Department of Osteoporosis, The Second Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China.
Department of Ultrasound, The Second Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China.
J Pharm Pharmacol. 2019 Oct;71(10):1469-1474. doi: 10.1111/jphp.13135. Epub 2019 Jul 11.
Osteoporosis is a skeletal disease with decreased bone mass and alteration in microarchitecture of bone tissue, and these changes put patients in risk of bone fracture. As a common symptom of osteoporosis and complication of osteoporotic fracture, chronic pain is a headache for clinicians. Nonsteroidal anti-inflammatory drugs (NSAIDs), selective COX-2 inhibitors and opioid drugs can temporarily reduce osteoporotic pain but have relevant side effects, such as addiction, tolerability and safety. The review summarized the recent advancements in the study of CB receptors in osteoporosis and osteoporotic pain and related mechanisms.
Recent studies indicated the two nociceptive receptors, cannabinoid receptor (CB) and transient receptor potential vanilloid type 1 (TRPV1) channel, are co-expressed in bone cells and play important role in the metabolism of bone cells, suggesting that dualtargeting these 2 receptors/channel may provide a novel approach for osteoporotic pain. In addition, both CB receptor and TRPV1 channel are found to be expressed in the glial cells which play vital role in mediating inflammation, chronic pain and metabolism of bone cells, suggesting a role of glial cells inosteoporotic pain.
Multiple-targeting against glial cells, CB receptors and TRPV1 channel may be one effective therapeutic strategy for osteoporotic pain in the future, following the elucidation of the complicated mechanism.
骨质疏松症是一种骨骼疾病，其特征是骨量减少和骨组织微观结构改变，这些变化使患者面临骨折风险。作为骨质疏松症的常见症状和骨质疏松性骨折的并发症，慢性疼痛令临床医生头疼。非甾体抗炎药（NSAIDs）、选择性 COX-2 抑制剂和阿片类药物可以暂时减轻骨质疏松性疼痛，但具有相关的副作用，如成瘾性、耐受性和安全性。本综述总结了近年来关于 CB 受体在骨质疏松症和骨质疏松性疼痛及其相关机制中的研究进展。
最近的研究表明，两种伤害性受体，大麻素受体（CB）和瞬时受体电位香草酸 1 型（TRPV1）通道，在骨细胞中共表达，并在骨细胞代谢中发挥重要作用，这表明双重靶向这些 2 个受体/通道可能为骨质疏松性疼痛提供一种新的治疗方法。此外，CB 受体和 TRPV1 通道都在神经胶质细胞中表达，这些细胞在介导炎症、慢性疼痛和骨细胞代谢中起着至关重要的作用，这表明神经胶质细胞在骨质疏松性疼痛中起作用。
针对神经胶质细胞、CB 受体和 TRPV1 通道的多靶点治疗可能是未来治疗骨质疏松性疼痛的一种有效策略，这需要进一步阐明其复杂的机制。
