de Molon Rafael Scaf
Department of Diagnosis and Surgery, School of Dentistry at Araçatuba, São Paulo State University, Araçatuba 16015-050, Brazil.
Dent J (Basel). 2025 Jul 9;13(7):309. doi: 10.3390/dj13070309.
Tanshinones are a class of lipophilic diterpenoid quinones extracted from (Dan shen), a widely used herb in traditional Chinese medicine. These compounds, particularly tanshinone IIA (T-IIA) and sodium tanshinone sulfonate (STS), have been acknowledged for their broad spectrum of biological activities, including anti-inflammatory, antioxidant, anti-tumor, antiresorptive, and antimicrobial effects. Recent studies have highlighted the potential of tanshinones in the treatment of osteolytic diseases, characterized by excessive bone resorption, such as osteoporosis, rheumatoid arthritis, and periodontitis. The therapeutic effects of tanshinones in these diseases are primarily attributed to their ability to inhibit osteoclast differentiation and activity, suppress inflammatory cytokine production (e.g., tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, and IL-6), and modulate critical signaling pathways, including NF-kB, MAPK, PI3K/Akt, and the RANKL/RANK/OPG axis. Additionally, tanshinones promote osteoblast differentiation and mineralization by enhancing the expression of osteogenic markers such as Runx2, ALP, and OCN. Preclinical models have demonstrated that T-IIA and STS can significantly reduce bone destruction and inflammatory cell infiltration in arthritic joints and periodontal tissues while also enhancing bone microarchitecture in osteoporotic conditions. This review aims to provide a comprehensive overview of the pharmacological actions of tanshinones in osteolytic diseases, summarizing current experimental findings, elucidating underlying molecular mechanisms, and discussing the challenges and future directions for their clinical application as novel therapeutic agents in bone-related disorders, especially periodontitis. Despite promising in vitro and in vivo findings, clinical evidence remains limited, and further investigations are necessary to validate the efficacy, safety, and pharmacokinetics of tanshinones in human populations.
丹参酮是一类从丹参中提取的亲脂性二萜醌类化合物,丹参是一种在传统中药中广泛使用的草药。这些化合物,特别是丹参酮IIA(T-IIA)和丹参酮磺酸钠(STS),因其广泛的生物活性而受到认可,包括抗炎、抗氧化、抗肿瘤、抗吸收和抗菌作用。最近的研究强调了丹参酮在治疗以骨吸收过多为特征的溶骨性疾病方面的潜力,如骨质疏松症、类风湿性关节炎和牙周炎。丹参酮在这些疾病中的治疗作用主要归因于它们能够抑制破骨细胞的分化和活性,抑制炎性细胞因子的产生(如肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β和IL-6),并调节关键信号通路,包括NF-kB、MAPK、PI3K/Akt和RANKL/RANK/OPG轴。此外,丹参酮通过增强成骨标志物如Runx2、ALP和OCN的表达来促进成骨细胞的分化和矿化。临床前模型表明,T-IIA和STS可以显著减少关节炎关节和牙周组织中的骨破坏和炎性细胞浸润,同时还能改善骨质疏松症患者的骨微结构。本综述旨在全面概述丹参酮在溶骨性疾病中的药理作用,总结当前的实验结果,阐明潜在的分子机制,并讨论将其作为骨相关疾病,特别是牙周炎的新型治疗药物进行临床应用所面临的挑战和未来方向。尽管在体外和体内研究中取得了有前景的结果,但临床证据仍然有限,需要进一步研究来验证丹参酮在人群中的疗效、安全性和药代动力学。