多发性骨髓瘤骨病发病机制的研究进展  

Advances in the pathogenesis of multiple myeloma bone disease

作　　者：胡聪 匡春梅 周文 HU Cong;KUANG Chunmei;ZHOU Wen(Institute of Oncology,School of Basic Medicine,Central South University,Changsha 410078,China)

机构地区：[1]中南大学基础医学院肿瘤研究所,长沙410078

出　　处：《中南大学学报（医学版）》2023年第9期1403-1410,共8页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(82130006);湖南省研究生科研创新项目(CX20220348);中南大学研究生科研创新项目(2022ZZTS0266)

摘　　要：多发性骨髓瘤(multiple myeloma,MM)是一种骨髓中浆细胞克隆增生性恶性肿瘤。随着中国人口老龄化,MM发病率呈上升趋势。多发性骨髓瘤骨病(multiple myeloma bone disease,MBD)是MM的显著特征之一,80%~90%的MM患者在首次就诊时即伴随溶骨性病变。MBD不仅增加患者伤残率,而且其所致的骨骼病变及骨骼相关事件严重降低患者身体机能。目前用于治疗MBD的药物效果不佳且伴有不良反应,因此,寻找新的治疗MBD的方法尤为重要。通常认为,破骨细胞活性增强和成骨细胞功能受抑是MBD的主要病理学机制。然而,越来越多的研究认为骨髓微环境中可溶性分子包括细胞因子、胞外体、代谢物等在MBD的发生中起不可或缺的作用。因此,从多种角度探讨MBD发生的分子机制,寻找预测性生物标志物及潜在治疗靶点,对MBD的临床治疗具有一定的意义。Multiple myeloma(MM)is a clonal proliferative malignant tumor of plasma cells in bone marrow.With the aging of population in China,the incidence of MM is on the rise.Multiple myeloma bone disease(MBD)is one of the common clinical manifestations of MM,and 80%−90%of MM patients are accompanied by osteolytic lesions at the time of their first visit to the clinic.MBD not only increases the disability rate of patients,but also severely reduces the physical function of patients due to skeletal lesions and bone-related events.Currently available drugs for treating of MBD are ineffective and associated with side effects.Therefore,it is important to find new therapeutic approaches for the treatment of MBD.It is generally believed that the increased osteoclast activity and suppressed osteoblast function are the main pathologic mechanisms for MBD.However,more and more studies have suggested that soluble molecules in the bone marrow microenvironment,including cytokines,extracellular bodies,and metabolites,play an important role in the development of MBD.Therefore,exploring the occurrence and potential molecular mechanisms for MBD from multiple perspectives,and identifying the predictive biomarkers and potential therapeutic targets are of significance for the clinical treatment of MBD.

关 键 词：多发性骨髓瘤骨病 骨髓微环境 细胞因子 胞外体 代谢产物 

分 类 号：R73[医药卫生—肿瘤]