激素型骨坏死与氧化应激

Hormonal osteonecrosis and oxidative stress

背景:糖皮质激素诱导骨坏死的确切机制尚不清楚,氧化应激是重要的机制之一。目的:综述目前已知相关文献,总结激素型骨坏死与氧化应激之间的关系,了解氧化应激在激素型骨坏死中的发病机制。方法:检索中国知网、万方、维普、中国生物医学文献数据库和Pub Med数据库中与激素型骨坏死和氧化应激的研究进展相关的文献,并通过阅读摘要进行初筛,最终共纳入96篇文章进行综述分析。结果与结论:(1)活性氧将间充质干细胞、骨细胞、成骨细胞、破骨细胞及血管之间所形成的信号交流网络紧密地联系在一起,抑制其成骨和血管生成,从而在激素型股骨头坏死中发挥着重要作用;(2)文章分别阐释了活性氧在骨代谢中的作用情况,其主要通过Wnt/β-catenin、MAPK、核转录因子κB和PI3K/AKT等信号通路调控骨代谢中的细胞增殖、凋亡及分化,从而介导糖皮质激素所导致的骨形成和吸收失衡;(3)由于目前激素型骨坏死的机制比较复杂,其具体机制过程尚未明确;另外由于目前技术限制,抗氧化策略并未对疾病产生非常显著的影响;(4)未来应基于现有的相关机制,进一步了解氧化应激在激素型股骨头坏死骨组织损伤中的机制研究;并进一步分析活性氧参与调控的不同信号通路,从而为临床治疗骨坏死提供治疗靶点的研究方向。

BACKGROUND:The exa ct mechanism of glucoco rticoid induced osteonecrosis is still unclea r,and oxidative stress is one of the important mechanisms.OBJECTIVE:To summarize the relationship between hormonal osteonec rosis and oxidative stress,and to understand the pathogenesis of oxidative stress in hormonal osteonecrosis by reviewing the currently known relevant lite rature.METHODS:CNKI,Wanfang,VIP,CBM and PubMed databases were searched for articles rega rding research progress of hormonal osteonecrosis and oxidative stress.After preliminarily sc reened by reading abstra cts,a total of 96 articles were finally included for review.RESULTS AND CONCLUSION:(1)Reactive oxygen species closely links the signal network formed by mesenchymal stem cells,osteocytes,osteoblasts,osteoclasts,and blood vessels to inhibit their osteogenesis and angiogenesis,thus playing an important role in steroid-induced femoral head necrosis.(2)The article explains separately the role of rea ctive oxygen species in bone metabolis m,which mainly regulates cell proliferation,apoptosis and differentiation in bone metabolism through Wnt/β-catenin,MAPK,nuclear facto r-KB and PI3K/AKT signaling pathways,thus mediating bone formation and resorption imbalance induced by glucocorticoid.(3)Due to the complex mechanism of hormone osteonecrosis at present,the specific mechanism and process are not clea r In addition,due to the current technical limitations,antioxidant strategies have not had a significant impact on the disease.(4)The mechanism of oxidative stress in steroid-induced osteonecrosis of the femoral head should be further studied based on existing mechanisms.Furthermore,diffe rent signaling pathways involved in reactive oxygen species regulation were further analyzed to provide therapeutic targets for clinical treatment of osteonecrosis.