褪黑素介导抗炎、抗氧化、抗骨质疏松作用在椎间盘退变修复中的研究进展

Research progress on anti-inflammatory,antioxidant and anti-osteoporosis effects of melatonin in the repair of intervertebral disc degeneration

目前,椎间盘退行性疾病(disc degeneration disease,DDD)已成为临床上中老年人的常见病,且发病年龄有年轻化趋势。椎间盘退变(intervertebral disc degeneration,IDD)是指椎间盘(intervertebral disc,IVD)在内外部因素共同作用下引起的老化、退化等一系列生理、病理过程,被认为是DDD的基本病理过程,是引发患者腰痛的主要原因,因此修复IDD是治疗DDD的重点。IDD过程中伴随着炎症介质的产生、炎症相关信号通路的活化以及氧化应激的发生。褪黑素作为一种吲哚类激素,具有显著的抗炎及抗氧化作用,近年来受到研究者关注,越来越多的研究表明褪黑素对IVD具有保护作用,对治疗骨质疏松症(osteoporosis,OP)也有一定的作用,其有望成为IDD修复的治疗药物。笔者拟对褪黑素在椎间盘退变修复中的最新研究进展做一综述,以期为后续研究及IDD的早期药物干预和修复治疗策略提供思路。

At present,Disc degeneration disease(DDD)has become a common clinical disease in the senior citizen,and the onset age tends to be younger.Intervertebral disc degeneration(IDD)refers to a series of physiological and pathological processes such as aging and degeneration caused by internal and external factors,which is considered to be the basic pathological process of DDD.The repair of IDD is the focus of DDD treatment,because IDD is the main reason of low back pain in patients.The process of IDD is accompanied by the production of inflammatory mediators,the activation of inflammation-related signaling pathways and the effects of oxidative stress.As an indole-like hormone,melatonin has significant anti-inflammatory and antioxidant effects,which has attracted the attention of researchers in recent years.More and more studies have shown that melatonin has a protective effect on IVD and Osteoporosis,and is expected to become a therapeutic drug for IDD repair.In this review,we reviewed the latest research progress of melatonin in the repair of IDD,in order to provide ideas for subsequent studies and early drug intervention and repair treatment strategies of IDD.