中药多糖类成分干预骨质疏松症的作用机制分析

Analysis of the mechanism of polysaccharides from traditional Chinese medicine in the intervention of osteoporosis

骨质疏松症(osteoporosis,OP)是临床常见的代谢性疾病。研究发现,成骨细胞介导的骨生成与破骨细胞介导的骨吸收之间的失衡是OP发生发展的关键病理机制,该过程涉及一系列复杂且高度调节的细胞因子及信号通路。针对骨骼稳态的各种调控机理,临床上主要采用降钙素、双膦酸盐等治疗OP。但是,很多药品存在一定的不良反应,或不适宜长期服用。OP可由过度饮酒、糖皮质激素滥用及雌激素缺乏等引起。实验证实,中药可通过改善雌激素分泌、微量元素代谢以及调节免疫应激而治疗OP。多糖类成分作为中药内独特的大分子物质,具有抑癌、消炎及抗氧化损伤等生物活性,可通过抑制成骨细胞凋亡、促进成骨细胞分化、抑制破骨细胞活性、抗氧化应激及调节免疫炎症等途径调控骨稳态,有效遏制绝经后骨质疏松症(POP)、糖皮质激素性骨质疏松症(GIOP),为OP的临床治疗提供了新思路。故本文通过检索相关中英文文献,系统综述了成骨-破骨细胞稳态失衡导致OP,中药多糖通过上述途径调衡骨组织稳态而治疗OP,旨在为中药多糖干预OP提供科学依据。

Osteoporosis(OP)is a common metabolic disease in clinic.Studies have found that the imbalance between osteoblast-mediated osteogenesis and osteoclast-mediated bone resorption is the key pathological mechanism of the occurrence and development of OP,which involves a series of complex and highly regulated cytokines and signal pathways.According to the various regulation mechanisms of bone homeostasis,calcitonin and bisphosphonate are mainly used to treat OP.However,many drugs have certain side effects or are not suitable for long-term use.OP may be caused by excessive drinking,glucocorticoid abuse,and estrogen deficiency.Experiments have proved that traditional Chinese medicine may treat OP by improving estrogen secretion,trace element metabolism,and regulating immune stress.As unique macromolecular substances in traditional Chinese medicine,polysaccharides have biological activities such as anti-cancer,anti-inflammation,and antioxidant injury.They regulate bone homeostasis by inhibiting osteoblast apoptosis,promoting osteoblast differentiation,inhibiting osteoclast activity,antioxidant stress,and regulating immune inflammation,and effectively curb postmenopausal osteoporosis(POP)and glucocorticoid-induced osteoporosis(GIOP).It provides a new idea for the clinical treatment of OP.Therefore,by searching the relevant Chinese and English literature,this paper systematically reviews the imbalance between osteoblast and osteoclast homeostasis leading to OP.Traditional Chinese medicine polysaccharides regulate bone tissue homeostasis and treat OP through the above ways.This provides a scientific basis for the intervention with traditional Chinese medicine polysaccharides in OP.