基于“肾主骨”理论的FGF23-Klotho轴调控Wnt/β-catenin信号通路与CKD-MBD的关系探讨

Exploring the Relationship Between FGF23-Klotho Axis Regulation of Wnt/β-catenin Signaling Pathway and CKD-MBD Based on the“Kidney Governing Bones”Theory

CKD-MBD是慢性肾脏病的常见并发症之一,因其具有高发病率及高死亡率的特点而引起医学工作者的广泛关注。在慢性肾脏病中,由Klotho降低和FGF23升高所引起的FGF23-Klotho轴失调、Wnt/β-catenin信号紊乱是导致CKD-MBD发病和进展的关键因素。“肾主骨”理论源于古籍《黄帝内经》,是先贤医家对肾与骨之间生理及病理关系的深刻总结,从肾论治骨病亦是历代医家沿用的治病法则之一。且FGF23-Klotho信号轴亦将肾脏与骨骼的生理、病理紧密连接,表明FGF23-Klotho轴与“肾主骨”理论的内涵联系密切。从“肾主骨”理论角度探讨FGF23-Klotho轴调控Wnt/β-catenin信号通路与CKD-MBD的关系,深化对“肾主骨”理论的认识,以期丰富中医药从肾论治CKD-MBD的相关理论。

CKD-MBD is one of the common complications of chronic kidney disease,which has attracted widespread attention from medical practitioners because of its high morbidity and mortality.In chronic kidney disease,the dysregulation of the FGF23-Klotho axis and Wnt/β-catenin signaling caused by decreased Klotho and elevated FGF23 are key factors leading to the pathogenesis and progression of CKD-MBD.The theory of“kidney governing bones”originated from the ancient book Huangdi Neijing,which is a profound summary of the physiological and pathological relationship between kidney and bone by sages and scholars.Treating bone diseases from the kidney is also one of the treatment principles used by doctors of all dynasties.The FGF23-Klotho signaling axis also closely links the physiology and pathology of kidney and bone,indicating that the FGF23-Klotho axis is closely related to the connotation of the“kidney governing bones”theory.To explore the relationship between the regulation of the Wnt/β-catenin signaling pathway by the FGF23-Klotho axis and CKD-MBD from the perspective of the“kidney governing bones”theory,deepen the understanding of the“kidney master bone”theory,in order to enrich the theoretical content of TCM treating CKD-MBD from kidney.