中医药靶向线粒体质量控制防治膝骨关节炎的研究进展  

Prevention and Treatment of Knee Osteoarthritis by Targeted Mitochondrial Quality Control with Traditional Chinese Medicine:A Review

作　　者：陈继鑫 周沁心 余伟杰 郭天赐 曹东东 牛朴钰 叶云天 刘爱峰[1] CHEN Jixin;ZHOU Qinxin;YU Weijie;GUO Tianci;CAO Dongdong;NIU Puyu;YE Yuntian;LIU Aifeng(National Clinical Research Center for Chinese Medicine Acupuncture,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine(TCM),Tianjin 300381,China;Shaoxing TCM Hospital,Shaoxing 312000,China)

机构地区：[1]天津中医药大学第一附属医院,国家中医针灸临床医学研究中心,天津300381 [2]绍兴市中医院,浙江绍兴312000

出　　处：《中国实验方剂学杂志》2024年第19期245-253,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上项目(81873316);天津市卫健委津门医学英才项目(TJSJMYXYC-D2-028);中华中医药学会骨病防治交叉研究项目(2023-GBJC-04)。

摘　　要：膝骨关节炎是常见的退行性关节疾病,其主要病理特点是膝关节软骨的退化和受损,伴有骨赘增生和炎症。近年来膝骨关节炎的患病率在全球范围内呈逐年上升的趋势,严重影响患者的生活质量,然而,膝骨关节炎发病机制尚不完全明确,目前的治疗手段仍有局限,寻找新的治疗策略是研究的热点。既往研究发现膝骨关节炎发病与线粒体调控异常相关,线粒体作为第二信使,具有细胞呼吸、活性氧生成和氧化磷酸化产生三磷酸腺苷的功能。线粒体质量控制(MQC)是维持线粒体的形态、数量和质量的重要机制。MQC与膝骨关节炎发病的联系涉及线粒体氧化应激、线粒体自噬、线粒体生物生成的不平衡、线粒体动力学异常(分裂和融合)、以及钙离子调节失衡等因素。机体代谢异常导致线粒体结构受损,从而导致膝骨关节炎的发生发展。中医药已经在干预MQC方面取得了一定的进展,采用多途径、多通路、多靶点的策略来治疗膝骨关节炎。多项研究显示MQC可能是中医药治疗膝骨关节炎的作用靶点之一,但目前尚缺乏中医药干预MQC治疗膝骨关节炎的总结性综述。该文基于MQC的5个方面对中医药治疗膝骨关节炎的研究进展进行梳理,以期为临床防治膝骨关节炎提供一定的理论依据。Knee osteoarthritis(KOA)is a common degenerative joint disease characterized primarily by the degeneration and damage of knee joint cartilage,accompanied by osteophyte formation and inflammation.In recent years,the prevalence of KOA has been increasing globally,significantly impacting the quality of life patients.However,the pathogenesis of KOA remains not fully understood,and current treatment methods are limited.Therefore,finding new therapeutic strategies is a research hotspot.Previous studies have found that the onset of KOA is related to abnormal mitochondrial regulation.Mitochondria,functioning as secondary messengers,play crucial roles in cellular respiration,reactive oxygen species(ROS)generation,and adenosine triphosphate(ATP)production through oxidative phosphorylation.Mitochondrial quality control is a pivotal mechanism for maintaining the morphology,quantity,and quality of mitochondria.The connection between mitochondrial quality control and the pathogenesis of KOA involves several factors,such as mitochondrial oxidative stress,mitophagy,imbalances in mitochondrial biogenesis,abnormal mitochondrial dynamics(fission and fusion),and dysregulation of calcium ions.Metabolic abnormalities in the body lead to mitochondrial structural damage,which in turn contributes to the onset and progression of KOA.Traditional Chinese medicine(TCM)has made some progress in intervening in mitochondrial quality control,employing multi-faceted,multi-pathway,and multi-target strategies to treat KOA.Several studies have shown that mitochondrial quality control may be one of the therapeutic targets of TCM in treating KOA.However,there is currently a lack of comprehensive reviews summarizing the TCM interventions in mitochondrial quality control for treating KOA.This paper systematically reviewed the research progress in TCM treatment of KOA based on five aspects of mitochondrial quality control,aiming to provide a theoretical basis for the clinical prevention and treatment of KOA.

关 键 词：膝骨关节炎 线粒体质量控制(MQC) 中医药 多途径 多通路 多靶点 综述 

分 类 号：R2-0[医药卫生—中医学] R22R242R285.5R684.3