诊断学理论与实践 ›› 2024, Vol. 23 ›› Issue (06): 634-640.doi: 10.16150/j.1671-2870.2024.06.012

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小檗碱对骨代谢的影响及相关机制研究进展

白梦瑶1, 孔博1, 杨丽惠1, 李丽娟1, 史燕青1, 孙立昊2()   

  1. 1.上海交通大学医学院附属瑞金医院无锡分院内分泌科,江苏 无锡 214125
    2.上海交通大学医学院附属瑞金医院内分泌代谢病科,上海 200025
  • 收稿日期:2024-07-05 出版日期:2024-12-25 发布日期:2024-12-25
  • 通讯作者: 孙立昊 E-mail: leoslh@163.com
  • 基金资助:
    无锡市卫生健康委青年项目(Q202205)

Research progress on effects of berberine on bone metabolism and related mechanisms

BAI Mengyao1, KONG Bo1, YANG Lihui1, LI Lijuan1, SHI Yanqing1, SUN Lihao2()   

  1. 1. Department of Endocrinology, Wuxi Branch of Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, Jiangsu Wuxi 214125, China
    2. Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2024-07-05 Published:2024-12-25 Online:2024-12-25

摘要:

骨质疏松症作为我国老年人常见的慢性疾病,伴随人口老龄化进程的加快,其患病率呈逐步上升趋势,流行病学调查显示,中国50岁以上人群骨质疏松症患病率为19.2%,65岁以上为32.0%。这不仅导致老年骨折患者数量不断增加,而且由于民众对该疾病的知晓率和治疗率均较低,使得骨质疏松症的危害尤为突出。小檗碱作为一种传统中药成分,已被证实对多种慢性代谢性及炎性疾病具有疗效,包括糖尿病、肿瘤、心血管疾病、高脂血症、炎症、细菌和病毒感染及骨质疏松症等。在骨代谢方面,无论是对绝经后引发的原发性骨质疏松症,还是糖尿病、肥胖、糖皮质激素应用等多种因素引发的继发性骨质疏松症,小檗碱均展现出一定程度的改善效果。同时在糖尿病、局部感染及炎症状态下的骨缺损修复研究中,小檗碱也表现出强大的骨再生能力。多项体内外研究显示,小檗碱不仅能够通过经典的Wnt/β -catenin、PI3K/AKT、MAPK、AMPK等信号通路来促进成骨细胞的分化和成熟,还可通过抑制 RANKL信号通路,有效抑制破骨细胞的分化和活性。同时,小檗碱还能改善组织氧化应激状态,并通过调节小分子非编码 RNA(miRNA)来对骨代谢进行调控。目前,相关研究多局限于细胞实验与动物实验阶段,距离临床应用仍有较大差距。本文聚焦小檗碱在成骨、破骨等方面的作用机制与研究进展,旨在为深入探究小檗碱治疗骨质疏松症的机制,提供全面且有价值的参考依据。

关键词: 小檗碱, 成骨细胞, 破骨细胞, 骨质疏松症

Abstract:

Osteoporosis is a common chronic disease in the elderly in China. With the acceleration of population aging, the prevalence of osteoporosis is gradually increasing. The prevalence of osteoporosis among people over 50 years old in China is 19.2%, and 32.0% for those over 65 years old. This not only results in an increasing number of elderly patients with fractures but also highlights the significant harm of osteoporosis due to the low awareness and treatment rate As a traditional Chinese medicine ingredient, berberine has been proven to be effective in treating a variety of chronic metabolic and inflammatory diseases, including diabetes, tumors, cardiovascular diseases, hyperlipidemia, inflammation, bacterial and viral infections, and osteoporosis. In terms of bone metabolism, berberine has shown certain improvements in both primary osteoporosis caused by menopause and secondary osteoporosis caused by multiple factors such as diabetes, obesity, and the use of glucocorticoids. Meanwhile, berberine has also shown strong bone regeneration ability in the study of bone defect repair under conditions of diabetes, local infection, and inflammation. Multiple in vivo and in vitro studies have shown that berberine can not only promote the differentiation and maturation of osteoblasts through classical signaling pathways such as Wnt/β‑catenin, PI3K/AKT, APK, and AMPK, but also effectively inhibit the differentiation and activity of osteoclasts by suppressing the RANKL signaling pathway. At the same time, berberine can also improve the oxidative stress state of tissues and regulate bone metabolism by regulating small non‑coding RNAs (miRNAs). This paper focuses on the mechanisms and research progress of berberine in osteogenesis and osteoclastogenesis, aiming to provide a reference for further in‑depth research on the mechanism of berberine in treating osteoporosis.

Key words: Berberine, Osteoblast, Osteoclast, Osteoporosis

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