椎间盘退变中外泌体的功能、作用机制和临床治疗  

The function, mechanism and clinical treatment of exosomes in intervertebral disc degeneration

作　　者：苗鸿雁 冯晶[2] 刘伟[2] 杜世阳 杨若鹏 尹志源 肖子钧 徐磊 MIAO Hong-yan;FENG Jing;LIU Wei;DU Shi-yang;YANG Ruo-peng;YIN Zhi-yuan;XIAO Zi-jun;XU Lei(Hubei University of Chinese Medcine,Wuhan,Hubei,430065,China)

机构地区：[1]湖北中医药大学,武汉430065 [2]武汉市第一医院骨科,湖北省430022

出　　处：《中国骨与关节杂志》2024年第3期231-236,共6页Chinese Journal of Bone and Joint

基　　金：武汉市卫生健康科研基金资助(WZ21C04、WX21M02)。

摘　　要：下腰痛是一种常见的症状,多由软组织损伤、骨质疏松、肿瘤、感染、骨折和非特异性疼痛等引起,而临床上40%~50%的下腰痛是由腰椎间盘退变(intervertebral disc degeneration,IVDD)引起的[1]。导致IVDD的确切病因尚不清楚,但随着机械负荷、衰老、肥胖、慢性应激等危险因素的增加,IVDD的患病率呈逐年上升趋势[2]。临床治疗IVDD的方法主要分为保守治疗和手术治疗。保守治疗包括卧床休息、药物治疗、牵引、针灸推拿等物理疗法[3],这些方法在缓解症状方面有着一定的作用,但不能逆转IVDD[4]。Intervertebral disc degeneration(IVDD)is the main cause of low back pain,and the prevalence rate is increasing year by year.However,the exact cause of IVDD is still unclear.Most conservative treatment and surgical treatment can not prevent the progress of IVDD or restore the original structure and function,and are often accompanied by obvious sequelae and complications.Exosomes are extracellular vesicles with a diameter of 40-160 nm,which are composed of lipid bilayers encapsulating proteins,nucleic acids,etc.,and play an important regulatory role as intercellular communication substances.By delivering a large number of bioactive substances to damaged cells,exosomes have received great attention in maintaining the stability of intervertebral disc structure and function.However,there are still some challenges in the production,application and efficacy evaluation of exosomes,which are worthy of further exploration.This article focuses on the mechanism of exosomes from different sources in regulating cell proliferation and apoptosis,endoplasmic reticulum stress,inflammation,pyroptosis,oxidative stress,autophagy,extracellular matrix stability,differentiation and angiogenesis in the process of IVDD in recent years,in order to provide thinking for subsequent in-depth research.

关 键 词：椎间盘退行性变 外泌体 综述 

分 类 号：R681.5[医药卫生—骨科学]