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抑制过度活跃的胰岛素样生长因子 1 可减轻小鼠创伤性异位骨化。

Suppression of Overactive Insulin-Like Growth Factor 1 Attenuates Trauma-Induced Heterotopic Ossification in Mice.

机构信息

Orthopaedic Institute, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi, China; Wuxi School of Medicine, Jiangnan University, Wuxi, China.

Department of Orthopedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi, China; Suzhou Medical College of Soochow University, Soochow University, Suzhou, China.

出版信息

Am J Pathol. 2024 Mar;194(3):430-446. doi: 10.1016/j.ajpath.2023.11.012. Epub 2023 Dec 13.

Abstract

Heterotopic ossification (HO) is the ectopic bone formation in soft tissues. Aside from hereditary HO, traumatic HO is common after orthopedic surgery, combat-related injuries, severe burns, or neurologic injuries. Recently, mammalian target of rapamycin (mTOR) was demonstrated to be involved in the chondrogenic and osteogenic processes of HO formation. However, its upstream signaling mechanism remains unknown. The current study used an Achilles tendon puncture-induced HO model to show that overactive insulin-like growth factor 1 (IGF-1) was involved in the progression of HO in mice. Micro-computed tomography imaging showed that IGF-1 not only accelerated the rate of osteogenesis and increased ectopic bone volume but also induced spontaneous ectopic bone formation in undamaged Achilles tendons. Blocking IGF-1 activity with IGF-1 antibody or IGF-1 receptor inhibitor picropodophyllin significantly inhibited HO formation. Mechanistically, IGF-1/IGF-1 receptor activates phosphatidylinositol 3-kinase (PI3K)/Akt signaling to promote the phosphorylation of mTOR, resulting in the chondrogenic and osteogenic differentiation of tendon-derived stem cells into chondrocytes and osteoblasts in vitro and in vivo. Inhibitors of PI3K (LY294002) and mTOR (rapamycin) both suppressed the IGF-1-stimulated mTOR signal and mitigated the formation of ectopic bones significantly. In conclusion, these results indicate that IGF-1 mediated the progression of traumatic HO through PI3K/Akt/mTOR signaling, and suppressing IGF-1 signaling cascades attenuated HO formation, providing a promising therapeutic strategy targeting HO.

摘要

异位骨化(HO)是指软组织中的异位骨形成。除遗传性 HO 外,骨科手术后、战斗相关损伤、严重烧伤或神经损伤后也常见创伤性 HO。最近,雷帕霉素靶蛋白(mTOR)被证明参与 HO 形成的软骨和成骨过程。然而,其上游信号机制尚不清楚。本研究使用跟腱穿刺诱导的 HO 模型表明,过度活跃的胰岛素样生长因子 1(IGF-1)参与了小鼠 HO 的进展。微计算机断层扫描成像显示,IGF-1 不仅加速了成骨速度,增加了异位骨体积,而且还在未受损的跟腱中诱导自发性异位骨形成。用 IGF-1 抗体或 IGF-1 受体抑制剂 picropodophyllin 阻断 IGF-1 活性可显著抑制 HO 的形成。从机制上讲,IGF-1/IGF-1 受体激活磷脂酰肌醇 3-激酶(PI3K)/Akt 信号通路,促进 mTOR 的磷酸化,导致肌腱源性干细胞在体外和体内向软骨细胞和成骨细胞的软骨和成骨分化。PI3K 抑制剂(LY294002)和 mTOR(雷帕霉素)抑制剂均可抑制 IGF-1 刺激的 mTOR 信号,并显著减轻异位骨的形成。总之,这些结果表明 IGF-1 通过 PI3K/Akt/mTOR 信号通路介导创伤性 HO 的进展,抑制 IGF-1 信号级联可减轻 HO 的形成,为靶向 HO 的治疗策略提供了有希望的选择。

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