spots in the treatment of DDH at present.Therefore,understanding the effect of GDF5 gene on cartilage development and differentiation is of great significance for the pathogenesis and treatment of DDH.Based on this,the progress of influence of GDF5 on DDH at the gene level was discussed recently at home and abroad,and the treatment schemes based on GDF5 such as intra-articular injection of recombinant human GDF5 were reviewed,in order to provide new strategies for clinical treatment of DDH.