丙戊酸对骨骼的影响：从临床研究到细胞培养——重新审视分子机制
The effect of VPA on bone: From clinical studies to cell cultures-The molecular mechanisms revisited.
作者信息
Pitetzis Dimitris A, Spilioti Martha G, Yovos John G, Yavropoulou Maria P
机构信息
1st Neurologic Department, AHEPA University Hospital, Aristotle University of Thessaloniki, AUTH, Greece.
Division of Endocrinology and Metabolism, 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, AUTH, Greece.
出版信息
Seizure. 2017 May;48:36-43. doi: 10.1016/j.seizure.2017.03.013. Epub 2017 Mar 22.
PURPOSE
Valproic acid (VPA) is a broad-spectrum antiepileptic drug, which is widely used as a first line treatment for idiopathic and symptomatic generalized epilepsy, as well as in non-epileptic psychiatric disorders in adult and pediatric patients. Although valproic acid is considered to be a generally well-tolerated drug, numerous studies have shown an increased bone loss and fracture risk in patients treated with VPA. The purpose of this review is to outline recent findings on VPA molecular mechanisms and their action on bone metabolism.
METHODS
Unrestricted electronic search of medical databases, complemented by additional manual searches, was performed by August 2016.
RESULTS/CONCLUSION: The main effects of VPA on bone metabolism involve a decrease in osteoblast proliferation, changes in collagen synthesis as well as an induction of vitamin D catabolism. Apart from these direct actions of VPA in bone, indirect effects affecting other endocrine organs also contribute to VPA-induced bone loss.
目的
丙戊酸（VPA）是一种广谱抗癫痫药物，广泛用作特发性和症状性全身性癫痫的一线治疗药物，也用于成人和儿童患者的非癫痫性精神疾病。尽管丙戊酸被认为是一种耐受性普遍良好的药物，但大量研究表明，接受VPA治疗的患者骨质流失和骨折风险增加。本综述的目的是概述关于VPA分子机制及其对骨代谢作用的最新研究结果。
方法
截至2016年8月，对医学数据库进行了无限制的电子检索，并辅以额外的手动检索。
结果/结论：VPA对骨代谢的主要影响包括成骨细胞增殖减少、胶原蛋白合成变化以及维生素D分解代谢的诱导。除了VPA在骨中的这些直接作用外，影响其他内分泌器官的间接作用也导致了VPA诱导的骨质流失。
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