5-羟色胺选择性重摄取抑制剂对骨代谢的影响及机制

Effect and mechanism of serotonin-selective reuptake inhibitor on bone metabolism

5-羟色胺选择性重摄取抑制剂(SSRI)是治疗抑郁症的一线药物,主要包括氟西汀、帕罗西汀、舍曲林、氟伏沙明、西酞普兰、艾司西酞普兰等。SSRI对骨代谢具有双重影响,短期使用可能会对骨骼有积极影响,但若长期使用可能导致骨骼问题。本文总结了SSRI对骨代谢的影响及其机制,可知SSRI能影响骨形成、骨吸收、间充质干细胞分化以及调节炎症细胞因子表达,并通过cAMP/PKA/CREB、Wnt/β-catenin、BMP/Smad、OPG/RANKL/RANK等经典信号通路以及中枢介导作用影响骨代谢。

Serotonin-selective reuptake inhibitor(SSRI)is the first-line drug for treating depression.SSRI mainly include fluoxetine,paroxetine,sertraline,fluvoxamine,citalopram and escitalopram,etc.SSRI has dual impact on bone metabolism.Shortterm use of SSRI may have a positive impact on bone,but long-term use may lead to bone problems.This article summarizes the effects and mechanisms of SSRI on bone metabolism,indicating that SSRI can affect bone formation,bone resorption,mesenchymal stem cell differentiation,and regulate the expression of inflammatory cytokines.The impact of SSRI on bone metabolism can be achieved by affecting classical signaling pathways such as cAMP/PKA/CREB,Wnt/β-catenin,BMP/Smad,OPG/RANKL/RANK,and through centrally mediated effects.