中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (16): 2613-2618.doi: 10.12307/2024.286

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

骨骼疾病中的铁死亡:骨质疏松治疗靶点

谢  恒1,顾  叶1,顾赢楚1,吴泽睿1,方  涛1,王秋霏1,彭育沁1,耿德春2,徐耀增2   

  1. 1苏州大学附属常熟医院常熟市第一人民医院骨科,江苏省常熟市  215500;2苏州大学附属第一医院骨科,江苏省苏州市  215006
  • 收稿日期:2023-02-23 接受日期:2023-04-24 出版日期:2024-06-08 发布日期:2023-07-31
  • 通讯作者: 顾叶,博士,副主任医师,苏州大学附属常熟医院常熟市第一人民医院骨科,江苏省常熟市 215500
  • 作者简介:谢恒,男,苏州大学在读硕士,主要从事关节外科的基础与临床研究。
  • 基金资助:
    江苏省青年医学重点人才资助项目(QNRC2016751),项目负责人:耿德春;江苏省六个一工程资助项目(LQY2016033),项目负责人:耿德春;江苏省科技厅重点研发计划(社会发展)项目(BE2021673,BE2020666),项目负责人:顾叶;苏州市科技局科技发展计划项目(SYSD2022023,SYSD2020013),项目负责人:顾叶;苏州市卫健委临床重点病种诊疗项目(LCZX201824),项目负责人:顾叶;江苏省常熟市科技局科技发展计划项目(CS202119),项目负责人:王秋霏;江苏省常熟市科技局科技发展计划项目(CS201817),项目负责人:顾叶;苏州大学横向课题项目(H200833),项目负责人:顾叶

Ferroptosis in bone diseases: therapeutic targets of osteoporosis

Xie Heng1, Gu Ye1, Gu Yingchu1, Wu Zerui1, Fang Tao1, Wang Qiufei1, Peng Yuqin1, Geng Dechun2, Xu Yaozeng2   

  1. 1Department of Orthopedics, Changshu First People’s Hospital, Changshu Affiliated Hospital of Soochow University, Changshu 215500, Jiangsu Province, China; 2Department of Orthopedics, First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
  • Received:2023-02-23 Accepted:2023-04-24 Online:2024-06-08 Published:2023-07-31
  • Contact: Gu Ye, MD, Associate chief physician, Department of Orthopedics, Changshu First People’s Hospital, Changshu Affiliated Hospital of Soochow University, Changshu 215500, Jiangsu Province, China
  • About author:Xie Heng, Master candidate, Department of Orthopedics, Changshu First People’s Hospital, Changshu Affiliated Hospital of Soochow University, Changshu 215500, Jiangsu Province, China
  • Supported by:
    Jiangsu Province Young Medical Key Talents Program, No. QNRC2016751 (to GDC); Jiangsu Six-One Project Funding Project, No. LQY2016033 (to GDC); Key Research & Development Plan (Social Development) Project of Jiangsu Provincial Department of Science and Technology, Nos. BE2021673 and BE2020666 (to GY); Science and Technology Development Plan Project of Suzhou Science and Technology Bureau, Nos. SYSD2022023 and SYSD2020013 (to GY); The Diagnosis and Treatment Project of Clinical Key Diseases of Suzhou Municipal Health and Health Commission, No. LCZX201824 (to GY); Science and Technology Plan Projects of Changshu Health Commission, Nos. CS202119 (to WQF) and CS201817 (to GY); Soochow University Horizontal Project, No. H200833 (to GY)

摘要:


文题释义:

铁死亡:是一种以脂质活性氧积累为特征的铁依赖性非凋亡细胞死亡模式。过量铁和活性氧的积累可导致细胞死亡,即铁死亡。
骨质疏松:是一种全身性骨骼疾病,其特征是骨密度和质量降低,骨微结构破坏,骨脆性增加,从而使患者骨折发生率增加。


背景:随着全球人口的老龄化加剧,骨质疏松症的发病率不断增加,了解其发病机制和提出治疗相关的新靶点显得至关重要。最近的研究表明,铁死亡与一些骨骼疾病的发病机制密切相关,例如炎性关节炎、骨质疏松症和骨关节炎等。

目的:通过总结既往关于骨质疏松中铁死亡机制的研究,为骨质疏松提供新的治疗思路和潜在的治疗靶点。
方法:由第一作者应用计算机检索2000-2022年出版的文献,以“铁死亡,骨质疏松,成骨细胞,破骨细胞,铁螯合剂,活性氧,核因子红系2相关因子2,Nrf2,血红素加氧酶1,HO-1,谷胱甘肽过氧化物酶4,GPX4”等为中文检索词检索中国知网、万方和维普数据库;以“ferroptosis,osteoporosis,osteoblasts,osteoclasts,iron chelators,reactive oxygen species,nuclear factor erythroid 2-related factor 2,heme oxygenase-1,glutathione peroxidase 4”等为英文检索词检索PubMed和Web of Science数据库,按照入选标准最终共纳入 70 篇文献。

结果与结论:①铁死亡与坏死、凋亡和自噬明显不同。在细胞形态和功能方面,它不具有典型坏死的形态学特征,它也不具有传统细胞凋亡的特征,如细胞收缩、染色质凝结、凋亡小体的形成和细胞骨架的解体。与自噬相反,铁死亡没有形成经典的封闭双层膜结构(自噬液泡)。形态学上,铁死亡主要表现为线粒体明显收缩,膜密度增加,线粒体嵴减少或消失,这与其他细胞死亡模式不同。②铁超载可通过显著抑制成骨分化和刺激破骨细胞生成来破坏骨稳态,从而导致骨质疏松。铁超载干扰干细胞向成骨细胞的分化,导致成骨细胞功能减弱,体内骨代谢进一步失衡,从而导致骨质疏松;在铁超载的刺激下,破骨细胞骨吸收增强,骨丢失超过新骨的形成。③铁螯合剂被证明通过抑制破骨细胞活性和刺激成骨细胞的成骨分化而具有骨保护作用,其潜在机制与抑制破骨细胞分化和促进成骨细胞分化有关;④抗氧化剂可以防止更多的活性氧产生,抑制骨吸收,从而改善骨代谢,有效预防骨质疏松症的发生。

https://orcid.org/0009-0002-7126-4102(谢恒)

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程

关键词: 铁死亡, 骨质疏松, 成骨细胞, 破骨细胞, 铁螯合剂, 活性氧, 核因子红系2相关因子2, 血红素加氧酶1, 谷胱甘肽过氧化物酶4, 综述

Abstract: BACKGROUND:  With the aging of the global population, the incidence rate of osteoporosis is also increasing. It is very important to further understand its pathogenesis and propose new therapeutic targets. Recent studies have shown that ferroptosis is closely related to the pathogenesis of some bone diseases, such as inflammatory arthritis, osteoporosis and osteoarthritis.
OBJECTIVE: To summarize the previous studies on the mechanism of ferroptosis in osteoporosis, so as to provide new therapeutic ideas and potential therapeutic targets for osteoporosis.
METHODS: The first author used the computer to search the documents published from 2000 to 2022 in CNKI, WanFang, VIP, PubMed and Web of Science with the key words of “ferroptosis, osteoporosis, osteoblasts, osteoclasts, iron chelators, reactive oxygen species, nuclear factor erythroid 2-related factor 2, heme oxygenase-1, glutathione peroxidase 4, review” in Chinese and English. A total of 70 articles were finally included according to the inclusion criteria.
RESULTS AND CONCLUSION: Ferroptosis is significantly different from necrosis, apoptosis and autophagy. In terms of cell morphology and function, it does not have the morphological characteristics of typical necrosis, nor does it have the characteristics of traditional apoptosis, such as cell contraction, chromatin condensation, the formation of apoptotic bodies and the disintegration of cytoskeleton. Contrary to autophagy, ferroptosis does not form a classical closed bilayer membrane structure (autophagic vacuole). Morphologically, ferroptosis is mainly manifested by obvious contraction of mitochondria, increased membrane density, and reduction or disappearance of mitochondrial cristae, which are different from other cell death modes. Iron overload can destroy bone homeostasis by significantly inhibiting osteogenic differentiation and stimulating osteoclast formation, leading to osteoporosis. Iron overload interferes with the differentiation of stem cells to osteoblasts, leading to a weakened osteoblast function and further imbalance of bone metabolism in the body, which eventually leads to osteoporosis. Stimulated by iron overload, osteoclast bone resorption is enhanced and bone loss exceeds new bone formation. Iron chelators have been proved to have osteoprotective effects by inhibiting osteoclast activity and stimulating osteogenic differentiation of osteoblasts. Its potential mechanism is related to inhibiting osteoclast differentiation and promoting osteoblast differentiation. Antioxidants can prevent reactive oxygen species production and inhibit bone absorption, thus improving bone metabolism and effectively preventing osteoporosis.

Key words: ferroptosis, osteoporosis, osteoblast, osteoclast, iron chelator, reactive oxygen species, Nuclear factor erythroid 2-related factor 2, heme oxygenase-1, glutathione peroxidase 4, review

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