摘要
糖尿病性骨质疏松症(diabetic osteoporosis,DOP)是长期高血糖状态致骨稳态失衡,出现以骨显微结构受损,骨量减少,骨脆性增加为特征的继发性骨质疏松症,为糖尿病患者致残率升高的主要原因之一。高糖毒性、晚期糖基化终末产物(AGEs)堆积与糖脂代谢异常等致自由氧(ROS)水平升高,诱导氧化应激并激活相关信号通路,通过介导炎症等细胞因子的释放,调控骨髓间充质干细胞(BMSCs)、成骨细胞(OB)及破骨细胞(OC)的生成、分化与凋亡,为本病发生发展的重要机制,p38丝裂原活化蛋白激酶(p38MAPK)信号通路为ROS下游信号通路,是骨代谢的重要调节因子,可通过响应氧化应激在DOP病理进程中起关键作用。中药可通过调控p38MAPK信号通路,以其多靶点的优势通过抗氧化应激及炎症反应等以治疗DOP,弥补西药治疗的不足之处。文章对p38MAPK信号通路与DOP之间的关系进行总结,明确p38MAPK信号通路对DOP的重要意义,并归纳靶向p38MAPK信号通路干预DOP的中药,为DOP的防治研究提供新思路。
Diabetic osteoporosis(DOP)is a secondary osteoporosis characterized by impaired bone microstructure,reduced bone mass and increased bone fragility due to imbalance in bone homeostasis caused by long-term hyperglycemia,and is one of the main causes of increased disability in diabetic patients.High glucose toxicity,accumulation of advanced glycation end products(AGEs)and abnormal glucolipid metabolism lead to increased levels of reactive oxygen species(ROS),which induce oxidative stress and activate related signaling pathways that mediate the release of inflammatory and other cytokines and regulate bone marrow mesenchymal stemcells(BMSCs).mesenchymal stemcells(BMSCs),osteoblast(OB)and osteoclast(OC)generation,differentiation and apoptosis,which are important mechanisms for the development of the disease.p38 mitogen-activated protein kinase(p38MAPK)signaling pathway is a downstream signaling pathway of ROS,which is an important regulator of bone metabolism and can be activated by In response to oxidative stress,it plays a key role in the pathological process of DOP.Modern research has found that traditional Chinese medicine can regulate the p38MAPK signaling pathway to treat DOP through antioxidant stress and inflammatory response with its multi-target advantage,which can make up for the shortcomings of western medicine treatment.In this paper,we will summarize the relationship between p38MAPK signaling pathway and DOP,clarify the importance of p38MAPK signaling pathway on DOP,and summarize the herbal medicines that target p38MAPK signaling pathway to intervene DOP,so as to provide new ideas for the prevention and treatment research of DOP.
作者
马雪
马欢欢
马英武
马泽斌
邓瑞
马旭升
MA Xue;MA Huanhuan;MA Yingwu;MA Zebin;DENG Rui;MA Xusheng(The First People's Hospital of Zhangjiachuan County,Tianshui 730030,Gansu,China)
出处
《实用中医内科杂志》
2025年第9期71-75,共5页
Journal of Practical Traditional Chinese Internal Medicine
基金
甘肃省科技重点研发计划项目(21YF5FA022)
兰州市人才创新创业项目(2021-RC-118)。
关键词
P38MAPK通路
糖尿病性骨质疏松症
氧化应激
炎性反应
中药
p38MAPK pathway
diabetic osteoporosis
oxidative stress
inflammatory response
traditional Chinese medicine
