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  

Osteoprotegerin/receptor activator of nuclear factor kappa-B/receptor activator of nuclear factor kappa-B ligand and the application of relevant target therapy in oral medicine

作　　者：周静 张钊[1] Zhou Jing;Zhang Zhao(Department of Prosthodontics,Hebei Key Laboratory of Stomatology,Hebei Clinical Research Center for Oral Diseases,School and Hospital of Stomatology,Hebei Medical University,Shijiazhuang 050017,Hebei Province,China)

机构地区：[1]河北医科大学口腔医学院·口腔医院修复科,河北省口腔医学重点实验室,河北省口腔疾病临床医学研究中心,河北省石家庄市050017

出　　处：《中国组织工程研究》2024年第23期3736-3742,共7页Chinese Journal of Tissue Engineering Research

基　　金：河北省财政厅老年病防治科研项目(361029),项目负责人:张钊;河北省财政厅2020年政府资助临床医学优秀人才培养项目带头人(2020048149-2),项目负责人:张钊;河北省卫生健康委员会医学科学研究课题计划指令性课题(20190098),项目负责人:张钊。

摘　　要：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。BACKGROUND:Osteoprotegerin(OPG)/receptor activator of nuclear factor-κB(RANK)/receptor activator of nuclear factor-κB ligand(RANKL)are important cytokines for coupling osteoclast and osteoblast differentiation and activation,and are key factors for regulating bone metabolism,which affect the immune system,bone regeneration and remodeling,and are closely related to the physiological and pathological remodeling of the alveolar bone.OBJECTIVE:To analyze the effects of the OPG/RANK/RANKL signaling pathway on alveolar bone remodeling and the progress in its targeted therapy application in the dental field.METHODS:We searched relevant articles included in CNKI and PubMed databases with the keywords of“OPG,anti-RANKL antibody,RANKL,periodontitis,orthodontic tooth movement,implant,tooth eruption,periapical lesion,alveolar bone resorption”in Chinese and English,respectively.A total of 63 articles were finally included for review.RESULTS AND CONCLUSION:Anti-RANKL therapy can treat oral diseases by targeting the inhibition of osteoclast formation and alveolar bone absorption.Local and systemic anti-RANKL therapy can inhibit the progression of periodontitis,peri-implantitis and periapical lesions,and it also plays an important role in preventing orthodontic relapse,strengthening orthodontic anchorage and implant osseointegration.RANKL therapy can treat oral diseases by promoting osteoclast differentiation and alveolar bone absorption.RANKL treatment can accelerate orthodontic tooth movement,shorten the treatment cycle and reduce the incidence of orthodontic complications.Although there are limitations in anti-RANKL therapy,they can be avoided by rational applications,such as excluding local and systemic risk factors before treatment,regular oral maintenance and avoiding traumatic alveolar surgery as much as possible during treatment.

关 键 词：抗核因子κB受体活化因子配体 骨保护素 抗核因子κB受体活化因子配体抗体 核因子ΚB受体活化因子配体 牙槽骨吸收 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R78