摘要
激素性股骨头坏死(steroid-induced osteonecrosis of the femoral head,SONFH)是国内外骨科学领域的研究重点,也是致残率较高的疾病.由于SONFH的发病机制尚不明确,探索其发病机制具有重要意义.近年研究表明,激素使用造成的股骨头细胞死亡与SONFH的进展与结局密不可分,因此本文对相关研究进展展开综述.本文重点关注细胞凋亡、自噬、铁死亡和焦亡四种细胞死亡模式在SONFH中的作用机制、主要死亡细胞类型和潜在信号通路.研究发现,糖皮质激素的使用可能导致多种细胞类型(包括成骨细胞、破骨细胞、骨髓间充质干细胞、软骨细胞和内皮细胞)通过上述途径死亡,从而促进SONFH的进展.此外,根据生物信息分析学的理论指导和部分焦亡标志分子如NLRP3和IL-1β的检测,本综述讨论指出焦亡作为SONFH新的研究方向,对其病理机制、治疗预后具有指导意义.
Abstract
Steroid-induced osteonecrosis of the femoral head(SONFH)is a focal point of research in the field of orthopedic science both domestically and internationally.It is a disease with a high rate of disability.The pathogenesis of SONFH is not yet fully understood,making the exploration of its mechanism of the disease very significant.Recent studies have indicated that cell death in the femoral head caused by steroid use is closely related to the progression and outcome of SONFH.Therefore,this article reviews the relevant research advancements.The article particularly focuses on the mechanisms of action,the main types of dying cells,and potential signaling pathways of four modes of cell death,including apoptosis,autophagy,ferroptosis,and pyroptosis,in SONFH.Research has found that the use of glucocorticoids may lead to the death of various cell types(including osteoblasts,osteoclasts,bone marrow mesenchymal stem cells,chondrocytes,and endothelial cells)through the aforementioned pathways,thereby promoting the progression of SONFH.In addition,based on the theoretical guidance of bioinformatics analysis and the detection of some pyroptosis marker molecules such as NLRP3 and IL-1 β,this review discusses pyroptosis as a new research direction for SONFH,which has guiding significance for its pathological mechanism and therapeutic prognosis.
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