Krajewska-Włodarczyk Magdalena, Stompór Tomasz
Department of Rheumatology, Municipal Polyclinical Hospital in Olsztyn.
Department of Nephology, Hypertensiology and Internal Diseases, Warmia-Mazurian University of Olsztyn.
Pol Merkur Lekarski. 2017 Jul 21;43(253):41-47.
Disorders of bone tissue metabolism and increased frequency of cardiovascular diseases are among the well-known, extra-articular complications of rheumatoid arthritis (ra). The mechanisms leading to local and generalized loss of bone tissue as well as those promoting calcification of vessels are similar. Recently, a great interest has aroused among the studies related to the meaning of the RANKL/RANK/OPG system and the Wnt/β-catenin signaling pathway, as biological links between the bone and vascular systems. In the course of ra, lowering of the mineral density of bones and intensification of vascular calcification seem to be associated with the increase of plasma concentration of osteoprotegerin (OPG) and sclerostin - the regulatory proteins of the RANKL/RANK/OPG system and the Wnt/β-catenin pathway. Molecular mechanisms associated with the osteoblasts' activation and repression of bone resorption in the future can become the target of a precise, combination therapy in osteoporosis and calcification changes. The article presents the role of the RANKL/RANK/ OPG system and the Wnt/β-catenin pathway in the pathogenesis of disorders of bone tissue metabolism and calcification of vessels in ra, with particular emphasis on the role of OPG and sclerostin.
骨组织代谢紊乱和心血管疾病发病率增加是类风湿关节炎（RA）常见的关节外并发症。导致局部和全身性骨组织丢失以及促进血管钙化的机制相似。最近，与RANKL/RANK/OPG系统和Wnt/β-连环蛋白信号通路的意义相关的研究引起了极大兴趣，它们是骨骼和血管系统之间的生物学联系。在RA病程中，骨矿物质密度降低和血管钙化加剧似乎与骨保护素（OPG）和硬化素血浆浓度升高有关，这两种蛋白是RANKL/RANK/OPG系统和Wnt/β-连环蛋白通路的调节蛋白。与成骨细胞活化和骨吸收抑制相关的分子机制未来可能成为骨质疏松症和钙化改变精准联合治疗的靶点。本文介绍了RANKL/RANK/OPG系统和Wnt/β-连环蛋白通路在RA骨组织代谢紊乱和血管钙化发病机制中的作用，特别强调了OPG和硬化素的作用。
