从“肝肾亏虚”探讨外泌体与膝骨关节炎的关系  

Discussion on the relationship between exosomes and knee osteoarthritis from“liver and kidney deficiency”

作　　者：崔栩鸣 李景银[2] 

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属医院,山东济南250014

出　　处：《中医临床研究》2024年第27期72-76,共5页Clinical Journal Of Chinese Medicine

摘　　要：膝骨关节炎(Knee Osteoarthritis,KOA)是一种临床常见的老年疾病,特点是关节软骨退化、滑膜发炎、骨质增生形成及软骨下骨硬化,临床治疗以缓解症状和延缓进展为主。目前治疗无法阻止或逆转疾病的进展,末期患者往往面临膝关节置换手术治疗,因此,迫切需要开发治疗KOA的有效疗法。外泌体是一种含有其源细胞各种成分的特殊细胞外囊泡,其中包含复杂的信号分子,如脂质、蛋白质、代谢物、核酸、细胞质和细胞表面蛋白。膝关节中的各种外泌体通过介导细胞间通讯,参与了关节炎症的启动和进展。通过向关节腔内注射生物工程外泌体或经过修饰的天然细胞外泌体,将特定的信号分子输送到膝关节腔内的各种组织,调节关节内微环境和相关细胞功能,是靶向治疗KOA的新方式。中医对KOA认识久远,认为肾主骨而肝主筋,肝肾亏虚则筋骨不用,“肝肾亏虚”理论从根本上阐述了KOA的发病机制和治疗原则。本篇探讨依据肝肾同源、精血互生的中医理念,以及与中医理论中“精”的特性的高度相似性,将外泌体重要来源之一的骨髓间充质干细胞归属于中医“精”的范畴,客观化及量化地揭示“肝肾亏虚”的理论涵义,或将为中医论治KOA提供新的研究思路。Knee osteoarthritis is a common clinical disease of the elderly,which is characterized by articular cartilage degener-Kation,synovial inflammation,bone hyperplasia and subchondral osteosclerosis.Clinical treatment is mainly to relieve symptoms and delay progress.Current treatments cannot stop or reverse the progression of the disease,and end-stage patients often face knee replacement surgery,therefore,there is an urgent need to develop effective therapies for the treatment of knee osteoarthritis.Exo-somes are specialized extracellular vesicles containing various components of their source cell,including complex signaling molecules such as lipids,proteins,metabolites,nucleic acids,and cytoplasmic and cell surface proteins.Various exosomes in the knee are involved in the initiation and progression of joint inflammation by mediating intercellular communication.By injecting bioengineered exosomes or modified natural cellular exosomes into the joint cavity,specific signaling molecules can be delivered to various tissues in the knee cavity to regulate the intra-articular microenvironment and related cell functions,which is a new way to target the treatment of knee osteoarthri-tis.Traditional Chinese medicine has a long history in the understanding of knee osteoarthritis,and believes that the kidney is the main bone and the liver is the main tendon,and if the liver and kidney are deficient,the tendons and bones will not function normally,“liver and kidney deficiency”theory fundamentally elaborates the pathogenesis and treatment principle of knee osteoarthritis.Based on the Chinese medicine concept that the liver and kidney have the same origin and the essence and blood are born from each other,and the high similarity with the characteristics of“essence”in Chinese medicine theory,this paper attributes the attribution of bone marrow mesenchymal stem cells,one of the main sources of exosomes,to the category of“essence”in TCM,and objectively and quantitatively reveals the theoretical meaning of“liver and kidne

关 键 词：外泌体 膝骨关节炎 肝肾亏虚 

分 类 号：R684.3[医药卫生—骨科学]