脉冲电磁场治疗绝经后骨质疏松症的研究进展  

Research progress of pulsed electromagnetic field in the treatment of postmenopausal osteoporosis

作　　者：肖豪 刘静 周君[1,2] Xiao Hao;Liu Jing;Zhou Jun(Department of Rehabilitation Medicine,The First Affiliated Hospital of University of South China,Hengyang 421001,Hunan Province,China;Laboratory of Rehabilitation Medicine,The First Affiliated Hospital of University of South China,Hengyang 421001,Hunan Province,China)

机构地区：[1]南华大学附属第一医院康复医学科,湖南省衡阳市421001 [2]南华大学附属第一医院康复医学实验室,湖南省衡阳市421001

出　　处：《中国组织工程研究》2022年第8期1266-1271,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金项目(81973917),项目负责人:周君;湖南省自然科学基金项目(2020JJ4085),项目负责人:周君。

摘　　要：背景:脉冲电磁场产生脉冲电流,利用应力耦合机制改善骨代谢,近年来越来越多的研究表明脉冲电磁场对骨髓间充质干细胞、成骨细胞、破骨细胞、骨细胞等均有影响,对绝经后骨质疏松症有抑制作用。目的:综述脉冲电磁场对绝经后骨质疏松症的作用及治疗机制。方法:检索PubMed、MEDLINE数据库、万方、CNKI中国期刊全文数据库、维普及中国生物医学文献数据库收录的相关文献。中文检索词为“绝经后骨质疏松症;脉冲电磁场;骨稳态;骨代谢;骨密度;生物力学性能;骨髓间充质干细胞;成骨细胞;破骨细胞;骨细胞”,英文检索词为“pulsed electromagnetic field;postmenopausal osteoporosis;bone homeostasis;Bone marrow mesenchymal stem cells;osteoblasts;osteoclasts;bone cells;bone metabolism;bone density”,最终纳入66篇文献进行归纳总结。结果与结论:脉冲电磁场具有提高骨密度、改善骨生物力学性能、促进骨形成、抑制骨吸收等作用,多途径多方面抑制绝经后骨质疏松症。目前脉冲电磁场调控Wnt/β-catenin信号通路、OPG/RANKL信号通路介导成骨分化的研究已较完善,可行性高;在骨髓间充质干细胞、成骨细胞、破骨细胞等研究机制中,发现SIRT1抑制NLRP3炎症小体介导骨髓间充质干细胞焦亡、长链非编码RNA及相关通路调控成骨分化、缺氧诱导因子驱动破骨细胞分化等理念仍处于初步探索阶段。脉冲电磁场能否通过SIRT1调控NLRP3炎症小体信号抑制骨髓间充质干细胞焦亡发挥抗骨质疏松作用具有重要的探索价值。BACKGROUND:Pulsed electromagnetic fields generate pulsed currents,and improve bone metabolism through the stress coupling mechanism.In recent years,increasing evidence has proved that pulsed electromagnetic fields can inhibit postmenopausal osteoporosis in many ways involving bone marrow mesenchymal stem cells,osteoblasts,osteoclasts,and bone cells.OBJECTIVE:To review the effect and therapeutic mechanism of pulsed electromagnetic field on postmenopausal osteoporosis.METHODS:We searched PubMed,CNKI,WanFang,VIP,and CBMdisc databases for relevant articles with the keywords of“pulsed electromagnetic field;postmenopausal osteoporosis;bone homeostasis;bone metabolism;bone density;biomechanical property;bone marrow mesenchymal stem cells;osteoblasts;osteoclasts;bone cells”in Chinese and English,respectively.Finally,66 articles met the criteria for review.RESULTS AND CONCLUSION:Pulsed electromagnetic fields can increase bone density,improve bone biomechanical properties,promote bone formation,and inhibit the activity of osteoclasts to inhibit postmenopausal osteoporosis.At present,pulsed electromagnetic fields are of high feasibility to mediate osteogenic differentiation via Wnt/β-catenin signaling pathway and OPG/RANKL signaling pathway.Research on the mechanism of bone marrow mesenchymal stem cells,osteoblasts,and osteoclasts indicates a series of concepts in the initial stage,including that SIRT1 inhibits NLRP3 inflammasome to mediate bone marrow mesenchymal stem cell pyrolysis,long-chain non-coding RNA and related pathways regulate osteogenic differentiation,and hypoxia-inducible factors drive osteoclast differentiation.It is of important value to explore whether pulsed electromagnetic fields can regulate NLRP3 inflammasome signals through SIRT1 to inhibit the pyrolysis of bone marrow mesenchymal stem cells,thereby exerting an anti-osteoporosis effect.

关 键 词：脉冲电磁场 绝经后骨质疏松症 骨稳态 生物力学性能 骨髓间充质干细胞 成骨细胞 破骨细胞 骨细胞 

分 类 号：R446[医药卫生—诊断学] R496[医药卫生—临床医学]