摘要
骨关节炎(OA)作为一种常见的慢性、高发性、致痛、致残的关节退行性病变,因其关节活动障碍、关节疼痛剧烈等临床症状和亟待优化、完善的治疗方案,给社会医疗、患者心理与经济带来了沉重的负担。既往研究表明,OA发病与关节软骨功能障碍、软骨细胞细胞外基质(ECM)的合成和降解紊乱、关节炎症密切相关。同时有研究证实,适度的自噬可恢复受损软骨细胞的功能、调控软骨细胞凋亡、促进ECM的合成与代谢、减轻OA关节的炎症反应,延缓OA的发生和进展。此外,根据OA临床症状可将其归属为中医学“痹症”的范畴,中医药在中医学“整体观念、辨证论治、个体化诊疗”等理论指导下治疗OA的临床有效性在数千年的实践中得到了充分验证,并具有不良反应少、患者耐受性好、接受程度高的特点和优势。因此,该文以期通过简单阐述自噬及其相关调控蛋白Unc-51样自噬激活激酶1(ULK1)、Beclin-1、微管相关蛋白轻链3(LC3)等在OA中的作用,并详细总结中药干预自噬及其相关标志物在防治OA的最新研究成果,为中药干预自噬防治OA的深入研究的提供一定方向和思路,同为临床上使用中医药防治OA提供文献参考和依据。
Osteoarthritis(OA)is a common chronic,highly prevalent,painful,and disabling degenerative joint disease.It has imposed a heavy burden on social healthcare and patients'psychology and economy due to its clinical symptoms such as impaired joint mobility and severe joint pain and the immature therapies.Studies have shown that OA is closely associated with articular cartilage dysfunction,synthesis and degradation disorders of chondrocyte extracellular matrix(ECM),and joint inflammation.Moderate autophagy can restore the function of damaged chondrocytes,regulate chondrocyte apoptosis,and promote the synthesis and metabolism of ECM to alleviate the inflammation of joints and delay the onset and progression of OA.According to the clinical symptoms,OA can be classified into the category of impediment in traditional Chinese medicine.With the theories of holistic conception,treatment based on syndrome differentiation,and individualised diagnosis and treatment,traditional Chinese medicine has demonstrated definite effects in the treatment of OA in thousands of years of practice.Moreover,traditional Chinese medicine causes mild adverse reactions,and the patients have high tolerance and acceptance.This paper briefly explains the roles of autophagy and the related regulatory proteins,such as Unc-51-like autophagy-activated kinase 1(ULK1),Beclin-1,and microtubule-associated protein light chain 3(LC3),and details the latest research achievements in the prevention and control of OA by traditional Chinese medicines and its related markers via the regulation of autophagy,so as to provide a idea for the in-depth research in this field and the clinical application of traditional Chinese medicine in preventing and treating OA.
作者
柴居堂
杨倩
宁红霞
刘文娟
刘涛
魏晓涛
刘小钰
CHAI Jutang;YANG Qian;NING Hongxia;LIU Wenjuan;LIU Tao;WEI Xiaotao;LIU Xiaoyu(Hebei Provincial Hospital of Chinese Medicine,Shijiazhuang 050000,China;Shijiazhuang Hospital of Traditional Chinese Medicine(TCM),Shijiazhuang 050000,China;Gansu Provincial Hospital of TCM,Lanzhou 730000,China;Gansu University of Chinese Medicine,Lanzhou 730000,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2024年第2期287-298,共12页
Chinese Journal of Experimental Traditional Medical Formulae
基金
河北省中医药管理局科研计划项目(2021044)
国家自然科学基金项目(81860863,81660802)。
关键词
骨关节炎
自噬
中医药
研究进展
osteoarthritis
autophagy
traditional Chinese medicine
research progress
