OPG/RANKL/RANK系统与骨破坏性疾病

近年来发现的OPG/RANKL/RANK系统在破骨细胞生成中起着至关重要的作用,是骨骼生理研究领域的重大进展。成骨细胞、骨髓基质细胞、激活的T淋巴细胞表达RANKL,与破骨细胞前体细胞或成熟破骨细胞表面上的RANK结合后,促进破骨细胞的分化及骨吸收活性。成骨细胞及骨髓基质细胞分泌表达OPG可与RANKL竞争性结合,从而阻断RANKL与RANK之间的相互作用。体内多种激素或因子通过影响骨髓微环境内的OPG/RANKL比率来调节骨代谢。此外,乳腺上皮细胞表达有RANK,孕期在性激素的诱导下可表达RANKL,OPG/RANKL/RANK系统在孕期乳腺发育以及母体向胎儿的钙转运过程中发挥重要作用。阻断RANKL/RANK通路有望给骨质疏松、类风湿关节炎及癌症骨转移等骨破坏性疾病的治疗开辟新的途径。进一步研究应了解OPG/RANKL/RANK系统与其它信号传导途径的关系,重视骨骼、免疫及内分泌系统之间的相互作用。目前,开发与OPG功能相似或促进其表达的合成药物有可能成为具有良好经济效益和社会效益的产业。     

RANKL在成釉细胞瘤骨吸收机制中的作用

目的:检测RANKL在成釉细胞瘤(ameloblastoma,AM)组织中的表达情况及探讨RANKL在AM骨吸收机制中的作用.方法:通过免疫组化方法检测RANKL在AM组织中的表达情况;通过建立AM细胞/新生大鼠骨细胞共培养体系,观察AM细胞诱导破骨细胞形成的活性,再以OPG(RANKL的抑制剂)进行干预,观察OPG对AM细胞诱导破骨细胞形成活性的影响.结果:RANKL在AM组织中有恒定的表达;AM细胞能够诱导新生大鼠骨细胞分化为成熟的破骨细胞,但此活性可被OPG明显抑制.结论:AM细胞诱导破骨细胞形成可能是AM骨吸收过程中局部破骨细胞形成的重要来源和机制,而RANKL在此过程中发挥重要作用.     

microRNAs在骨形成中的作用——运动调控骨代谢的新机制

microRNAs(miRNAs)是一类具有组织或发育阶段特异性的小分子、非编码单链RNA,通过转录后与靶基因特定序列结合来发挥其调控作用. 作为骨中的最重要的两种重要细胞--成骨细胞和破骨细胞,其代谢平衡与骨形成密切相关.研究发现,miRNAs在调节成骨细胞和破骨细胞分化及功能发挥上具有重要作用,并且运动训练可通过调节miRNAs进而调控骨细胞分化. 一般来说,适宜强度运动训练可上调某些miRNAs表达来促进成骨细胞或破骨细胞分化及功能;当失重或过量运动时,则会产生抑制作用. 本文就miRNAs调控干细胞向成骨细胞和破骨细胞分化及功能发挥的分子生物学机制以及运动训练调节与骨代谢相关miRNAs表达的研究进展进行综述.     

RANKL与骨重建

骨是一种动态更新的组织,它不断进行骨吸收（bone resorption）与骨形成（bone formation）的平衡,这个过程称之为骨重建（bone remodeling）．核因子κB受体活化因子配体（receptor activator of nuclear factor κB ligand,RANKL）是骨吸收和骨形成耦联的关键,具有诱导破骨细胞（osteoclast, OC）生成、活化,抑制破骨细胞凋亡的作用．RANKL最初发现于活化的T细胞,但骨重建过程中RANKL主要来源于骨细胞、成骨细胞和骨髓基质细胞．RANKL/核因子κB受体活化因子（receptor activator of nuclear factor κB,RANK）/骨保护素（osteoprotegerin, OPG）信号通路在成骨细胞调控破骨细胞生成的过程中起着重要的调节作用,是维持骨重建平衡的关键．本文就RANKL及其在骨中的分子作用机制作一综述.     

钙敏感受体在骨代谢中的研究进展

钙敏感受体感受细胞外的钙离子水平,调控一系列激素的释放以维持机体的钙稳态。钙稳态的调节过程与骨代谢相偶联,钙敏感受体通过直接或间接对破骨和成骨细胞的调控,动员或者抑制骨钙入血。虽然钙敏感受体已被证实调控骨代谢,但是详尽的调控机制仍在不断探究中。目前认为细胞外的高钙水平会激活钙敏感受体,抑制甲状旁腺激素分泌并促进降钙素释放,进而破骨细胞被抑制,成骨细胞动员,增加了骨质合成。本文就近年来关于钙敏感受体调控骨代谢的研究进展作一综述,为促进钙敏感受体及相关作用因子治疗骨代谢疾病的研究提供参考。     

RANKL/RANK/OPG信号通路对骨代谢和血管钙化作用机制的研究现状

核因子-κB受体活化因子配体(receptor activator of nuclear factor-kappa B ligand,RANKL)/核因子-κB受体活化因子(receptor activator of nuclear factor kappa B,RANK)/骨保护素(osteoprotegerin,OPG)信号通路是调节骨代谢过程中破骨细胞功能的重要通路。OPG能够与RANKL结合并阻止其与RANK结合,抑制破骨细胞生成从而抑制骨吸收,增加骨密度,改善骨质疏松。其中,RANKL/OPG的比值是骨吸收和骨形成平衡的关键。目前血管钙化已不再被看作是单纯的钙磷的被动沉积,而是由血管平滑肌细胞和内皮细胞主动参与的一种与骨形成相似的病理生理过程。在这个过程中,RANKL/RANK/OPG信号通路也起到重要作用。本文就RANKL/RANK/OPG信号通路在骨代谢和血管钙化中的作用机制进行了综述。     

破骨细胞在类风湿性关节炎骨破坏中的作用及其调控机制

类风湿性关节炎 (RA)是一种严重的慢性炎症性疾病 ,关节软骨及骨的破坏是患者致残的主要原因。近年大量相关研究表明 ,破骨细胞 (OC)在RA骨破坏的病理过程中起关键作用。多种细胞因子参与了对OC生成、活化的调控。其中起正调控作用的主要有IL 1、TNFα、RANKL、M CSF、IL 6、IL 8、IL 17、IL 7、IL 11、IL 15等 ,起负调控作用的有OPG、IL 4、IL 10、IL 12、IL 13、IL 18、IFN λ等。OC及其调控因子的研究为RA骨破坏的治疗提供了一些潜在的靶点 ,具有重要的理论意义和实用价值     

天然产物多糖在骨质疏松中的应用及其分子机制研究进展

骨质疏松症是一种全身性骨代谢疾病,其特征是骨量的降低和骨组织微结构的破坏,最终导致骨脆性和骨折风险增加。骨质疏松严重影响着人类的生命周期和生活质量,并对社会造成巨大的经济负担。目前市场上的抗骨质疏松药物主要是化学合成药物,可以较有效地改善患者骨质疏松的症状,但长期服用会产生不良的副作用。研究发现,某些多糖能够促进成骨细胞形成、抑制破骨细胞活性,进而影响骨骼重塑过程,且因其副作用较少,更适合长期使用而受到大众青睐。该文通过对大量文献信息的整合,介绍了近年来研究较多的与改善骨骼健康状况有关的多糖。实验表明,多糖主要通过调节成骨细胞和破骨细胞的活性保护骨骼健康,多条信号通路如Wnt/β-catenin信号通路、BMP/Smad信号通路和OPG/RANKL/RANK信号通路等参与调节过程。该综述对多糖抗骨质疏松的作用及其分子机制最新研究成果进行归纳和总结,旨在为进一步推进更加安全有效的抗骨质疏松症新药物的开发提供理论依据和研究方向。     

热作用下成骨细胞HSP70 mRNA的表达变化及其对破骨细胞增殖的影响

目的:研究不同温度热作用对小鼠成骨细胞系中HSP70 mRNA表达水平的影响及其培养液对小鼠破骨细胞增殖的影响.方法:取小鼠成骨细胞系MC3T3,不同温度(37℃-39℃-41℃-42.5℃)作用其一周,RT PCR方法观察其HSP70表达水平变化,同时取其培养液上清与小鼠破骨前体细胞RAW264.7共培养,MTT法观察其增殖情况.结果:经不同温度热(37℃-39℃-41℃-42.5℃)处理后,MC3T3细胞系中HSP70表达水平明显增加,并且呈现与温度梯度依赖性,其处理后的上清液分别与小鼠破故前体细胞系RAW264.7共培养,MTT法测定其增值水平,结果其增殖受到抑制,且抑制水平与温度呈梯度依赖关系.结论:热刺激可以促进成骨细胞中HSP70的表达,促使成骨细胞抑制破骨细胞增殖,HSP70可能是参与调控成骨细胞与破骨细胞平衡的重要因子.     

中药防治假体周围骨溶解的研究进展

现如今人工关节置换术越来越多的应用于重建关节功能改善关节疾病患者的生活质量,但是术后并发症严重影响了手术的效果,人工假体周围骨溶解及假体无菌性松动又是人工关节置换术后失败的主要原因之一,所以如何预防以及发病后如何去治疗成为现今关节医生面临的重要课题。OPG/RANKL/RANK系统,炎性因子的产生,破骨细胞、成骨细胞这些都是影响人工假体术后产生无菌性松动,和引发假体周围骨溶解的重要因素,有效药物的干预治疗成为现如今关节置换术后以及围手术期的热门话题,中药因其副作用小,疗效独特,及深入的研究逐渐受到广大医生的注意,因此中药在治疗人工假体松动及骨溶解方面也得到了重大突破,本文从中医肾藏精,精生髓,髓能养骨理论着手总结中药作用于OPG/RANKL/RANK系统,抑制炎性因子、破骨细胞及促进成骨细胞增殖的研究现状。     

仙灵骨葆对骨质疏松大鼠OPG/RANK/RANKL 表达的影响

目的:观察仙灵骨葆治疗骨质疏松模型大鼠后,对大鼠体内OPG/RANKL/RANK表达的影响。方法:卵巢摘除法建立SD大鼠骨质疏松模型,设立假手术组、对照组(单纯去卵巢组)、雌激素组(给予17β-雌二醇)和治疗组(给予仙灵骨葆)。术后1周开始给药,给药12周后检测各组大鼠股骨骨密度,ELISA法检测血清中OPG/RANKL含量,RT-PCR检测骨组织中OPG/RANK/RAN-KL mRNA表达,免疫组化检测骨组织中RANK的表达。结果:对照组大鼠骨密度显著低于假手术组;治疗组和雌激素组大鼠O-PG表达显著高于对照组,RANK及RANKL的表达显著低于对照组。结论:采用卵巢摘除法成功建立大鼠骨质疏松模型;仙灵骨葆可促进骨质疏松大鼠OPG的表达,并抑制RANK及RANKL的表达,对骨质疏松模型大鼠有治疗作用。     

Functions of RANKL/RANK/OPG in bone modeling and remodeling

The discovery of the RANKL/RANK/OPG system in the mid 1990s for the regulation of bone resorption has led to major advances in our understanding of how bone modeling and remodeling are regulated. It had been known for many years before this discovery that osteoblastic stromal cells regulated osteoclast formation, but it had not been anticipated that they would do this through expression of members of the TNF superfamily: receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG), or that these cytokines and signaling through receptor activator of NF-κB (RANK) would have extensive functions beyond regulation of bone remodeling. RANKL/RANK signaling regulates osteoclast formation, activation and survival in normal bone modeling and remodeling and in a variety of pathologic conditions characterized by increased bone turnover. OPG protects bone from excessive resorption by binding to RANKL and preventing it from binding to RANK. Thus, the relative concentration of RANKL and OPG in bone is a major determinant of bone mass and strength. Here, we review our current understanding of the role of the RANKL/RANK/OPG system in bone modeling and remodeling.     

Imbalance of RANK,RANKL and OPG expression during tibial fracture repair in diabetic rats

To clarify the mechanisms of altered bone repair in the diabetic state, we investigated RANK, RANKL and OPG expression by immunohistochemistry and RT-PCR in the fracture sites of rats that were either healthy or made diabetic by alloxan. Histomorphometric analysis of the fracture site at 7 days after fracture revealed that diabetic rats (db) have significantly less hard tissue formation at the fracture site, compared to controls. The number of RANK, RANKL and OPG positive cells was decreased in the db group; however, the RANKL/OPG ratio was similar in controls and db at this time. At day 14, numbers of RANKL and OPG positive cells and the mRNA expression for these markers were higher in the control group than in db (P = 0.008). The RANKL/OPG ratio in the db group was greater than in controls. Our results demonstrate an imbalance of RANKL/OPG expression associated with diabetes that may contribute to the delay of fracture repair during the course of diabetes.     

Changes in RANKL/OPG/RANK gene expression in peripheral mononuclear cells following treatment with estrogen or raloxifene

The RANKL/OPG/RANK pathway is the key mediator of osteoclastogenesis. Mononuclear cells may be implicated in post-menopausal osteoporosis. The effect of estrogen or raloxifene on bone resorption and the expression of RANKL/OPG/RANK in peripheral blood mononuclear cells (PBMCs) was examined. Twenty-nine women with post-menopausal osteoporosis were treated with estrogen (HRT) or raloxifene for 12 months. Bone mineral density (BMD) was measured at baseline and at 12 months at the spine and hip. Serum C-terminal telopeptide (CTX) and OPG were measured at baseline and at 1, 3, 6 and 12 months. PBMCs were isolated from 17 women and changes in RANKL, OPG and RANK mRNA were determined. The effects of estrogen or raloxifene in PBMCs in vitro were also assessed. BMD increased following treatment (lumbar spine % change mean [S.E.M.]: 4.3% [0.9], p<0.001). Serum CTX decreased (6 months: -43.7% [6.0], p<0.0001). Serum OPG declined gradually (12 months: -26.4% [4.4], p<0.001). RANKL, OPG and RANK gene expression decreased (6 months: RANKL 50.0% [24.8] p<0.001, OPG: 21.7% [28] p<0.001, RANK: 76.6% [10.2] p=0.015). Changes in OPG mRNA correlated with changes in BMD (r=-0.53, p=0.027) and CTX (r=0.7, p=0.0044). Down-regulation in RANKL, OPG, RANK mRNA and reduction in bone resorption was also seen in vitro. These results suggest that the expression of RANKL/OPG/RANK in PBMCs are responsive to the slowing in bone turnover/remodeling associated with treatment with estrogen or raloxifene. Further confirmatory studies are needed.     

Disturbance of the OPG/RANK/RANKL pathway and systemic inflammation in COPD patients with emphysema and osteoporosis

Background

Osteoporosis is one of the systemic features of COPD. A correlation between the emphysema phenotype of COPD and reduced bone mineral density (BMD) is suggested by some studies, however, the mechanisms underlying this relationship are unclear. Experimental studies indicate that IL-1β, IL-6 and TNF-α may play important roles in the etiology of both osteoporosis and emphysema. The OPG/RANK/RANKL system is an important regulator of bone metabolism, and participates in the development of post-menopausal osteoporosis. Whether the OPG/RANK/RANKL pathway is involved in the pathogenesis of osteoporosis in COPD has not been studied.

Methods

Eighty male patients (current or former smokers) completed a chest CT scan, pulmonary function test, dual x-ray absorptiometry measurements and questionnaires. Among these subjects, thirty patients with normal BMD and thirty patients with low BMD were selected randomly for measurement of IL-1β, IL-6, TNF-α (flow cytometry) and OPG/RANK/RANKL (ELISA). Twenty age-matched healthy volunteers were recruited as controls.

Results

Among these eighty patients, thirty-six had normal BMD and forty-four had low BMD. Age, BMI and CAT score showed significant differences between these two COPD groups (p < 0.05). The low-attenuation area (LAA%) in the lungs of COPD patients was negatively correlated with lumbar vertebral BMD (r = 0.741; p < 0.0001). Forward logistic regression analysis showed that only LAA% (p = 0.005) and BMI (p = 0.009) were selected as explanatory variables. The level of IL-1β was significantly higher in the COPD patients as compared to the normal controls (p < 0.05), but the difference between the two COPD groups did not reach significance. The levels of IL-6 and TNF-α among the three groups were significantly different (p < 0.05). The level of RANKL and the RANKL/OPG ratio were significantly higher in COPD patients with low BMD compared to those with normal BMD and the normal controls (p < 0.05), and correlated negatively with lumbar vertebral BMD, but positively with LAA%.

Conclusions

Radiographic emphysema is correlated with low BMD in current and former smokers with COPD. IL-1β, IL-6, TNF-α, and the osteoporosis-related protein system OPG/RANK/RANKL may have some synergetic effects on emphysema and bone loss in COPD.     

OPG/RANK/RANKL系统与骨质疏松研究最新进展

骨质疏松是严重威胁中老年人健康的骨科常见病,OPG/RANK/RANKL是参与调节骨重建的最重要的分子系统之一,与骨疾病相关的骨质疏松有密切联系,并已成为药物设计的新靶点.因此,对该系统的深入研究将为骨生理、病理机制阐明及骨疾病防治带来积极影响.     

钛颗粒对小鼠颅骨OPG/RANKL mRNA及蛋白表达的影响

目的:观察钛颗粒对小鼠颅骨中OPG/RANKL mRNA及其蛋白表达的影响,探讨关节置换术后骨溶解的发生机制。方法:取成年BALB/C小鼠40只,随机分为假手术组、钛颗粒低剂量组、钛颗粒中剂量组及高剂量组,每组10只。除假手术组外,其余各组分别将钛颗粒15、30、60 mg涂抹于小鼠颅骨表面后缝合切口。8周后取颅骨组织及外周血,运用real-time PCR及ELISA技术测定OPG/RANKL基因及蛋白表达情况。结果:与假手术组相比,钛颗粒低剂量组外周血中OPG蛋白表达及颅骨组织中OPG mRNA的表达均显著上升(P0.01),外周血中RANKL蛋白表达降低,但无统计学差异,颅骨组织中RANKL mRNA表达无显著差异;中剂量组及高剂量组外周血中OPG蛋白表达显著降低(p0.01),RANKL蛋白表达显著升高(P0.01),OPG mRNA表达显著降低(P0.01),RANKL mRNA表达显著升高(P0.01)。低中高三种不同剂量钛颗粒组组间相比,外周血中OPG、RAKNL蛋白及颅骨组织中其mRNA表达均存在明显差异(P0.01),高剂量组对OPG、RANKL蛋白及mRNA表达的影响更显著。结论:钛颗粒可以改变OPG/RANKL的mRNA及蛋白表达量,这可能是其导致关节置换术后体骨溶解进而产生松动的原因之一。     

Assessment and clinical implications of RANK/RANKL/OPG pathway as markers of bone tumor progression in patients with NET harboring bone metastases

Abstract

Introduction: The impact on the survival of bone metastases (BM) in patients with neuroendocrine tumor (NET) is a matter of debate. BM have a key role in causing symptoms and in decreasing patients’ quality of life. Although the mechanisms of the development of BM are not completely clear, it is now well understood that the Receptor Activator of Nuclear factor Kappa-B-/Ligand (RANK/RANKL)/osteoprotegerin (OPG) pathway plays a relevant role.

Aim: To characterize the RANK/RANKL/OPG pathway in patients affected with NET.

Patients and methods: Two cohorts of 15 patients each were enrolled in the study; one cohort was affected with NET without BM and the second cohort was affected with NET with BM. The serum RANK/RANKL/OPG pathway was assessed in both the groups.

Results: Serum OPG levels and RANKL/OPG ratio were lower and higher, respectively, in NET patients harboring BM than in those without BM. During the ROC analysis, a cut-off value of 1071?pg/ml for OPG and 0.62 for RANKL/OPG ratio were able to significantly distinguish between the two groups.

Conclusions: This study indicates that RANK/RANKL/OPG pathway is imbalanced in patients with NET harboring BM. Specific alterations of this pathway could predict an early development of BM.     

胰岛素对2型糖尿病骨质疏松大鼠血清与骨OPG、RANKL表达的影响

目的:探讨胰岛素对2型糖尿病骨质疏松大鼠血清及骨OPG(osteoprotegerin)、RANKL(OPG receptor activator nuclear factork B)表达水平的影响。方法:以高脂高糖饲料喂养4周同时饮用3%果糖水导致胰岛素抵抗小鼠,再以小剂量链脲佐菌素(30mg/kg)腹腔注射1次,2周后诱导建立2型糖尿病小鼠模型。对照组动物则给予正常饲料及饮用水进行喂养。模型建立成功后,对模型2组大鼠进行胰岛素治疗,分别采用OPG和RANKLelisa试剂盒对正常动物模型和糖尿病动物模型血清和骨组织中OPG,RANKL含量进行比较分析,采用血糖分析仪对不同组动物的血糖进行比较分析,采用骨密度分析仪对动物的骨密度进行分析,了解高血糖对于骨密度及血清,骨组织中OPG,RANKL含量的影响以及胰岛素对高血糖骨质疏松造成的结果的影响。结果:相较于正常组大鼠,模型组大鼠血清及髂骨中OPG、血糖、糖化血红蛋白、髂骨密度表达显著下调(P0.05),而RANKL表达显著上调(P0.05),胰岛素处理的模型大鼠血清及骨中OPG含量较模型组大鼠显著升高,血清及骨组织中RANKL表达显著下调(P0.05)。结论:胰岛素能够显著降低2型糖尿病骨质疏松大鼠血清及骨组织中RANKL的表达,显著上调OPG的表达。