基于骨免疫学论中医药抑制类风湿关节炎骨破坏的研究进展

Traditional Chinese Medicine in Inhibiting Bone Destruction in Rheumatoid Arthritis Based on Bone Immunology Theory:A Review

类风湿关节炎(RA)是一种以滑膜炎、软骨与骨破坏为主要病理表现的自身免疫性疾病,致残率较高。RA免疫及炎症反应与骨细胞代谢互为影响,其核心环节为破坏机体核因子κB受体活化因子配体/核因子κB受体活化因子/骨保护素(RANKL/RANK/OPG)信号通路的平衡,导致成骨细胞减少,以及破骨细胞凋亡减退及异常活化。西药目前以抑制炎症反应及相关细胞因子分泌,减缓疾病进展,但长期使用其不良反应难以忽视。中医药在防治骨破坏中研究逐步深入,但在基础及临床研究方面仍存在一定局限性。

Rheumatoid arthritis(RA)is an autoimmune disease characterized by synovitis,cartilage,and bone destruction,with a high rate of disability.The immune and inflammatory responses in RA interact with bone cell metabolism,with a key mechanism involving the imbalance in the receptor activator of nuclear factor-κB ligand(RANKL)/RANK/osteoprotegerin(OPG)signaling pathway.This imbalance leads to decreased osteoblasts and increased osteoclast apoptosis and abnormal activation.While western medicine primarily focuses on inhibiting inflammatory responses and related cytokine secretion to slow disease progression,long-term use is associated with notable adverse effects.Research into traditional Chinese medicine(TCM)for preventing and treating bone destruction in RA has advanced,but both basic and clinical research still face certain limitations.