中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (25): 6610-6620.doi: 10.12307/2026.295

• 组织构建综述 tissue construction review • 上一篇    下一篇

骨-血轴在骨量调控与造血功能维持中的作用

洪琳灵1，2，张昆朋1，2，郑力铭3，叶宝东1，2，刘静静1，2   

  1. 1浙江中医药大学附属第一医院，浙江省杭州市   310060；2浙江中医药大学第一临床医学院，浙江省杭州市   310053；3浙江大学医学院附属第二医院骨科，浙江省杭州市   310009
  • 收稿日期:2025-11-11 修回日期:2025-12-23 出版日期:2026-09-08 发布日期:2026-04-23
  • 通讯作者: 刘静静，博士，浙江中医药大学附属第一医院血液内科&血液病中西医结合实验室，浙江省杭州市 310060；浙江中医药大学第一临床医学院，浙江省杭州市 310053 共同通讯作者：郑力铭，博士，特聘研究员，浙江大学医学院附属第二医院骨科，浙江省杭州市 310009 共同通讯作者：叶宝东，博士，教授/主任医师，浙江中医药大学附属第一医院血液内科&血液病中西医结合实验室，浙江省杭州市 310060；浙江中医药大学第一临床医学院，浙江省杭州市 310053
  • 作者简介:洪琳灵，女，2004年生，浙江省宁波市人，汉族，本科在读，主要从事中医药与血液系统疾病的研究。
  • 基金资助:
    国家自然科学基金项目(32401092)，项目负责人：郑力铭；浙江中医药大学附属第一医院“仁和优博”人才计划，项目负责人：刘静静

Role of bone–blood axis in bone mass regulation and hematopoietic function maintenance

Hong Linling1, 2, Zhang Kunpeng1, 2, Zheng Liming3, Ye Baodong1, 2, Liu Jingjing1, 2   

  1. 1First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310060, Zhejiang Province, China; 2First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China; 3Orthopedics Department, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China 
  • Received:2025-11-11 Revised:2025-12-23 Online:2026-09-08 Published:2026-04-23
  • Contact: Liu Jingjing, PhD, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310060, Zhejiang Province, China; First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China Co-corresponding author: Zheng Liming, PhD, Distinguished Research Fellow, Orthopedics Department, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China Co-corresponding author: Ye Baodong, PhD, Professor/Chief physician, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310060, Zhejiang Province, China; First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
  • About author:Hong Linling, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310060, Zhejiang Province, China; First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
  • Supported by:
    National Natural Science Foundation of China, No. 32401092 (to ZLM); “Renhe Excellent Doctoral Talent Program” of The First Affiliated Hospital of Zhejiang Chinese Medical University (to LJJ)

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摘要：



文题释义：
骨-血轴：宏观角度是指骨骼系统与血液系统间的双向调控网络，微观角度则是骨相关细胞如成骨谱系干细胞、破骨细胞、骨细胞等骨源性细胞与血液细胞如造血干细胞、髓系细胞、淋系细胞通过直接接触、旁分泌及代谢产物交换构成的双向调控网络。
造血功能：指造血干细胞在骨髓微环境的支持下，通过多谱系分化与稳态维持实现血液系统再生的生理过程。其功能评估通常包括造血干细胞的克隆形成能力、CD34+细胞在骨髓有核细胞中的比例，以及淋巴系与髓系分化倾向的分析等量化指标。

背景：骨骼系统除了作为运动系统的重要组成部分，也是骨髓的重要支撑结构。众所周知，骨髓微环境是维持造血干细胞功能的关键场所，而造血过程本身也可调控骨骼系统的重塑，维持骨量的稳定。骨骼与造血系统间的精密协同效应维持着血液和骨骼系统的健康，而目前针对这两系统间的相互作用仍缺乏系统的归纳总结。
目的：系统梳理骨骼与造血系统间相互作用的研究进展，旨在为这两者间的相互调控作用提供参考，并通过分析既往文献，为贫血、白血病等血液系统相关疾病和骨质疏松、骨关节炎等骨骼系统疾病探寻潜在的治疗靶点。
方法：检索中国知网、万方及PubMed数据库在2000年1月至2025年7月与文章主题相关的文献， 以“骨量调控，造血功能，骨髓微环境，骨血轴”及“bone mass regulation，hematopoietic function，bone marrow microenvironment，bone and blood axis”等为检索词，选择著作、研究性论文和综述等文献，最终纳入115篇文献进行分析。
结果与结论：①系统阐述了骨髓微环境中“骨-血轴”的双向调控网络及其核心机制；②研究结果显示，骨髓微环境作为一个由多种细胞与非细胞成分构成的动态系统，不仅通过Wnt/β-连环蛋白、Notch、核因子κB受体活化因子/核因子κB受体活化因子配体/骨保护素及Hippo-Yes相关蛋白等核心信号通路精密调控造血干细胞的静息、自我更新与分化，同时接受造血系统的反向调控；③这种双向对话同样主导着骨重塑过程，其中免疫细胞(如巨噬细胞与T淋巴细胞)通过分泌特定因子成为连接骨骼系统与造血系统的关键桥梁；④该对话网络的失衡是导致骨质疏松、骨髓纤维化及白血病等跨系统疾病发生的重要病理基础；⑤此文以“骨-血轴”为框架理解骨髓微环境，为揭示血液疾病与骨骼疾病的共发病机制提供了全新视角；靶向该轴心的关键信号节点或利用协同干预策略(如地诺单抗、恩西地平等)，有望为未来跨系统疾病的整合性治疗开辟新路径。
https://orcid.org/0009-0004-0780-2345 (刘静静) 


中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 骨量调控, 造血功能, 骨髓微环境, 骨血轴, 血液疾病, 治疗靶点

Abstract: BACKGROUND: The bone marrow serves not only as a primary hematopoietic organ but also as an essential component of bone tissue. The bone marrow microenvironment is a critical niche for maintaining hematopoietic stem cell function, while the hematopoietic process, in turn, regulates bone mass homeostasis. The precise synergistic effect between the skeletal and hematopoietic systems maintains the health of both systems, but a systematic summary of the interactions between these two systems is still lacking.
OBJECTIVE: To systematically review the research progress on the interaction between the skeletal and hematopoietic systems, aiming to provide a reference for their mutual regulation, and to explore potential therapeutic targets for hematological diseases such as anemia and leukemia, and skeletal diseases such as osteoporosis and osteoarthritis through analysis of previous literature.
METHODS: We searched the CNKI, WanFang, and PubMed databases for literature related to the article's topic from January 2000 to July 2025, using search terms such as "bone mass regulation, hematopoietic function, bone marrow microenvironment, bone and blood axis." We selected works, research papers, and review articles, ultimately including 115 articles for analysis.
RESULTS AND CONCLUSION: (1) This study systematically expounds the bidirectional regulatory network of the "bone-blood axis" in the bone marrow microenvironment and its core mechanisms. (2) The research results show that the bone marrow microenvironment, as a dynamic system composed of various cellular and non-cellular components, not only precisely regulates the quiescence, self-renewal and differentiation of hematopoietic stem cells through core signaling pathways such as Wnt/β-catenin, Notch, nuclear factor κB receptor activator/nuclear factor κB receptor activator ligand/osteoplastin and Hippo-YAP, but also receives reverse regulation from the hematopoietic system. (3) This bidirectional dialogue also dominates the bone remodeling process, in which immune cells (such as macrophages and T lymphocytes) secrete specific factors and become the key bridges connecting the skeletal system and the hematopoietic system. (4) The imbalance of this dialogue network is an important pathological basis for the occurrence of cross-system diseases such as osteoporosis, myelofibrosis and leukemia. (5) This article uses the "bone-blood axis" as a framework to understand the bone marrow microenvironment, providing a new perspective for revealing the co-pathogenesis of hematological and skeletal diseases; targeting the key signaling nodes of this axis or using coordinated intervention strategies (such as denosumab and romiplostim), is expected to open up new paths for the integrated treatment of cross-system diseases in the future.

Key words: bone mass regulation, hematopoietic function, bone marrow microenvironment, bone-blood axis, hematological diseases, therapeutic targets

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