促炎因子及基质金属蛋白酶在骨关节炎发病机制及相关治疗中的地位和作用

背景:虽然已经提出了一些与骨关节炎相关的危险因素,包括遗传易感性、衰老、肥胖、关节结构及力线异常等,但骨关节炎的发病机制在很大程度上仍不清楚。目的:综述国内外相关文献,总结促炎因子及基质金属蛋白酶在骨关节炎中的作用机制及相关治疗进展。方法:第一作者以“骨关节炎,白细胞介素1,白细胞介素6,白细胞介素17,C-反应蛋白,肿瘤坏死因子α,基质金属蛋白酶,治疗”为中文检索词,以“osteoarthritis,Interleukin-1,Interleukin-6,Interleukin-17,C-reactive protein,tumor necrosis factor-α,matrix metalloproteinase,treatment”为英文检索词,检索1990年1月以来PubMed和中国知网数据库收录的基础及临床研究。结果与结论:①骨关节炎是一种由多种因素导致的关节疾病,发病机制复杂,主要受到多种信号通路的调控,其中炎症细胞因子及基质金属蛋白酶在骨关节炎发病机制中的作用已经越来越明显,调控着骨关节炎的发生和发展,但仍需要更深入的研究探讨;②相信在不远的将来,明确骨关节炎的致病机制,探究新型的治疗手段,特别是干细胞疗法、基因治疗等方法的引入,有望使今后对骨关节炎的治疗和预防更具针对性。

Proinflammatory factors and matrix metalloproteinases:status and roles in the pathogenesis of osteoarthritis

BACKGROUND: Although some risk factors related to osteoarthritis have been proposed, including genetic susceptibility, aging, obesity, joint structure andforce line abnormalities, the pathogenesis of osteoarthritis is still unclear to a large extent.OBJECTIVE: To review the related literature worldwide, and summarize the mechanism of proinflammatory factors and matrix metalloproteinases in osteoarthritis as well as relevant therapeutic advances.METHODS: With the key words of “osteoarthritis, interleukin-1, interleukin-6, interleukin-17, C-reactive protein, tumor necrosis factor-α, matrixmetalloproteinase, treatment” as the key words in English and Chinese respectively, the first author searched for the basic and clinical research in PubMed andCNKI databases in the period from January 1990 to present.RESULTS AND CONCLUSION: Osteoarthritis is a kind of joint disease caused by many factors. The pathogenesis is complex, mainly regulated by a variety ofsignal pathways, among which the role of inflammatory cytokines and matrix metalloproteinases in the pathogenesis of osteoarthritis has become increasinglyobvious. However, in-depth investigations on regulating the occurrence and development of osteoarthritis are still required. It is believed that in the nearfuture, clarifying the pathogenic mechanism of osteoarthritis and developing new treatments, especially introducing stem cell therapy and gene therapy, areexpected to greatly target the treatment and prevention of osteoarthritis.