中国中医科学院广安门医院,北京市西城区北线阁5号,100053
doctorjq@126.com
收稿:2022-12-03,
修回:2023-02-07,
纸质出版:2023-05-17
移动端阅览
张富渊,姜泉,李达等.清热活血方药重塑类风湿关节炎骨免疫微环境的研究思路[J].中医杂志,2023,64(10):999-1003.
ZHANG Fuyuan,JIANG Quan,LI Da,et al.Research Thinking on Remodeling Bone Immune Microenvironment of Rheumatoid Arthritis with Qingre Huoxue Formulaand Medicinals (清热活血方药)[J].Journal of Traditional Chinese Medicine,2023,64(10):999-1003.
张富渊,姜泉,李达等.清热活血方药重塑类风湿关节炎骨免疫微环境的研究思路[J].中医杂志,2023,64(10):999-1003. DOI: 10.13288/j.11-2166/r.2023.10.006.
ZHANG Fuyuan,JIANG Quan,LI Da,et al.Research Thinking on Remodeling Bone Immune Microenvironment of Rheumatoid Arthritis with Qingre Huoxue Formulaand Medicinals (清热活血方药)[J].Journal of Traditional Chinese Medicine,2023,64(10):999-1003. DOI: 10.13288/j.11-2166/r.2023.10.006.
破骨细胞在类风湿关节炎骨破坏中发挥着重要作用,骨免疫微环境中免疫细胞可以通过复杂的通信网络分泌细胞因子、趋化因子、生长因子和细胞外基质的蛋白质等调控破骨细胞,同时破骨细胞还可以反作用于免疫细胞,达到双向调节,实现空间相互作用。认为“湿、热、瘀”是类风湿关节炎的核心病机,湿热瘀阻是骨破坏的主要证候,据此提出清热活血方药可以多通道、多靶点调控类风湿关节炎炎症反应,重塑骨免疫微环境,延缓骨破坏。
Osteoclasts play a major role in the bone destruction of rheumatoid arthritis (RA). In the bone immune microenvironment, immune cells can secrete cytokines, chemokines, growth factors and extracellular matrix proteins through complex communication networks. Proteins regulate osteoclasts, and osteoclasts can react on immune cells to achieve two-way regulation and spatial interaction. It is believed that “damp, heat and stasis” are the core pathogenesis of RA, and damp-heat obstruction is the main syndrome of bone destruction. Therefore,
Qingre Huoxue Formula
and Medicinals
(清热活血方药) is proposed to regulate the inflammatory response of RA through multiple channels and multiple targets, thereby remodeling the bone immune microenvironment and delaying bone destruction.
NAKASHIMA T . Osteoclast biology and osteoimmunology [J]. Nihon Rinsho Meneki Gakkai Kaishi , 2015 , 38 ( 1 ): 17 - 25 .
TATEIWA D , YOSHIKAWA H , KAITO T . Cartilage and bone destruction in arthritis: pathogenesis and treatment strategy: a literature review [J]. Cells , 2019 , 8 ( 8 ): 818 .
LIN Y J , ANZAGHE M , SCHULKE S . Update on the path mechanism, diagnosis, and treatment options for rheumatoid arthritis [J]. Cells , 2020 , 9 ( 4 ): 880 .
FRAENKEL L , BATHON JM , ENGLAND BR , et al . 2021 American college of rheumatology guideline for the treatment of rheumatoid arthritis [J]. Arthritis Care Res (Hoboken) , 2021 , 73 ( 7 ): 924 - 939 .
李光耀 . 清热活血方治疗类风湿关节炎5年放射学观察及其拆方对TNF-α、IL-6影响 [D]. 北京 : 中国中医科学院 , 2018 .
柯丽青 , 成文翔 , 林结桃 , 等 . 基于网络药理学探讨清热活血方抗类风湿性关节炎的作用机制 [J]. 世界中医药 , 2021 , 16 ( 22 ): 3292 - 3297 .
GUO Q , WANG Y , XU D , et al . Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies [J]. Bone Res , 2018 , 6 ( 7 ): 15 .
MCINNES IB , SCHETT G . Pathogenetic insights from the treatment of rheumatoid arthritis [J]. Lancet , 2017 , 389 ( 10086 ): 2328 - 2337 .
REDLICH K , HAYER S , RICCI R , et al . Osteoclasts are essential for TNF-alpha-mediated joint destruction [J]. J Clin Invest , 2002 , 110 ( 10 ): 1419 - 1427 .
BAUM R , GRAVALLESE EM . Impact of inflammation on the osteoblast in rheumatic diseases [J]. Curr Osteoporos Rep , 2014 , 12 ( 1 ): 9 - 16 .
BOYCE BF . Advances in the regulation of osteoclasts and osteoclast functions [J]. J Dent Res , 2013 , 92 ( 10 ): 860 - 867 .
YOKOTA K . Inflammation and osteoclasts [J]. Nihon Rinsho Meneki Gakkai Kaishi , 2017 , 40 ( 5 ): 367 - 376 .
ONO T , HAYASHI M , SASAKI F , et al . RANKL biology: bone metabolism, the immune system, and beyond [J]. Inflamm Regen , 2020 , 40 : 2 . doi: 10.1186/s41232-019-0111-3 http://dx.doi.org/10.1186/s41232-019-0111-3 .
TAKAYANAGI H . Osteoimmunology and the effects of the immune system on bone [J]. Nat Rev Rheumatol , 2009 , 5 ( 12 ): 667 - 676 .
OKAMOTO K , TAKAYANAGI H . Regulation of bone by the adaptive immune system in arthritis [J]. Arthritis Res Ther , 2011 , 13 ( 3 ): 219 .
LI Y , TORALDO G , LI A , et al . B cells and T cells are critical for the preservation of bone homeostasis and attainment of peak bone mass in vivo [J]. Blood , 2007 , 109 ( 9 ): 3839 - 3848 .
SAIDENBERG KN , BESSIS N , COHEN-SOLAL M , et al . Osteoprotegerin and inflammation [J]. Eur Cytokine Netw , 2002 , 13 ( 2 ): 144 - 153 .
ASAGIRI M , TAKAYANAGI H . The molecular understanding of osteoclast differentiation [J]. Bone , 2007 , 40 ( 2 ): 251 - 264 .
SHIM JH , STAVRE Z , GRAVALLESE EM . Bone loss in rheumatoid arthritis: basic mechanisms and clinical implications [J]. Calcif Tissue Int , 2018 , 102 ( 5 ): 533 - 546 .
TSUKASAKI M , TAKAYANAGI H . Osteoimmunology: evolving concepts in bone-immune interactions in health and disease [J]. Nat Rev Immunol , 2019 , 19 ( 10 ): 626 - 642 .
SCHLUNDT C , SCHELL H , GOODMAN SB , et al . Immune modulation as a therapeutic strategy in bone rege-neration [J]. J Exp Orthop , 2015 , 2 ( 1 ): 1 .
SCHMIDT-BLEEK K , SCHELL H , LIENAU J , et al . Initial immune reaction and angiogenesis in bone healing [J]. J Tissue Eng Regen Med , 2014 , 8 ( 2 ): 120 - 130 .
TANG M , TIAN L , LUO G , et al . Interferon-gamma-mediated osteoimmunology [J]. Front Immunol , 2018 , 9 : 1508 . doi: org/10.3389/fimmu.2018.01508 http://dx.doi.org/org/10.3389/fimmu.2018.01508 .
WEYAND CM , GORONZY JJ . The immunology of rheumatoid arthritis [J]. Nat Immunol , 2021 , 22 ( 1 ): 10 - 18 .
LEE D , ROJAS OL , GOMMERMAN JL . B cell depletion therapies in autoimmune disease: advances and mechanistic insights [J]. Nat Rev Drug Discov , 2021 , 20 ( 3 ): 179 - 199 .
MEEDNU N , ZHANG H , OWEN T , et al . Production of RANKL by memory B cells: a link between B cells and bone erosion in rheumatoid arthritis [J]. Arthritis Rheumatol , 2016 , 68 ( 4 ): 805 - 816 .
FREYTES DO , KANG JW , MARCOS-CAMPOS I , et al . Macrophages modulate the viability and growth of human mesenchymal stem cells [J]. J Cell Biochem , 2013 , 114 ( 1 ): 220 - 229 .
TAKAYANAGI H . RANKL as the master regulator of osteoclast differentiation [J]. J Bone Miner Metab , 2021 , 39 ( 1 ): 13 - 18 .
LI H , HONG S , QIAN J , et al . Cross talk between the bone and immune systems: osteoclasts function as antigen-presenting cells and activate CD4 + and CD8 + T cells [J]. Blood , 2010 , 116 ( 2 ): 210 - 217 .
IBANEZ L , ABOU-EZZI G , CIUCCI T , et al . Inflammatory osteoclasts prime TNF alpha-producing CD4 + T cells and express CX3 CR1 [J]. J Bone Miner Res , 2016 , 31 ( 10 ): 1899 - 1908 .
MCDONALD MM , KHOO WH , NG PY , et al . Osteoclasts recycle via osteomorphs during RANKL-stimulated bone resorption [J]. Cell , 2021 , 184 ( 5 ): 1330 - 1347 .
王建 , 巩勋 , 唐晓颇 , 等 . 1602例类风湿关节炎患者中医证候分布特点的多中心横断面调查 [J]. 中医杂志 , 2018 , 59 ( 11 ): 963 - 967 .
刘蔚翔 , 姜泉 . 类风湿关节炎“湿、热、瘀”病机理论探析 [J]. 中医杂志 , 2020 , 61 ( 24 ): 2148 - 2153 .
郑桂华 , 邱明山 , 徐振兴 , 等 . 类风湿关节炎血清瘦素、CD4 + /CD8 + 淋巴细胞比值与中医证型分析 [J]. 风湿病与关节炎 , 2021 , 10 ( 4 ): 13 - 16 .
姚传辉 , 陶庆文 , 陈嘉琪 , 等 . 类风湿关节炎寒热证候淋巴细胞亚群及细胞因子的差异分析 [J]. 中国中西医结合杂志 , 2021 , 41 ( 12 ): 1456 - 1460 .
牛旭艳 , 李健 , 吕诚 , 等 . 类风湿性关节炎热证“药-证对应”机制的网络药理学研究 [J]. 中国实验方剂学杂志 , 2012 , 18 ( 8 ): 299 - 303 .
张旭飞 . 类风湿关节炎血瘀证与血浆凝血因子ⅩⅢ的相关性研究 [D]. 承德 : 承德医学院 , 2018 .
李克嵩 , 巩勋 , 姜泉 , 等 . 863例女性类风湿关节炎患者不同证候与相关指标关系探讨 [J]. 中国中医骨伤科杂志 , 2020 , 28 ( 10 ): 10 - 12,16 .
周新尧 , 吕爱平 , 姜泉 , 等 . 清热活血类方药对类风湿关节炎骨破坏影响的研究与思考 [J]. 中国中西医结合杂志 , 2016 , 36 ( 7 ): 891 - 895 .
张迪 , 刘英 , 姜萍 , 等 . 清热活血法联合托珠单抗治疗类风湿关节炎的临床疗效观察 [J]. 时珍国医国药 , 2019 , 30 ( 8 ): 1928 - 1931 .
郭明阳 , 罗勇 , 刘德芳 , 等 . 类风湿关节炎骨代谢变化及清热解毒方药的干预作用 [J]. 中国中医药信息杂志 , 2011 , 18 ( 12 ): 14 - 16 .
JIANG Q , ZHOU X , WANG L , et al . A one-year evaluation of radiographic progression in patients with rheumatoid arthritis treated by Qingre Huoxue Decoction .[J]. Chin J Integr Med , 2012 , 18 ( 4 ): 256 - 261 .
杜羽 . 清热活血方药治疗类风湿关节炎3年远期临床疗效评价 [D]. 北京 : 北京中医药大学 , 2013 .
李光耀 , 唐晓颇 , 姜泉 , 等 . 清热活血方药治疗类风湿关节炎骨破坏5年期放射学观察 [J]. 世界中西医结合杂志 , 2019 , 14 ( 4 ): 516 - 520 .
武子英 . 清热活血方调节CIA大鼠肠道微生态和Th/Treg的分子机制研究 [D]. 北京 : 中国中医科学院 , 2018 .
崔家康 . 清热活血方调控外泌体miRNA干预类风湿关节炎骨破坏的机制及方药优化研究 [D]. 北京 : 中国中医科学院 , 2020 .
刘彦龙 , 杨林 , 刘娟云 . 清热活血方药对类风湿患者成纤维样滑膜细胞OPG、RANKL、TNF-α及IL-17表达影响分析 [J]. 中国中医基础医学杂志 , 2015 , 21 ( 5 ): 549 - 552 .
李波 . 从Dkk/Wnt信号通路探讨清热活血方药治疗类风湿关节炎的“护骨”机制 [D]. 杭州 : 浙江中医药大学 , 2016 .
李剑明 . 清热活血方对CIA大鼠滑膜组织B细胞浸润程度及IL-21、CXCL13表达的影响 [D]. 北京 : 中国中医科学院 , 2019 .
管印 . 金银花复方治疗活动期RA湿热瘀阻证临床观察及单体GALU对FLS影响的研究 [D]. 南京 : 南京中医药大学 , 2021 .
李露 , 曹晔文 , 王欣妍 , 等 . 基于网络药理学的“土茯苓-金银花”药对治疗类风湿关节炎作用机制研究 [J]. 北京中医药 , 2021 , 40 ( 4 ): 425 - 430 .
刘维 , 杨会军 , 吴沅皞 , 等 . 中药及其有效成分影响类风湿关节炎成纤维样滑膜细胞增殖和凋亡的研究进展 [J]. 中草药 , 2016 , 47 ( 5 ): 844 - 850 .
0
浏览量
0
下载量
3
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号