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[风湿病与骨代谢]

[Rheumatism and bone metabolism].

作者信息

Dischereit G, Lange U

机构信息

Abteilung für Internistische Rheumatologie, Osteologie, Physikalische Medizin, Justus-Liebig-Universität Gießen, Kerckhoff-Klinik, Bad Nauheim, Deutschland.

Rheumazentrum Mittelhessen, Sebastian-Kneipp-Str. 36, 35080, Bad Endbach, Deutschland.

出版信息

Orthopade. 2019 Nov;48(11):911-916. doi: 10.1007/s00132-019-03809-3.

Abstract

Inflammatory rheumatic diseases are often associated with secondary osteoporosis, as many inflammatory messengers can interfere with bone metabolism and adversely affect it. In addition to a decrease in densitometric bone density, remodeling occurs in the trabecular bone, which can lead to a disturbed microarchitecture and increase the risk of fracture.Central to this is the close integration of bone metabolism and the immune system. Proinflammatory cytokines play an important role not only in the inflammatory process, but also as mediators of bone resorption because they stimulate osteoclastogenesis and induce further signal transduction cascades with negative influence on the bone. The understanding gained in recent years of the underlying immunological processes has led to the development of new and targeted treatment approaches.

摘要

炎性风湿性疾病常与继发性骨质疏松相关,因为许多炎性介质会干扰骨代谢并对其产生不利影响。除了骨密度计测量的骨密度降低外,小梁骨还会发生重塑,这可能导致微结构紊乱并增加骨折风险。其核心是骨代谢与免疫系统的紧密整合。促炎细胞因子不仅在炎症过程中起重要作用,还作为骨吸收的介质,因为它们刺激破骨细胞生成并诱导进一步的信号转导级联反应,对骨骼产生负面影响。近年来对潜在免疫过程的认识推动了新的靶向治疗方法的发展。

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