摘要
膝骨关节炎(Knee osteoarthritis,KOA)是最常见的退行性疾病,其发病机制尚未完全阐明。研究表明,线粒体功能障碍与衰老及退行性疾病密切相关,维持线粒体功能稳态对KOA治疗具有重要意义。线粒体自噬可通过清除受损线粒体来维持线粒体稳态,因此调控线粒体自噬可能成为KOA治疗的潜在靶点。此外,近年研究发现,巨噬细胞在维持关节内免疫微环境稳态中发挥关键作用。M1/M2型巨噬细胞极化失衡会导致炎性因子和金属蛋白酶等物质的异常释放,从而加速KOA进展。中医“脾失散津,浊毒内生”理论与线粒体自噬/巨噬细胞极化在机制上具有相似性。本文基于“脾失散津,浊毒内生”理论,结合现代医学研究,探讨中医药通过调控线粒体自噬/巨噬细胞极化防治KOA的作用机制。这一研究不仅有助于深入揭示中医理论的现代科学内涵,同时可为中医药防治KOA提供新的组方思路和临床参考。
Knee osteoarthritis(KOA)is the most common degenerative joint disease,and its pathogenesis remains incompletely understood.Studies have shown that mitochondrial dysfunction is closely associated with aging and degenerative diseases,making the maintenance of mitochondrial homeostasis is crucial for KOA treatment.Mitophagy,by clearing damaged mitochondria,helps preserve mitochondrial balance,suggesting that regulating mitophagy could be a potential therapeutic target for KOA.Additionally,recent research has revealed that macrophages play a key role in maintaining immune microenvironment homeostasis within the joint.An imbalance in M1/M2 macrophage polarization can lead to excessive release of inflammatory cytokines and matrix metalloproteinases,thereby accelerating KOA progression.The Traditional Chinese Medicine(TCM)theory of"spleen lost essence,turbid toxin endogenous"shares mechanistic similarities with mitophagy/macrophage polarization.Based on this theory and modern medical research,this paper explores the mechanisms by which TCM may prevent and treat KOA through the regulation of mitophagy/macrophage polarization.This study not only contributes to a deeper understanding of the scientific basis of TCM theory but also provides novel insights into TCM formulation strategies and clinical approaches for KOA management.
作者
叶子丰
谭旭仪
院一蔚
邝高艳
卢敏
YE Zifeng;TAN Xuyi;YUAN Yiwei;KUANG Gaoyan;LU Min(Hunan University of Chinese Medicine,Changsha 410208,China;The First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;The Affiliated Hospital of Hunan Academy of Chinese Medicine,Changsha 410006,China)
出处
《中国中医基础医学杂志》
2025年第9期1547-1552,共6页
JOURNAL OF BASIC CHINESE MEDICINE
基金
国家自然科学基金项目(82174414,82274543)
国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)
湖南省中医药管理局“十四五”第一批中医药领军人才培养项目(rsk-023-01)。
关键词
膝骨关节炎
脾失散精
浊毒内生
线粒体自噬
巨噬细胞极化
Knee osteoarthritis
Spleen lost essence
Turbid toxin endogenous
Mitophagy
Macrophage polarization
