从铁死亡探讨独活寄生汤防治骨关节炎的机制

Mechanism of Duhuo Jisheng Decoction in Prevention and Treatment of Osteoarthritis from Perspective of Ferroptosis

铁死亡通过与脂质过氧化、炎症反应和氧化应激等相互作用,造成软骨退变、滑膜炎和细胞外基质降解,加速骨关节炎(osteoarthritis,OA)的病情进展。铁死亡是造成软骨细胞死亡的重要原因,且主要与活性氧聚集、细胞结构破坏有关,并在滑膜增生及细胞外基质降解中发挥作用。从铁死亡的角度抑制炎症、氧化应激等,为OA的治疗提供新的靶点。独活寄生汤通过抑制炎症反应、氧化应激,调控自噬、凋亡等机制,改善软骨退变,延缓OA进程。既往关于独活寄生汤的研究大多相对孤立,无法体现中医治疗的整体观念,而铁死亡的出现则将各种病理机制联系到一起,不仅有利于OA机制的研究,也为独活寄生汤防治OA的研究提供新的思路,更能体现中医整体观念及中医药多靶点、多通路的特性。但目前关于铁死亡及其对OA的影响研究尚不够全面,不同机制间的串扰更是错综复杂,需要进一步完善和挖掘。

Ferroptosis causes cartilage degeneration,synovitis,and extracellular matrix degradation through interactions with lipid peroxidation,inflammatory reactions,and oxidative stress,accelerating the progression of osteoarthritis(OA).Ferroptosis is an important cause of chondrocyte death,mainly related to the aggregation of reactive oxygen species,cell structure destruction,and plays a role in synovial hyperplasia and extracellular matrix degradation.Inhibiting inflammation and oxidative stress from the perspective of Ferroptosis provides new targets for the treatment of OA.Duhuo Jisheng Decoction improves cartilage degeneration and delays the process of OA by inhibiting inflammatory reactions,oxidative stress,regulating autophagy,apoptosis,and other mechanisms.Previous studies on Duhuo Jisheng Decoction have mostly been relatively isolated and cannot reflect the overall concept of traditional Chinese medicine treatment.However,the emergence of Ferroptosis links various pathological mechanisms together,which not only benefits the study of OA mechanisms but also provides new ideas for the study of Duhuo Jisheng Decoction in prevention and treatment of OA.It can also reflect the overall concept of traditional Chinese medicine and the characteristics of multiple targets and pathways in traditional Chinese medicine.However,the current research on Ferroptosis and its impact on OA is not comprehensive enough,and the crosstalk between different mechanisms is even more complex,requiring further improvement and exploration.