中药调控JAK/STAT信号通路治疗骨关节炎的研究进展

Progress in regulation of JAK/STAT signaling pathway by traditional Chinese medicine in treatment of osteoarthritis

骨关节炎(osteoarthritis,OA)涵盖了多部位病变,包括关节软骨、韧带、关节囊和滑膜组织等病变,产生骨赘和骨硬化等现象,致使关节软骨受损。OA主要表现为关节间隙狭窄、滑膜炎症、软骨重塑和分解,伴随着关节周围肌肉组织发生改变。OA主要发生在膝、髋、手和脊柱等部位,临床表现以关节的慢性疼痛、局部肿胀僵硬伴活动受限,甚至影响关节功能活动,影响患者日常活动[1]。

Osteoarthritis(OA)mainly lies in the lesions of articular cartilage and surrounding tissues,producing osteophytes and bone sclerosis,resulting in damage to the articular cartilage.The main pathological mechanism of OA rests with a large number of inflammatory cytokines and inflammatory mediators produced by joint synovial lesions as well as pathological vascular growth at the junction of the synovium and cartilage,which may be one of the key reasons for promoting synovitis and cartilage damage.The OA mainly occurs in the knees,hips,hands and the spine.It is mainly manifested by chronic joint pain,swelling and stiffness,and limitation of motion seriously affects the functional activities of patients.The treatment of OA mainly relies on oral administration or intraarticular injection of drugs to relieve symptoms.When OA develops to the middle and late stages,the action and life of patients will be seriously affected.Therefore,surgical replacement of joints is considered to ensure the basic life demands of patients.Studies show that traditional Chinese medicine(TCM)treatment has attracted widespread attention and application due to its unique advantages in prevention and treatment of OA.Janus kinase(JAK)/signaling transduction and transcriptional activator(STAT)signaling pathway may be one of the important signaling pathways that regulate the chondrocyte proliferation,differentiation and apoptosis.Moreover,it is closely associated with intra-articular inflammatory response.The JAK/STAT signaling pathway regulates the expression of inflammatory factors and related proteins through TCM so as to reduce the inflammatory response and decrease the chondrocyte damage.It has an important reference value for OA treatment.In this paper,the roles and mechanisms of the TCM monomers and active ingredients and the Chinese herbal compounds in OA by regulating JAK/STAT signaling pathway and affecting related cytokine and protein expression levels have been reviewed,providing a new method and direction for TCM treatment of OA.