多发性骨髓瘤骨病微环境改变与治疗进展  

Microenvironmental alterations and therapeutic advances in multiple myeloma bone disease

作　　者：魏依昕 张连生[1] 李莉娟[1] 李晓莎 WEI Yixin;ZHANG Liansheng;LI Lijuan;LI Xiaosha(Lanzhou University Second Hospital,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院,兰州730030

出　　处：《中国免疫学杂志》2024年第5期1010-1015,共6页Chinese Journal of Immunology

基　　金：国家自然科学基金(8236010019);国家血液系统疾病临床医学研究中心委托课题(2021WWA01)。

摘　　要：多发性骨髓瘤骨病(MBD)是多发性骨髓瘤(MM)患者临床常见的并发症,骨相关事件的发生严重影响患者的生存质量与预后。MBD的发病机制涉及生理性骨重塑的失衡,如破骨细胞的过度激活、成骨细胞的抑制及微环境中骨细胞、骨髓基质细胞及免疫细胞等多种细胞与细胞因子的相互作用。目前MBD的治疗在标准抗骨髓瘤治疗基础上,控制肿瘤进展,同时在适应证范围内使用骨相关药物作用于骨重塑。为防止骨破坏,在抗骨吸收的同时,诱导新骨形成来修复现有病变是必不可少的,目前多种新型骨靶向药物在临床前及临床试验中表现出抗骨病作用。本文总结了骨髓微环境改变、骨重塑机制及治疗的新进展。Multiple myeloma bone disease(MBD)is a common clinical complication in patients with multiple myeloma(MM),and the occurrence of bone-related events seriously affects the quality of survival and prognosis of patients.The pathogenesis of MBD involves an imbalance in physiologic bone remodeling:overactivation of osteoclasts,suppression of osteoblasts,and multiple cell-cytokine interactions in the microenvironment,including osteoblasts,bone marrow stromal cells,and immune cells.The current treatment of MBD is based on standard antimyeloma therapy to control tumor progression,along with the use of bone-related drugs acting on bone remodeling within the indications.To prevent bone destruction.In order to prevent bone destruction,it is essential to induce new bone formation to repair the existing lesions while resisting bone resorption,and a variety of novel bone-targeting drugs are currently demonstrating anti-osteopathic effects in preclinical and clinical trials.This article summarizes new advances in the mechanisms of bone remodeling and treatment of MBD.

关 键 词：多发性骨髓瘤 骨病 骨髓微环境 治疗 

分 类 号：R733.3[医药卫生—肿瘤]