[骨质疏松症的病理生理学:局部因素的作用]

[The physiopathology of osteoporosis: the role of local factors].

作者信息

Girasole G, Giuliani N

机构信息

Istituto di Clinica Medica Generale e Terapia Medica, Università degli Studi di Parma.

出版信息

Ann Ital Med Int. 1995 Oct;10 Suppl:9S-17S.

DOI:
PMID:8562275
Abstract

Bone remodelling continues throughout life and depends on two processes that are tightly coupled: resorption of old bone by osteoclasts and subsequent new bone formation by osteoblasts. Evidence accumulated during the last few years has clearly indicated that bone marrow microenvironment plays an essential role in regulating bone remodelling. Indeed major advances in our understanding of the ontogeny of osteoclasts and osteoblasts indicate that both cell types derive from progenitors present in the marrow, and that systemic and local factors regulate their development and the coupling of their function. In particular, a network of cytokines and growth factors is essential for the regulation of both osteoclastogenesis and osteoblast formation: these factors play a pivotal role in the paracrine regulatory control of bone turnover under physiological conditions. Among this array of local factors, IL-6, IL-1, TNF, GM-CSF, cytokines with osteoclastogenic and bone resorptive properties, have been implicated in the pathophysiology of osteoporosis since their production is increased in vivo in humans and animals with estrogen deficiency. These findings provide emerging insights into the pathophysiology of osteoporosis and deserve further investigation.

摘要

骨重塑在一生中持续进行,它依赖于两个紧密相连的过程:破骨细胞对旧骨的吸收以及随后成骨细胞形成新骨。过去几年积累的证据清楚地表明,骨髓微环境在调节骨重塑中起着至关重要的作用。事实上,我们对破骨细胞和成骨细胞个体发生的理解取得的重大进展表明,这两种细胞类型均源自骨髓中的祖细胞,并且全身和局部因素调节它们的发育及其功能的耦合。特别是,细胞因子和生长因子网络对于破骨细胞生成和成骨细胞形成的调节至关重要:这些因子在生理条件下对骨转换的旁分泌调节控制中起关键作用。在这一系列局部因素中,具有破骨细胞生成和骨吸收特性的白细胞介素-6、白细胞介素-1、肿瘤坏死因子、粒细胞-巨噬细胞集落刺激因子等细胞因子,因其在雌激素缺乏的人类和动物体内的产生增加,已被认为与骨质疏松症的病理生理学有关。这些发现为骨质疏松症的病理生理学提供了新的见解,值得进一步研究。

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