摘要
强直性脊柱炎(ankylosing spondylitis,AS)是一种自身免疫功能异常引起的以慢性炎症性关节炎为主要表现的疾病,可发展为脊柱关节炎,慢性炎症和病理性骨形成是它的两个主要病理特点。进行性的脊柱关节僵硬引起的脊柱活动障碍是患者最常见的主诉,因此对脊柱关节的异常骨增生的病理机制得到广泛的关注。但随着对AS研究的深入,发现在脊柱局部过度骨化的同时伴有系统性的骨丢失,表明AS发病过程不仅仅是单一的成骨或破骨异常,而是处于兼有两者的骨代谢失衡环境中。目前研究发现AS疾病中Wnt、BMP信号通路和炎症反应在AS疾病中既促进成骨,又能影响破骨细胞形成;而破骨细胞在发挥骨吸收作用的同时,它的产物又参与了新生骨形成。但大多数研究均是着重于描述单独的成骨或破骨机制,未能明确地阐明它们是如何在引起脊柱周围骨质增生的同时导致全身骨量丢失的具体作用机制。AS病理过程中炎症因子是否在不同的部位发挥不同的作用,如何在控制新生骨形成的同时减少骨质疏松发生的风险,这些问题仍需要得到进一步的探索研究。
Ankylosing spondylitis(AS)is a disease characterized by chronic inflammatory arthritis caused by abnormal autoimmune function,which can develop into spinal arthritis.Chronic inflammation and pathological bone formation are its two main pathological features.Progressive spinal dyskinesia is the most important complaint in patients.So the pathological mechanism of abnormal osseous hyperplasia of the spinal joint is widely concerned.However,with the further study of AS,it is found that partial ossification of the spinal column often accompanied by systemic bone loss.This indicated that pathogenesis of AS is not due to the occurrence of abnormal osteogenesis or bone resorption alone,but because of an unbalanced environment of bone metabolism with both.Recent studies have shown Wnt,BMP signaling pathway and inflammatory reaction in AS disease not only promote osteogenesis,but also affect osteoclast formation.Nevertheless osteoclast plays a role in bone resorption,while its products participate in new bone formation.However,most studies have only focused on describing a single mechanism of osteogenesis or osteoclasts in the AS,and have not clearly elucidated how they contribute to bone mass loss in the whole body while causing bone hyperplasia around the spine.In the pathological process of AS,whether the inflammatory factors play different roles in different parts of the body,and how to control the formation of new bone and reduce the risk of osteoporosis,need to be further explored.
作者
胡劲涛
柴乐
任伟凡
吕建兰
全仁夫
HU Jintao;CHAI Le;REN Weifan;LV Jianlan;QUAN Renfu(Zhejiang Chinese Medical University,Hangzhou310053;Hangzhou Xiaoshan District Hospital of Traditional Chinese Medicine,Hangzhou311200,China)
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2019年第6期875-879,共5页
Chinese Journal of Osteoporosis
基金
浙江省重大科技专项(2014C03031)
关键词
强直性脊柱炎
炎症
骨代谢
ankylosing spondylitis
inflammation
bone metabolism
