巨噬细胞极化在骨质疏松症中的研究进展

Research progress of macrophage polarization in osteoporosis

骨质疏松症(osteoporosis,OP)是一种严重威胁骨骼健康,增加骨折风险,对生活质量造成重大影响的慢性疾病。巨噬细胞作为免疫系统的重要成员,在特定刺激下极化为具有促炎特性的M1型巨噬细胞和具有抗炎和促修复特性的M2型巨噬细胞。M1/M2比例的失衡会引发骨吸收增加、骨密度下降和骨折风险升高等骨质疏松症的病理变化。笔者概述了巨噬细胞极化过程以及不同巨噬细胞分型在骨质疏松中的作用机制。M1巨噬细胞通过分泌TNF⁃α、IL⁃23和IL⁃1等炎性因子、触发RANKL/OPG系统并促进破骨细胞分化并抑制骨生成细胞的作用,从而加剧骨质疏松发展。M2巨噬细胞通过分泌BMP2、TGF⁃β和IL⁃4等炎性因子,刺激NF⁃κB等信号通路,抑制破骨细胞的激活并促进成骨细胞的活性,改善骨质疏松的状况。此外,笔者还介绍了巨噬细胞与其他细胞之间的通讯对骨形成的影响。针对巨噬细胞极化,笔者从化学药物、生物活性分子以及中药领域分别介绍了通过调控巨噬细胞M1/M2比率治疗和预防骨质疏松的最新策略,期望为骨质疏松症的治疗提供新的视角和方向。

Osteoporosis(OP)is a chronic disease that seriously threatens bone health,increases the risk of fractures,and significantly impacts quality of life.Macrophages,as important members of the immune system,polarize into pro⁃inflammatory M1 macrophages and anti⁃inflammatory and pro⁃repair M2 macrophages under specific stimuli.Imbalance in the M1/M2 ratio lead to pathological changes in osteoporosis,including increased bone resorption,decreased bone mineral density,and increased risk of fractures.This article provides an overview of macrophage polarization and the mechanisms of different macrophage subtypes in osteoporosis.M1 macrophages secrete inflammatory factors such as TNF⁃α,IL⁃23,and IL⁃1,trigger the RANKL/OPG system,promote osteoclast differentiation,and inhibit osteoblasts,thereby exacerbating the development of osteoporosis.On the other hand,M2 macrophages secrete inflammatory factors such as BMP2,TGF⁃β,and IL⁃4,stimulate signaling pathways like NF⁃κB,inhibit osteoclast activation,and promote osteoblast activity,relieving the condition of osteoporosis.Additionally,this article discusses the communication between macrophages and other cells and its impact on bone formation.Regarding macrophage polarization,this article introduces the latest strategies in the fields of chemical drugs,bioactive molecules,and traditional Chinese medicine for the treatment and prevention of osteoporosis by regulating the M1/M2 ratio of macrophages.It aims to provide new perspectives and directions for the treatment of osteoporosis.