低剂量放疗缓解骨关节炎  

Low-dose Radiation Therapy for Osteoarthritis

作　　者：马国榕 杨永泽 孟欣 高玉婷 李树直 郭洪章 金晓东[2] MA Guo-Rong;YANG Yong-Ze;MENG Xin;GAO Yu-Ting;LI Shu-Zhi;GUO Hong-Zhang;JIN Xiao-Dong(The First Clinical Medical College,Gansu University of Chinese Medicine,Lanzhou 730000,China;Institute of Modern Physics,Chinese Academy of Sciences,Lanzhou 730030,China;Department of Orthopedics,Gansu Provincial People’s Hospital,Lanzhou 730099,China;Department of Emergency,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China;College of Life Sciences,Northwest Normal University,Lanzhou 730070,China)

机构地区：[1]甘肃中医药大学第一临床医学院,兰州730000 [2]中国科学院近代物理研究所,兰州730030 [3]甘肃省人民医院骨科,兰州730099 [4]西安交通大学第二附属医院急诊科,西安710004 [5]西北师范大学生命科学学院,兰州730070

出　　处：《生物化学与生物物理进展》2024年第6期1382-1392,共11页Progress In Biochemistry and Biophysics

基　　金：甘肃省自然科学基金(20JR10RA358);甘肃中医药大学研究生创新创业基金(2022CX62)资助项目。

摘　　要：骨关节炎(osteoarthritis,OA)是一种慢性退行性关节疾病,也是最常见的关节炎类型,几乎涉及任何关节,可导致患者慢性疼痛和残疾。19世纪末期伦琴发现了X射线,到20世纪80年代Luckey认为低水平辐射(LDRT)对生物可能有益,逐步应用于一些疾病的治疗,但目前LDRT的运用并未得到普及。本文介绍了OA的流行病学、危险因素、临床表现、治疗方法以及发病机制,重点讨论了LDRT缓解OA的可能机制以及临床研究进展,还探讨了LDRT治疗OA引起的不良反应(急性反应和致癌风险)。在临床上,LDRT本身具有非侵入性、不良反应较小等优势,在治疗OA展现出疼痛缓解、运动改善等疗效,因此LDRT在治疗OA中有广阔的应用前景。Osteoarthritis(OA)is a chronic degenerative joint disease and the most common type of arthritis.It involves almost any joint and can lead to chronic pain and disability.In the late 19th century,Roentgen discovered X-rays,and then began to use radiotherapy to treat tumors.In the 1980s,Luckey thought that low-level radiation(LDRT)might be beneficial to biology,and it was gradually applied to the treatment of some diseases.This paper introduces the epidemiology,risk factors,clinical manifestations and treatment methods of OA,points out that the cartilage injury and the important effect of synovial inflammation in the pathogenesis of OA,namely when the homeostasis of articular cartilage are destroyed,synthetic metabolism and catabolism imbalances,cartilage cells damaged their breakdown products consumed by synovial cells.Synovial cells and synovial macrophages secrete proinflammatory cytokines,metalloproteinases and proteolytic enzymes,leading to cartilage matrix degradation and chondrocyte damage,which aggravates synovial inflammation and cartilage damage,forming a vicious cycle.The possible mechanism and clinical research progress of LDRT in alleviating OA are discussed.LDRT can regulate inflammatory response,inhibit the production of pro-inflammatory cytokines,and promote the production of anti-inflammatory cytokines,thereby achieving anti-inflammatory effect.Studies have shown that after irradiation,the expression of inducible nitric oxide synthase(iNOS)was decreased,the release of reactive oxygen species(ROS)and the production of superoxide were inhibited,the anti-inflammatory phenotype of macrophages was differentiated from M1 to M2,the inflammatory CD8+T cells were transformed into CD4+T cells,and the number of dendritic cells(DC)was significantly reduced.LDRT inhibit the production of proinflammatory factors in leukocytes,reduce their recruitment and adhesion,and down-regulate the expression levels of cell adhesion molecules such as selectin,intercellular adhesion molecule(ICAM)and vascular endothelial cell a

关 键 词：低剂量放疗 骨关节炎 炎症抑制 临床研究 不良反应 

分 类 号：R684.3[医药卫生—骨科学]