Piezo1蛋白在股骨头坏死发病机制中的意义

Significance of Piezo1 protein in the pathogenesis of osteonecrosis of femoral head

背景:机械敏感离子通道蛋白Piezo1参与骨科多种疾病的发生、发展,但在股骨头坏死发病机制中的作用尚未见系统报道。目的:分析机械敏感离子通道蛋白Piezo1在股骨头坏死发病及疾病进展中的作用,为临床早期预防及治疗股骨头坏死提供理论依据。方法:通过中文检索词“股骨头坏死”“Piezo1”“骨形成”“骨丢失”“血管新生”“炎症反应”以及英文检索词“osteonecrosis of femoral head”“Piezo1”“bone formation”“bone loss”“angiogenesis”“inflammation”在中国知网、PubMed等平台进行检索,共检索到文献1032篇,最终根据入组标准纳入92篇文献进行综述。结果与结论:(1)Piezo1可以通过细胞外环境的力学机械刺激,影响成骨细胞、破骨细胞和内皮细胞的分化与增殖,从而参与创伤性股骨头坏死的发展过程;(2)Piezo1能够介导炎症途径来调控激素性股骨头坏死和酒精性股骨头坏死的发展进程;(3)结果表明,在不同诱因导致的股骨头坏死疾病中,Piezo1能通过不同方式参与该疾病的病理进展过程,Peizo1有可能成为预防及治疗股骨头坏死的新靶点。

BACKGROUND: Piezo1, a mechanically-sensitive ion channel protein, participates in the occurrence and development of many orthopedic diseases, but its role in the pathogenesis of osteonecrosis of femoral head has not been systematically reported.OBJECTIVE: To analyze the significance of Piezo1 in the pathogenesis and progression of osteonecrosis of femoral head, providing theoretical basis for the early clinical prevention and treatment of osteonecrosis of femoral head.METHODS: The Chinese and English search words “osteonecrosis of femoral head” “Piezo1” “bone formation” “bone loss” “angiogenesis” “inflammation” were searched on CNKI and PubMed. A total of 1 032 papers were retrieved, and 92 papers were finally included according to the inclusion criteria for the review. RESULTS AND CONCLUSION:(1) Piezo1 can participate in the development of trauma-induced osteonecrosis of femoral head by influencing the differentiation and proliferation of osteoblasts, osteoclasts and endothelial cells through mechanical stimulation of the extracellular environment.(2) Piezo1 mediates inflammatory pathways to regulate the development of steroid-induced and alcohol-induced osteonecrosis of femoral head.(3) It is suggested that Piezo1 may participate in the pathological process of osteonecrosis of femoral head caused by different pathogenic factors in different ways, to provide a new target and direction for the treatment of osteonecrosis of femoral head.