摘要
随着社会的发展,慢性肾病的患病率不断上升,患病人群基数不断扩大。肾性骨病作为慢性肾病的主要并发症,容易继发骨质疏松及骨折,严重影响患者预后。近年来,随着对肾性骨病关注度的不断提高,研究的不断深入,相关学者进一步完善了肾脏-PTH信号通路在肾性骨病中的作用机制,也发现了在肾性骨病的发病进展中有其他重要的分子信号通路同时参与调控。研究显示,肾性骨病的发病机制为一相互联系的分子信号通路网:以肾脏-PTH通路为肾性骨病中调控骨-肾轴的轴心通路,Wnt/β-catenin通路、BMP通路协助调节骨形成与骨吸收(作为肾脏-PTH通路下游通路),klotho基因平衡协助通路与轴心之间的关系,骨FGF23分子反馈调节轴心通路。故有必要进行相关药物的研究,通过调控与轴心相关的分子信号通路提高预后效果,同时兼顾肾性骨病后期导致的骨疾病,以建立更有效的治疗方案。笔者综述了上述关于肾性骨病信号通路机制的相关研究进展,为深入探讨肾性骨病发病机制及临床肾性骨病的防治提供参考。
With the development of society,the prevalence of chronic kidney disease is on the rise,and the base of patient population has been expanding.As one of the main complications of chronic kidney disease,renal osteodystrophy is prone to osteoporosis and fracture,which seriously affects the prognosis of patients.In recent years,with the increasing attention to renal osteopathy and the deepening of research,relevant scholars have further studied the mechanism of renal-PTH signaling pathway in renal osteopathy.It has been found that other important molecular signaling pathways are involved in the regulation of the progression of renal osteopathy.Researches show that the pathogenesis of renal osteodystrophy is referred to a network of signaling pathways,in which the renal-PTH pathway plays the central role.The balance of bone formation and resorption is regulated through the Wnt/β-catenin pathway and the BMP pathway.Klotho gene and bone FGF23 molecule help to balance and to feedback.Therefore,it is necessary to conduct research on related medicine and to improve the prognosis by regulating the molecular signaling pathway related axis.Meanwhile,bone diseases as a late clinical syndrome of chronic kidney disease should be taken care,in order to establish a more effective treatment.This article reviews the abovementioned research progress on the signaling pathway of renal osteopathy and provides a reference for further investigation of the pathogenesis of renal osteodystrophy for the prevention and treatment.
作者
伍子贤
戴如璋
林少豪
冯元蓝
梁德
江晓兵
任辉
唐晶晶
WU Zixian;DAI Ruzhang;LIN Shaohao;FENG Yuanlan;LIANG De;JIANG Xiaobing;REN Hui;TANG Jingjing(Guangzhou University of Chinese Medicine,Guangzhou 510405;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2020年第1期146-151,共6页
Chinese Journal of Osteoporosis
关键词
慢性肾病
肾性骨病
分子信号通路网
骨质疏松
chronic kidney disease
renal osteodystrophy
network of signaling pathways
osteoporosis
