雌激素及相关化合物干预骨关节炎作用机制:关节保护与骨软骨细胞的修复  

Mechanism of estrogen and estrogen-related compounds in osteoarthritis:joint protection and repair of bone cartilage cells

作　　者：王健[1] 陶海荣[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院骨科,上海市201900

出　　处：《中国组织工程研究》2014年第33期5372-5376,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:雌激素通过成骨细胞、破骨细胞、细胞分泌的因子,以及多条骨代谢调控途径参与了骨关节炎骨代谢的调控。目的:综合阐述雌激素及雌激素相关化合物在关节保护、骨与软骨细胞的修复、滑膜炎症的抑制等方面对骨关节炎的作用。方法:作者检索1992至2014年PubMed、Embase、Elseveir数据库文献。检索词为:"Osteoarthritis,Estrogens,Matrix Metalloproteinases,Interleukins,Tumor Necrosis Factor-alpha"。按照事先制定的标准逐一评价纳入研究的文献,提取有效资料进行综合分析。结果与结论:雌激素可通过增加成骨细胞中骨保护素和核因子κB受体活化因子配体的表达,抑制破骨性骨吸收,防止骨关节炎的发生和进展。雌激素能上调抗破骨细胞的细胞因子,而下调亲破骨细胞的细胞因子,通过Wnt与骨形态发生蛋白信号系统也参与骨关节炎患者骨代谢的调控。雌激素可以通过下丘脑-垂体-肾上腺轴的作用促进肾上腺皮质分泌糖皮质激素,从而间接抑制基质金属蛋白酶类的产生,对关节软骨起到保护作用。外源性雌激素通过抑制骨的吸收可能会有助于延缓骨关节炎的发展。雌激素和雌激素相关的化合物在骨关节炎进展的后期阶段可能会抑制滑膜炎症和炎症递质导致的软骨流失。BACKGROUND：The bone metabolism of osteoarthritis is regulated by estrogen with osteoblasts, osteoclasts and cytokines, as wel as a number of regulatory pathways. OBJECTIVE：To describe the role of estrogen and estrogen-related compounds for joint protection, repair of bone and cartilage cells, and inhibition of synovitis in osteoarthritis. METHODS：Author researched PubMed, Embase, Elseveir database from 1992 to 2014, with the key words of“osteoarthritis, estrogens, matrix metal oproteinases, interleukins, tumor necrosis factor-alpha”. After the quality of the included studies was evaluation, valid data were extracted and analyzed. RESULTS AND CONCLUSION：Estrogen can increase the expression of osteoprotegerin and nuclear factor-κB factor ligands in osteoblasts, inhibit bone resorption, prevent the onset and progression of osteoarthritis. Estrogen upregulates anti-osteoclast cytokines, downregulates pro-osteoclast factors, and contribute to regulate bone metabolism of osteoarthritis patients through bone morphogenetic protein and Wnt signaling. Estrogen promotes the adrenal cortex secretion of glucocorticoids and indirectly inhibits the production of matrix metal oproteinases by the hypothalamus-hypophysis-adrenal gland axis. Exogenous estrogen inhibits bone resorption, which may help to delay the development of osteoarthritis. Estrogen and estrogen-related compounds may inhibit the cartilage loss caused by synovitis and inflammatory factors in the late stage of osteoarthritis.

关 键 词：组织构建 骨组织工程 骨关节炎 雌激素 骨代谢 骨保护素 基质金属蛋白酶 白细胞介素 肿瘤坏死因子α 核因子ΚB受体活化因子配体 

分 类 号：R318[医药卫生—生物医学工程]