Imbalance of osteoprotegerin/receptor activator of nuclear factor-κB ligand and oxidative stress in patients with obstructive sleep apnea-hypopnea syndrome

Background:Obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with a higher prevalence of osteoporosis.However,the underlying mechanisms linking OSAHS with bone loss are still unclear.The aim of this study was to investigate the changes of receptor activator of nuclear factor-κB ligand (RANKL,an osteoclastogenesis-promoting factor) and osteoprotegerin (OPG,the decoy receptor for RANKL),oxidative stress and bone metabolism markers in OSAHS,in order to understand the potential mechanisms underlying bone loss in OSAHS patients.Methods:Forty-eight male patients with OSAHS,confirmed by polysomnography (PSG) study,were enrolled.Twenty male subjects who were confirmed as not having OSAHS served as the controls.The subjects’bone mineral density (BMD) was assessed in lumbar spine and femoral neck using dual-energy X-ray absorptiometry (DXA).Blood samples were collected from all subjects for measurement of RANKL,OPG,the bone formation marker bone-specific alkaline phosphatase (BAP),the bone resorption marker tartrate-resistant acid phosphatase 5b (TRAP-5b),and total antioxidant capacity (TAOC).Results:The BMD and the T-score of the femoral neck and the lumbar spine were significantly lower in OSAHS patients as compared to the control group (P< 0.05).The serum level of BAP was significantly decreased in the OSAHS group (15.62 ± 5.20 μg/L) as compared to the control group (18.83 ± 5.50 μg/L,t= -2.235,P< 0.05),while the levels of TRAP-5b did not differ between the two groups (t= -1.447,P> 0.05).The serum level of OPG and the OPG/RANKL ratio were lower in the OSAHS group compared to the control group (bothP< 0.05).TAOC level was also decreased significantly in the OSAHS group (P< 0.05).Correlation analysis showed that the TAOC level was positively correlated with BAP in the OSAHS group (r= 0.248,P= 0.04),but there were no correlations between TAOC and the BMD or the T-scores.The correlations between the level of OPG (or the OPG/RANKL ratio) and BMD or TAOC did not reach significance.Conclusion:In OSAHS patients,lower levels of TAOC were associated with decreased bone formation,suggesting a role of oxidative stress in bone loss,while the role of OPG/RANKL imbalance in bone metabolism in OSAHS needs further evaluation .

Influence of baicalin on the expression of receptor activator of nuclear factor-κB ligand and osteoprotegerin in human periodontal ligament cells

Objective To study the effect of baicalin on the expression of receptor activator of nuclear factor-κB ligand(RANKL)and osteoprotegerin(OPG)in cultured human periodontal ligament(HPDL)cells.Methods Small interfering RNA(siRNA)eukaryotic expression vector targeted transforming growth factor βⅡ receptor(TGF-β RⅡ)was constructed and transfected into T cells.HPDL cells with T cells transfected with siRNA or not were placed in the culture medium that had been added with lipopolysaccharide(LPS)and baicalin.The obtained solution was divided into six groups according to the components(group Ⅰ:HPDL cells+LPS+T cells transfected with siRNA1+baicalin;group Ⅱ:HPDL cells+LPS+T cells transfected with siRNA1;group Ⅲ:HPDL cells+LPS+T cells+baicalin;group Ⅳ:HPDL cells+LPS+T cells;group Ⅴ:HPDL cells+baicalin;group Ⅵ:HPDL cells)and was cultured for 48 hours.RT-PCR was used to observe the effect of baicalin on the expression of OPG-RANKL in HPDL cells.Results The ratio of RANKL/OPG in group Ⅰ was lower than that in group Ⅱ(P<0.01)and higher than that in group Ⅲ(P<0.01);The ratio of RANKL/OPG in group Ⅲ was lower than that in group Ⅳ(P<0.01);the ratio of RANKL/OPG in group Ⅳ was higher than that in group Ⅵ(P<0.01);the ratio of RANKL/OPG in group Ⅴ was lower than that in group Ⅵ(P<0.05).Conclusion ① Baicalin could decrease the ratio of RANKL/OPG in HPDL cells.② The TGF-β signaling transduction plays an important role in the effect of baicalin on the RANKL/OPG ratio in HPDL cells.③ Baicalin acts not only through TGF-β to regulate RANKL/OPG in HPDL cells,but also through other pathways.

Role of osteoprotegerin/receptor activator of nuclear factor kappa B/receptor activator of nuclear factor kappa B ligand axis in nonalcoholic fatty liver disease

Concomitantly with the increase in the prevalences of overweight/obesity, nonalcoholic fatty liver disease(NAFLD) has worldwide become the main cause of chronic liver disease in both adults and children. Patients with fatty liver display features of metabolic syndrome(Met S), like insulin resistance(IR), glucose intolerance, hypertension and dyslipidemia. Recently, epidemiological studies have linked obesity, Met S, and NAFLD to decreased bone mineral density and osteoporosis, highlighting an intricate interplay among bone, adipose tissue, and liver. Osteoprotegerin(OPG), an important symbol of the receptor activator of nuclear factor-B ligand/receptor activator of nuclear factor kappa B/OPG system activation, typically considered for its role in bone metabolism, may also play critical roles in the initiation and perpetuation of obesityrelated comorbidities. Clinical data have indicated that OPG concentrations are associated with hypertension, left ventricular hypertrophy, vascular calcification, endothelial dysfunction, and severity of liver damage in chronic hepatitis C. Nonetheless, the relationship between circulating OPG and IR as a key feature of Met S as well as between OPG and NAFLD remains uncertain. Thus, the aims of the present review are to provide the existent knowledge on these associations and to discuss briefly the underlying mechanisms linking OPG and NAFLD.

Increased Expression of Receptor Activator of Nuclear Factor-κB Ligand in Osteoblasts from Adolescent Idiopathic Scoliosis Patients with Low Bone Mineral Density

Persistent generalized low bone mineral density (BMD) has been reported in patients with adolescent idiopathic scoliosis (AIS).However,the exact mechanisms and causes of the low BMD in AIS patients are largely unknown.The purpose of this study was to examine the relationship between the receptor activator of NF-κB ligand (RANKL)/osteoprotegerin (OPG) levels in osteoblasts (OBs) from AIS patients with low BMD and with comparison made between the patients and controls.Twenty AIS patients and eight age-matched controls were included in the present study.The BMD of lumbar spine and proximal femur was measured in all subjects.OBs from the cancellous bone of each subject was harvested and primarily cultured.The mRNA and protein expression of RANKL and OPG in OBs was detected by RT-PCR and Western blotting.The results showed BMD was lower in AIS patients than in controls.A significantly higher mRNA and protein expression of RANKL was observed in OBs from AIS patients,while no significant difference was found in the expression of OPG between AIS patients and controls.As a result,RANKL/OPG ratio in patients with AIS was remarkably higher than controls.Our study preliminarily demonstrated expression of RANKL was higher in OBs from AIS patients with low BMD as compared with controls,suggesting the unbalanced RANKL/OPG ratio caused by an over-expression of RANKL in OBs may be responsible for the low BMD in AIS patients.

Effect of Triptolide on Expression of Receptor Activator of Nuclear Factor-κB Ligand in Rat Adjuvant Induced Arthritis

The effect of triptolide （TP） on the expression of receptor activator of nuclear factor-κB ligand （RANKL） and osteoprotegerin （OPG） was explored in rat adjuvant induced arthritis （AA）. AA was induced in Wistar rats. Arthritis rats were treated with TP and methotrexate （MTX） at the onset （day 9） of arthritis. On the peak of arthritis （day 24）, the expression of RANKL and OPG protein in the joints and RANKL mRNA in peripheral blood mononuclear cells （PBMC） was detected. TNF-α and IL-1β levels in peripheral blood were determined. Bone erosion scores were also evaluated. The results showed that bone erosion scores in TP and MTX groups were lower than in AA group （.P〈0.01） ; The expression levels of RANKL in the synovium （P〈0.01） and bone （P〈0.05）, and OPG level in synovium （P〈0.05） were lower in TP group than in AA group （P〈0.05）. In TP group, the expression levels of RANKL mRNA and TNF-α, IL-1β in PBMC were lower than in AA group （all P〈0.01）. It was concluded that TP could inhibit rat adjuvant arthritis bone erosion by suppressing the expression of RANKL.

Receptor activator of nuclear factorκB ligand/osteoprotegerin axis and vascular calcifications in patients with chronic kidney disease

Vascular calcifications are commonly observed in patients with chronic kidney disease(CKD) and contribute to the excessive cardiovascular morbidity and mortality rates observed in these patients populations. Although the pathogenetic mechanisms are not yet fully elucidated, recent evidence suggests a link between bone metabolism and the development and progression of vascular calcifications. Moreover, accumulating data indicate that receptor activator of nuclear factor κB ligand/osteoprotegerin axis which plays essential roles in the regulation of bone metabolism is also involved in extra-osseous bone formation. Further studies are required to establish the prognostic significance of the above biomarkers as predictors of the presence and severity of vascular calcifications in CKD patients and of cardiovascular morbidity and mortality. Moreover, randomized clinical trials are needed to clarify whether inhibition of osteoclast activity will protect from vascular calcifications.

骨保护素/核因子κB受体活化因子/核因子κB受体活化因子配体调节骨代谢及其靶向治疗在口腔领域的应用

背景:骨保护素/核因子κB受体活化因子/核因子κB受体活化因子配体是偶联破骨细胞、成骨细胞分化和活化的重要细胞因子,是调节骨代谢的关键因子,影响着免疫系统、骨的再生和重塑,与牙槽骨的生理性及病理性改建密切相关。目的:分析总结骨保护素/核因子κB受体活化因子/核因子κB受体活化因子配体信号通路对牙槽骨改建的影响及其靶向治疗在口腔领域应用研究中的进展。方法:检索中国知网及PubMed数据库收录的相关文献。中文检索词为“骨保护素,抗RANKL抗体,核因子κB受体活化因子配体,牙周炎,正畸牙移动,种植,牙齿萌出,根尖周病变,牙槽骨吸收”,英文检索词为“OPG,anti-RANKL antibody,RANKL,periodontitis,orthodontic tooth movement,implant,tooth eruption,periapical lesion,alveolar bone resorption”,最终纳入63篇文献进行归纳总结。结果与结论:①抗核因子κB受体活化因子配体通过靶向抑制破骨细胞形成和牙槽骨吸收来治疗口腔疾病;②局部和全身抗核因子κB受体活化因子配体治疗可以抑制牙周炎、种植体周围炎、根尖周病变的进展,且其在预防正畸后复发、增强正畸支抗和种植体骨结合方面也发挥重要作用;③核因子κB受体活化因子配体通过靶向促进破骨细胞分化来治疗口腔疾病;④核因子κB受体活化因子配体治疗可以加速正畸牙移动、缩短治疗周期、减少正畸并发症的发生;⑤虽然抗核因子κB受体活化因子配体治疗存在局限性,但是可以通过合理应用如应用前排除危险因素,应用期间定期口腔维护、避免创伤性牙槽手术等措施来规避。

Receptor activator of nuclear factor kappa B ligand and osteoprotegerin expression in chronic apical periodontitis：possible association with inflammatory cells

Background Receptor activator of nuclear factor kappa B （NF-κB） ligand （RANKL） and osteoprotegerin （OPG） have been recently shown to play important roles in bone resorption. The aim of this study was to investigate the possible association between the expression of bone resorption regulators （RANKL and OPG） and inflammatory cell infiltration in chronic apical periodontitis.Methods The samples of chronic periapical lesions （n=40） and healthy periapical tissues （n=10） were examined for immunohistochemical analysis of RANKL and OPG. Lesion samples were further analyzed for the inflammatory infiltration condition. The inflammatory cell infiltration was scored in relation to immunohistochemical reactivity for CD3, CD20 and CD68.Results The number of RANKL-positive cells and the ratio of RANKL/OPG in chronic apical periodontitis were significantly higher than those in healthy periapical tissues （P＜0.001）. The number of RANKL-positive cells was higher in lesions with severe inflammatory infiltration than in those with light inflammatory infiltration （P＜0.05）. Significantly increased RANKL expression was found with T lymphocytes （CD3＋）, macrophages （CD68＋） and B lymphocytes （CD20＋）infiltration （P＜0.05）. No association was found between the ratio of RANKL/OPG and inflammatory cell infiltration.Conclusions RANKL expression was increased with T, B lymphocytes and macrophages infiltration, respectively in chronic periapical lesions. RANKL appears to be closely related to periapical inflammatory infiltrates. The relative ratio of RANKL/OPG may be a key determinant of RANKL-mediated bone resorption.

Effect of Wenhua Juanbi Recipe(温化蠲痹方) on Expression of Receptor Activator of Nuclear Factor Kappa B Ligand,Osteoprotegerin,and Tumor Necrosis Factor Receptor Superfamily Member 14 in Rats with Collagen-Induced Arthritis

Objective： To study the effect of Wenhua Juanbi Recipe（温化蠲痹方, WJR） on expression of receptor activator of nuclear factor kappa B ligand（RANKL）, osteoprotegerin（OPG）, and tumor necrosis factor receptor superfamily member 14（TNFRSF14, also known as LIGHT） in rats with collagen-induced arthritis（CIA）. Methods： CIA rats were generated by subcutaneous injection of bovine collagen type-Ⅱ at the tail base. Sixty CIA rats were randomly assigned（10 animals/group） to： model, methotrexate（MTX）-treated（0.78 mg/kg body weight）, and WJR-treated（22.9 g/kg） groups. Healthy normal rats（n=10） were used as the normal control. Treatments or saline were administered once daily by oral gavage. Rats were sacrificed at day 28 post-treatment and knee synovium and peripheral blood serum were collected. Toe swelling degree and expression of RANKL, OPG, and LIGHT were determined by Western blot and immunohistochemistry. Results： Compared with the normal group, toe swelling degree was significantly increased in the model group（P〈0.01）. After treatment, toe swelling degree decreased significantly in the WJR and MTX groups compared with the model group（P〈0.01）. Compared with the normal group, expression of RANKL and LIGHT were significantly increased and OPG significantly decreased in peripheral blood and synovium of the model group（P〈0.01）. Conversely, RANKL and LIGHT expression were significantly reduced and OPG increased in the WJR and MTX groups compared with the model group（P〈0.01）. No statistically significant difference existed between WJR and MTX groups. Conclusion： WJR likely acts by reducing RANKL expression and increasing OPG expression, thus inhibiting RANKL/RANK interaction and reducing LIGHT expression, thereby inhibiting osteoclast formation/activation to block bone erosion.

2型糖尿病患者骨保护素和NF-κB受体活化因子配体与左室舒张功能障碍的相关研究

【目的】探讨2型糖尿病(T2DM)患者血清骨保护素(OPG)和可溶性NF-κB受体活化因子配体(sRANKL)水平与可能左室舒张功能障碍(LADD)的相关性。【方法】本研究纳入68例T2DM患者和37例健康对照者,利用ELISA方法测定血清OPG和sRANKL水平,同时利用心脏彩超测定T2DM患者左室舒张功能,E/A<1定义为LADD。进一步将T2DM患者分为E/A≥1和E/A<1两个亚组。采用Spearman相关性分析、logistics回归分析和ROC曲线评估血清OPG和sRANKL与T2DM患者可能LADD的相关性。【结果】与健康对照者相比,T2DM患者血清OPG水平明显升高,差异有统计意义(P<0.01),而sRANKL水平降低,但无统计学意义(P=0.032)。亚组分析则显示E/A<1组的OPG水平较E/A≥1组升高(P<0.01),而sRANKL降低(P<0.01)。Spearman相关性分析显示,血清OPG水平与E/A比值呈负相关,而sRANKL则与E/A比值呈正相关。单因素logistics回归分析显示,血清OPG水平[OR(95%CI)=1.068(1.031,1.106),P<0.001]和sRANKL水平[OR(95%CI)=0.976(0.959,0.992),P=0.003]与T2DM患者可能LVDD显著相关。ROC曲线分析显示,联合OPG与sRANKL诊断糖尿病患者可能LADD的敏感性为78.13%,特异性为88.3%(曲线下面积:0.857;95%CI=(0.768,0.946);P<0.001)。【结论】T2DM患者血清中升高的OPG和降低的sRANKL水平提示其可能与LADD相关。

Cannabinoid receptor-2 selective antagonist negatively regulates receptor activator of nuclear factor kappa B ligand mediated osteoclastogenesis

Background The cannabinoid receptor-2 （CB2） is important for bone remodeling. In this study, we investigated the effects of CB2 selective antagonist （AM630） on receptor activator of nuclear factor kappa B （RANK） ligand （RANKL）induced osteoclast differentiation and the underlying signaling pathway using a monocyte-macrophage cell line-RAW264.7.Methods RAW264.7 was cultured with RANKL for 6 days and then treated with AM630 for 24 hours. Mature osteoclasts were measured by tartrate-resistant acid phosphatase （TRAP） staining using a commercial kit. Total ribonucleic acid （RNA）was isolated and real-time reverse transcriptase-polymerase chain reaction （RT-PCR） was done to examine the expression of RANK, cathepsin K （CPK） and nuclear factor kappa B （NF-κB）. The extracellular signal-regulated kinase （ERK）,phosphorylation of ERK （P-ERK） and NF-κB production were tested by Western blotting. The effect of AM630 on RAW264.7 viability was determined using the 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazoliumbromide （MTT） assay.Results AM630 did not affect the viability of RAW264.7. However, this CB2 selective antagonist markedly inhibited osteoclast formation and the inhibition rate was dose-dependent. The dose of 〉100 nmol/L could reduce TRAP positive cells to the levels that were significantly lower than the control. AM630 suppressed the expression of genes associated with osteoclast differentiation and activation, such as RANK and CPK. An analysis of a signaling pathway showed that AM630 inhibited the RANKL-induced activation of ERK, but not NF-κB.Conclusion AM630 could inhibit the osteoclastogenesis from RAW264.7 induced with RANKL.

低能量激光对人牙周膜细胞白细胞介素-6、肿瘤坏死因子-α、骨保护素、核因子-κB受体活化因子配体表达的影响

目的通过观察高糖环境下低能量激光(LLL)对受静压力刺激的人牙周膜细胞(HPDLC)白细胞介素-6(IL-6)、肿瘤坏死因子(TNF)-α、骨保护素(OPG)、核因子-κB受体活化因子配体(RANKL)表达的影响,以期探究LLL对糖尿病患者牙周组织炎症及正畸治疗过程中骨改建调控的分子生物学机制。方法体外培养HPDLC,模拟正畸加力,结合LLL照射,将所培养细胞随机分为4组:低糖型杜氏改良Eagle培养基(DMEM)+压力刺激(A组),高糖型DMEM+压力刺激(B组),低糖型DMEM+LLL照射+压力刺激(C组),高糖型DMEM+LLL照射+压力刺激(D组),其中C、D组根据给予的激光能量密度值不同又分C1、D1组(能量密度值:3.75 J/cm2)和C2、D2组(能量密度值:5.625 J/cm2)。根据已有分组,对A、B、C、D组细胞进行加力,对C、D组细胞在细胞加力前进行LLL照射。分别观察0、12、24、48、72 h,定时提取各组细胞培养上清液,采用酶联免疫吸附(ELISA)法检测各组不同时段IL-6、TNF-α、OPG、RANKL的蛋白表达。结果1)在持续静压力刺激下,HPDLC分泌的IL-6、TNF-α浓度随时间逐渐上升;12 h后IL-6、TNF-α的浓度在A组与B、C1、C2组组间两两比较的差异均有统计学意义(P<0.05),B组与D1、D2组组间两两比较的差异也均有统计学意义(P<0.01)。2)OPG蛋白浓度在24h之前呈现出上升趋势,24h后随时间出现下降趋势;RANKL蛋白浓度随时间呈上升趋势;OPG/RANKL比值随时间呈下降趋势;持续静压力刺激12h后,A组与B、C1、C2组,B组与D1、D2组组间两两比较的OPG、RANKL及OPG/RANKL的比值的差异均具有统计学意义(P<0.05)。结论1)在高糖环境持续静压力刺激下,HPDLC分泌的IL-6、TNF-α浓度随时间呈现上升趋势;OPG的表达水平降低,RANKL的表达水平增加,OPG/RANKL的比值减小,提示高糖环境会促进骨吸收反应的发生;给予LLL照射干预后发现,IL-6、TNF-α的浓度出现下降,表明其可拮抗高糖环境所致的炎症因子水平的升高,并且能上调人HPDLC中OPG的表达,下调HPDLC中RANKL的表达,从而上调OPG/RANKL的比值,逆转高糖所致的骨代谢失衡。2)在3.75~5.625J/cm2这一能量密度范围内,随着给予的激光能量密度值的增大,其表现出的降低炎症因子及对HPDLC骨代谢的调控作用增强,提示在一定范围内,LLL调节骨改建的能力随剂量增加而增强。

Efficacy of recombinant human osteoprotegerin combined with tinidazole in the treatment of periodontitis mice and its correlation with serum RANKL and MCP-1 levels

Objective: To investigate the effect of recombinant human osteoprotegerin combined with tinidazole on mice with periodontitis and the effect on serum RANKL and MCP-1 levels. Methods: 80 SPF-cleaned mice were randomly divided into 4 groups, 20 each, model group, tinidazole group and recombinant human osteoprotegerin group were modeled by Kimura et al., and tinidazole group received tinidazole. After intragastric administration, the recombinant human osteoprotegerin group was injected with recombinant human osteoprotegerin in the periodontal pocket according to the tinidazole group. The periodontal changes of the four groups of mice were observed and recorded, and the gingival rating was performed. Epithelial tissue morphology was observed by hematoxylin-eosin (HE) staining. Serum levels of IL-4, IL-6, RANKL and MCP-1 were measured by enzyme-linked immunosorbent assay. Results:After the intervention, the model group developed severe inflammatory reactions, including redness, hemorrhage, and deep periodontal pockets. The teeth were significantly loosened. The mice in the tinidazole group and the recombinant human osteoprotegerin group recovered substantially, and the gingival rating of the recombinant human osteoprotegerin group was better than that. The tinidazole group and the model group (P<0.05). The results of HE staining showed that the model group had edema, vasodilation and a large amount of inflammatory infiltration. The epithelial structure of the mice in the tinidazole group and the recombinant human osteoprotegerin group was intact and arranged closely and orderly. After intervention, the IL-4 in the tinidazole group and the recombinant human osteoprotegerin group was significantly higher than the model group and IL-6 was significantly lower than the model group (P<0.05), and the recombinant human osteoprotegerin group IL-4 was significantly higher after the intervention. IL-6 was significantly lower in the tinidazole group than in the tinidazole group (P<0.05). After the intervention, the tinidazole group and the recombinant human osteoprotegerin group were significantly reduced, and the recombinant human osteoprotegerin group RAKNL and MCP-1 were significantly lower than the model group (P>0.05). Conclusion: Recombinant human osteoprotegerin combined with tinidazole has a better therapeutic effect on gums and teeth in mice with periodontitis, and can lower the levels of RAKNL and MCP-1 in serum, inhibit bone resorption and protect teeth.

核因子κB受体活化因子配体抑制剂地舒单抗在肺癌骨转移中的应用

目前,随着基因靶向治疗和免疫治疗在肺癌领域中取得巨大突破,晚期肺癌患者总生存期(OS)显著延长,但发生远处骨转移及骨相关事件(SRE),如骨痛、病理性骨折、脊髓压迫、高钙血症等风险也随之增大,严重影响了患者的生活质量。因此,在全身治疗基础上应积极预防和治疗骨转移及SRE治疗。临床研究表明,核因子κB受体活化因子(RANK)配体(RANKL)/RANK/骨保护素信号通路在肿瘤骨转移中发挥着重要作用,阻断该通路能有效预防和治疗SRE。RANKL抑制剂地舒单抗(商品名:安加维)是一种人免疫球蛋白G2单克隆抗体,可特异性结合RANKL而阻断破骨细胞参与的RANKL/RANK/骨保护素信号通路激活,最终发挥预防骨转移及SRE的作用。与双磷酸盐类药物比较,地舒单抗疗效显著,能明显延长患者OS和SRE的发生时间。同时,地舒单抗还具有抗肿瘤作用。该文就地舒单抗的作用机制、临床研究及安全性等方面的最新研究进行了阐述,以期为临床医生提供参考。

龈沟液RANKL、音猬因子水平对牙缺失Nobel种植体早期稳定性评估价值

目的探讨龈沟液核因子-κB受体活化因子配体(RANKL)、音猬因子水平对牙缺失Nobel种植体早期稳定性评估价值。方法选取2020年6月至2021年12月邯郸市第一医院牙缺失患者128例作为观察组,均为Nobel种植体修复,选取同期体检健康者64例作为对照组。对比两组及观察组术后即刻、术后3个月龈沟液RANKL、音猬因子水平、种植体稳定系数(ISQ)值,多重线性回归模型分析Nobel种植体早期稳定性影响因素,并分析龈沟液RANKL、音猬因子水平对早期稳定性评估价值。结果观察组术后3个月龈沟液RANKL、音猬因子水平低于术后即刻,差异有统计学意义(P<0.05);观察组术后3个月ISQ值高于术后即刻,差异有统计学意义(P<0.05)。术后即刻龈沟液RANKL、音猬因子水平与术后3个月ISQ值呈负相关(P<0.05)。术后即刻及术后3个月龈沟液RANKL、音猬因子水平对应的线性系数差异有统计学意义(P<0.05);建立多重线性回归模型:术后3个月ISQ值=100.968-4.607×术后咬(牙合)痛-2.886×常食坚果-0.254×术后即刻龈沟液RANKL-0.280×术后即刻龈沟液音猬因子,回归模型具有统计学意义(P<0.05),自变量可解释术后3个月ISQ值74.59%的变异量。结论牙缺失患者进行Nobel种植后龈沟液RANKL、音猬因子呈低表达,术后通过检测二者水平可有效判断种植体早期稳定性。

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

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。

丹参酮ⅡA调节骨关节炎小鼠骨代谢的作用机制

目的探讨丹参酮ⅡA(TanⅡA)通过介导Yes激酶相关蛋白(Yes-associated protein,YAP)、核因子-κB受体活化因子配基(receptor activator of nuclear factor-κB ligand,RANKL)/核因子κB受体活化因子(eceptor activator of nuclear factor-κB,RANK)/骨保护蛋白(osteoprotegerin,OPG)调节骨关节炎小鼠骨代谢的作用机制。方法建立骨关节炎小鼠模型,将60只小鼠随机分成假手术组、模型组、TanⅡA低剂量组和TanⅡA高剂量组,每组15只,造模成功后灌胃给药,连续4周。HE和番红O固绿染色观察软骨组织病理损伤并进行Mankin评分。酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测血清骨碱性磷酸酶(bone alkaline phosphatase,BALP)、骨钙素(osteocalcin,OC)、Ⅰ型胶原交联羧基末端肽(C-telopeptide of typeⅠcollagen,CTX)、白细胞介素(interleukin,IL)-1β、IL-6、IL-8和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)。蛋白质印迹法(Western blotting)检测基质金属蛋白酶(matrix metalloproteinases,MMPs)、YAP、RANK、RANKL和OPG蛋白。结果TanⅡA可改善小鼠软骨组织病理变化并降低Mankin评分。与假手术组比较,模型组BALP、OC水平下降,CTX、TNF-α、IL-6、IL-1β、IL-8、MMP1、MMP3和MMP13水平升高(P<0.05)。与模型组比较,TanⅡA低剂量组、TanⅡA高剂量组BALP、OC水平升高,CTX、TNF-α、IL-6、IL-1β、IL-8、MMP1、MMP3和MMP13水平降低(P<0.05)。与假手术组比较,模型组小鼠软骨组织中YAP、OPG和RANK蛋白水平下降,RANKL蛋白水平升高(P<0.05);与模型组比较,TanⅡA 2组小鼠软骨组织中YAP、OPG和RANK蛋白水平上升,RANKL蛋白水平下降(P<0.05)。结论TanⅡA可能通过介导YAP、RANK/RANKL/OPG信号通路调控骨关节炎。

PTHrP促进RANKL诱导巨噬细胞分化为破骨细胞参与中耳胆脂瘤骨破坏

目的:骨质进行性吸收破坏是中耳胆脂瘤最重要的临床特征之一,可导致一系列颅内外并发症,而目前中耳胆脂瘤骨破坏的机制尚未明确。本研究旨在探究甲状旁腺激素相关蛋白(parathyroid hormone-related protein,PTHrP)参与中耳胆脂瘤骨破坏的机制。方法:收集后天性中耳胆脂瘤患者的25例胆脂瘤标本和13例外耳道正常皮肤组织标本。采用免疫组织化学染色方法检测PTHrP、核因子κB受体活化因子配体(receptor activator for nuclear factor-kappa B ligand,RANKL)和骨保护素(osteoprotegerin,OPG)在中耳胆脂瘤和外耳道正常皮肤组织中的表达,抗酒石酸酸性磷酸酶(tartrate-resistant acid phosphatase,TRAP)染色法检测中耳胆脂瘤和外耳道正常皮肤组织中是否存在TRAP阳性多核巨噬细胞。选取小鼠单核巨噬细胞RAW264.7细胞进行干预,分为RANKL干预组和PTHrP+RANKL共同干预组,采用TRAP染色法检测2组破骨细胞的生成情况,实时聚合酶链反应(real-time polymerase chain reaction,real-time PCR)检测干预后2组破骨细胞相关基因TRAP、组织蛋白酶K(cathepsin K,CTSK)和活化T细胞核因子1(nuclear factor of activated T cell cytoplasmic 1,NFATc1)的mRNA表达水平,骨吸收陷窝实验检测2组破骨细胞的骨吸收功能。结果:免疫组织化学染色结果显示,PTHrP和RANKL在中耳胆脂瘤组织中的表达均显著增高,OPG表达降低(均P<0.05),且PTHrP的表达与RANKL、RANKL/OPG比值均呈显著正相关,与OPG表达呈显著负相关(分别r=0.385、r=0.417、r=-0.316,均P<0.05)。同时,PTHrP、RANKL的表达水平与中耳胆脂瘤的骨破坏程度均呈显著正相关(分别r=0.413、r=0.505,均P<0.05)。TRAP染色结果显示中耳胆脂瘤上皮周围基质中有大量TRAP阳性细胞,并存在细胞核数量为3个或3个以上的TRAP阳性破骨细胞。RANKL或PTHrP+RANKL联合干预5 d后,与RANKL干预组相比,PTHrP+RANKL联合干预组的破骨细胞数量显著增加(P<0.05),且破骨细胞相关基因TRAP、CTSK和NFATc1的mRNA表达水平均升高(均P<0.05)。骨吸收陷窝扫描电镜结果显示RANKL干预组、PTHrP+RANKL联合干预组的骨片表面均形成骨吸收陷窝;与RANKL干预组相比,PTHrP+RANKL联合干预组的骨片表面骨吸收陷窝数量显著增加(P<0.05),面积也更大。结论:PTHrP可能通过促进RANKL诱导胆脂瘤组织周围基质中的巨噬细胞分化为破骨细胞,参与中耳胆脂瘤骨破坏。

人骨关节炎软骨细胞上调成骨细胞中骨保护素的作用途径

背景:研究发现上调的刺猬蛋白信号将导致骨关节炎标志物蛇毒蛋白Runx2、聚蛋白多糖酶5、COL10A1以及基质金属蛋白酶13的升高,而抑制刺猬蛋白能减轻骨关节炎的严重程度。猜测骨关节炎软骨细胞能够通过印度刺猬蛋白(Indian hedgehog protein,IHH)信号通路影响成骨细胞来影响骨的形成。目的:探索人骨关节炎软骨细胞对软骨下成骨细胞的影响。方法:收集骨关节炎患者的胫骨平台标本,使用酶解法提取软骨细胞,利用酶预消化+骨块法提取成骨细胞。采用甲苯胺蓝染色和免疫荧光鉴定软骨细胞;采用碱性磷酸酶染色和免疫荧光鉴定成骨细胞,在海藻酸钠珠中以维持软骨细胞表型,将其与成骨细胞共培养,共培养系统中分别加入IHH信号通路的抑制剂(Cyclopamine,10 nmol/L)和激活剂(Purmorphamine,10 nmol/L),48 h后收集各组成骨细胞,利用qRT-PCR检测成骨细胞中Gli1、骨保护素、Runx2、甲状旁腺激素相关肽、碱性磷酸酶、核因子κB受体活化因子配体(receptor activator of NF-kBligand,RANKL)以及骨钙素等基因mRNA的表达;利用Westernblot检测各处理组的成骨细胞中GLi1、骨保护素、RANKL蛋白的表达。结果与结论:①与骨关节炎软骨细胞共同培养时,成骨细胞中GLi1、骨保护素、RUNX2的mRNA表达水平明显增加,而甲状旁腺激素相关肽的mRNA表达水平相对降低(P<0.05);加入IHH抑制剂(Cyclopamine)后,IHH信号通路目的基因Gli1在mRNA和蛋白水平上表达均明显降低(P<0.05),加入IHH信号通路激活剂(Purmorphamine)后,Gli1在mRNA及蛋白水平上表达均明显升高(P<0.05);骨保护素在实验中表现出与Gli1相同的变化趋势。②成骨细胞骨保护素/RANKL比值测定结果显示,与骨保护素的趋势相同。③结果表明,人骨关节炎软骨细胞能够促进成骨细胞中Gli1、骨保护素、Runx2等蛋白的表达;其中骨保护素的上调与IHH信号通路相关;骨关节炎软骨细胞能够通过IHH信号通路上调成骨细胞骨保护素的表达进而上调骨保护素/RANKL的比值,这将有助于软骨下骨中的骨形成。

补骨脂素对成骨细胞核因子-κB受体激活配体和骨保护素表达的影响

目的研究补骨脂素(psoralen,PSO)对体外培养的小鼠成骨细胞(OB)分化及核因子-κB受体激活配体(receptor activator of nuclearfactor-κB ligand,RANKL)和骨保护素(osteoprotegerin,OPG)表达的影响。方法取第1代BALB/c小鼠颅盖骨成骨细胞,将PSO以0.1、1、10μmol/L3种浓度分别加入新生大鼠颅骨成骨细胞培养液中,MTT法观察各组药物对成骨细胞的增殖作用并绘制细胞生长曲线;用PNPP法测定成骨细胞内碱性磷酸酶(alkaline phosphatase,ALP)活性;RT-PCR法检测成骨细胞OPG和RANKL的转录水平。结果细胞生长曲线显示各组成骨细胞数量均随时间延长而增加,中、高浓度PSO能显著提高成骨细胞的ALP活性,促进OPG、RANKL的表达(P<0.05),OPG/RANKL升高(P<0.05)。结论低浓度PSO(0.1μmol/L)对骨更新作用不明显,而中、高浓度PSO(1、10μmol/L)能通过上调OPG、RANKL mRNA表达及OPG/RANKL比例,促进成骨细胞的生成功能,增强骨更新。