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| 外泌体在针灸干预间充质干细胞抗骨质疏松症中作用机制 |
| Exploration of the mechanism of exosomes in the treatment of osteoporosis with acupuncture-mediated bone marrow mesenchymal stem cell therapy |
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| DOI：10.3969/j.issn.1006-7108.2026.06.020 |
| 中文关键词: 骨质疏松症 针灸 外泌体 骨髓间充质干细胞 信号通路 |
| 英文关键词:osteoporosis acupuncture exosomes bone marrow mesenchymal stem cells signaling pathways |
| 基金项目:国家自然科学地区基金项目（82260862） |
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| 中文摘要: |
| 骨质疏松症的治疗面临长期用药安全性和有效性的双重挑战。近年来，针灸调控骨代谢的作用机制与外泌体的治疗潜力成为研究热点。本综述系统梳理了针灸通过激活Wnt/β-catenin信号通路、下调DKK1表达，显著改善骨密度和骨微结构的证据，同时深入探讨了间充质干细胞来源外泌体通过携带miR-196a、miR-27a等功能性miRNA靶向调控Wnt、Hippo、PI3K/Akt和NF-κB等多条信号通路，从而促进成骨分化、抑制破骨活性的分子机制。特别关注了针灸可能通过调节外泌体释放及其内容物来增强骨形成的新发现。尽管现有研究证实了针灸-外泌体协同治疗的潜力，但仍面临外泌体规模化生产、标准化治疗方案和临床转化证据不足等挑战。未来研究应着力于外泌体工程化修饰和针灸预处理策略的优化，以推动这一无细胞治疗新策略的临床应用。 |
| 英文摘要: |
| The treatment of osteoporosis faces dual challenges regarding long-term medication safety and efficacy. Recent research has focused on acupuncture's regulatory mechanisms in bone metabolism and the therapeutic potential of exosomes. This review systematically synthesizes evidence demonstrating acupuncture-mediated activation of the Wnt/β-catenin pathway and downregulation of DKK1 expression, which significantly improves bone mineral density and microstructure. It further elucidates molecular mechanisms whereby mesenchymal stem cell-derived exosomes deliver functional miRNAs (e.g., miR-196a, miR-27a) to modulate multiple signaling pathways (Wnt, Hippo, PI3K/Akt, NF-κB), enhancing osteogenic differentiation while suppressing osteoclastic activity. Special emphasis is placed on emerging findings suggesting that acupuncture may potentiate bone formation by modulating exosome secretion and cargo composition. Despite demonstrated potential of acupuncture-exosome combinatory therapy, challenges persist in exosome scalable production, standardized protocols, and limited clinical translation evidence. Future investigations should prioritize engineered exosome modifications and optimized acupuncture preconditioning strategies to advance clinical implementation of this cell-free therapeutic paradigm. |
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