骨质疏松基础研究的现状与展望

Current situation and prospect of basic research on osteoporosis

骨质疏松症是一种严重危害老年人健康的疾患。目前临床上治疗骨质疏松的药物主要有骨矿化促进药、骨吸收抑制药和骨形成促进药,可供选择种类仍然有限,亟待更多的基础研究成果向临床转化。本文将阐述骨质疏松基础领域新的潜在的治疗靶点和相关机制的研究现状:(1)骨质疏松发生发展的病理生理机制:骨重塑过程中的免疫调节(RANK/RANKL通路和WNT通路);(2)单克隆抗体生物制剂研究(抗骨硬化蛋白Romosozumab)与骨质疏松;(3)细胞因子(骨形态发生蛋白、转化生长因子-β、生长激素和胰岛素样生长因子-1)与骨质疏松;(4)转录因子(GATA4、SFRP1、Tph1和DDK1)与骨质疏松;(5)干细胞与骨质疏松;(6)其他:"骨骼-肠道菌群"调节轴和miRNAs等。

Osteoporosis is a severe disease for the aged people worldwide.There are only three alternatives,namely mineralization drugs,anti-resorptions and bone formation promoters.More basic achievements need to be proved efficiently in patients.We summarized the front basic research of osteoporosis such as the new potential treatment targets and the related mechanism.Firstly,we summarized the progress about the physiopathologic research including the immune regulation of bone remodeling namely RANK/RANKL pathway and WNT signal pathway.Secondly,the monoclonal antibody biology drugs benefit the osteoporosis.Thirdly,cytokines including bone morphogenetic protein,transforming growth factor,growth hormone and insulin-like growth factor influence the bone formation and resorption.Fourthly,transcriptions such as GATA4,SFRP1,Tph1 and DDK1 are also related with osteoporosis.Fifthly,mesenchymal stem cells play roles in the etiopathology of osteoporosis and their potential use for the treatment of this disease is discussed.Lastly,the relationship between bone-gut microbiome axis and miRNAs and osteoporosis is described.