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| 骨性关节炎发病机制研究进展 |
| The research progress of the pathogenesis of osteoarthritis |
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| DOI：10.3969/j.issn.1006.7108.2016.07.023 |
| 中文关键词: 骨性关节炎 基础研究 发病机制 水通道蛋白 细胞因子 |
| 英文关键词:Osteoarthritis Basic research Pathogenesis Aquaporins Cytokines |
| 基金项目:陕西省重点科技创新团队项目（2013KCT-26);陕西省中医药管理局课题（13-LC054);陕西省自然科学基础研究计划项目 (2010JM4002);陕西省科学技术研究发展计划项目（201 lkjxx33);咸阳市科学技术研究项目（2010K15-02(9));陕西省教育厅重点学科及卫生部国家临床重点专科建设专项基金资助；全国名老中医药专家李堪印传承工作室建设项目资助;咸阳市科技术计划项目（2013K12-01) |
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| 中文摘要: |
| 骨性关节炎（osteoarthrith,OA)是一种慢性全身性进展性关节疾病，临床上最常表现为受累关节的慢性疼痛，伴活动受限，严重者关节肿大僵硬甚至畸形，主要病理改变为关节软骨退行性改变及其局部骨质硬化增生，但其具体发病机制不明。过去普遍认为骨内压增高在OA的病机中发挥重要作用，然而随着临床的迫切需求和分子生物学、免疫学等相关学科的飞速发展，对其发病机制的研究有了新的认识，逐渐认为基质金属蛋白酶降解、细胞凋亡、细胞因子、水通道蛋白等也参与到OA的发生发展全过程中，尤其是后两者值得关注。细胞因子是由多种细胞产生的具有调控免疫应答反应的多肽分子，其中以白细胞介素1和胰岛素样生长因子在OA中作用显著，前者抑制软骨聚糖蛋白和胶原的合成并促进其水解，后者促进软骨细胞增殖及软骨基质合成；水通道蛋白（aquaporins，AQPs)通过调控关节软骨细胞中水的进出而调节其内环境，维持软骨细胞渗透压稳定并调节细胞外基质的合成及降解平衡，目前研究发现表达于软骨细胞的AQPs亚型为AQP1和AQP3，它们与关节软骨退变密切相关，而具体作用机制需要进一步研究。 |
| 英文摘要: |
| Osteoarthritis (OA) is a chronic progressive disease. The most common clinical manifestation is chronic joint pain, with limited activity, severe joint swelling and stiffness, even deformity. The main pathological changes are articular cartilage degeneration and its local bone sclerosis, but its specific pathogenesis is unknown. It is widely believed that the increase in bone internal pressure plays an important role in the pathogenesis of OA. However，with the urgent need in the clinic and the rapid development of molecular biology, immunology and other related disciplines, the pathogenesis research has new progress. It is gradually believed that the degradation of matrix metalloproteinases，cell apoptosis，cytokines (CK), and aquaporins (AQPs) are also involved in the development of OA, especially the latter two. Cytokines are polypeptide molecules that are produced by a variety of ceils, which have the function of regulating immune response. Among others, interleukin 1 (IL-1 ) and insulin like growth factors (IGFs) play a significant role in OA. IL-1 inhibits the synthesis of glucosamine and collagen and promotes their hydrolysis. IGFs promote the proliferation of chondrocytes and synthesis of cartilage matrix. AQPs regulates micro environment by regulation of water flow of the chondrocytes，and maintains the stability of cellular osmolarity and the balance of synthesis and degradation of the extracellular matrix. The subtypes of AQPs in cartilage are AQP1 and AQP3, which are closely related to articular cartilage degeneration. However, further research is needed for the specific pathological mechanism. |
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