摘要
后纵韧带骨化症(ossification of the posterior longitudinal ligament, OPLL)是由脊柱后纵韧带组织的异位骨化物压迫脊髓和神经根而产生的一系列临床表现,并导致其功能受损的一种退行性疾病。该疾病在亚洲国家中多发,中国人的平均患病率为3.08%,疾病进展可导致截瘫,但尚无有效的预防和治愈手段。OPLL的发病原因目前仍不明确,大多数学者认为可能与基因、激素、环境、生活方式等因素有关,但仍停留在推测及学说阶段。通过检索Pubmed、Embase、CNKI和万方数据库,根据纳入的文献将OPLL发病机制分为胞外微环境、胞内细胞因子、遗传因素、生物力学因素、内分泌及生活习惯等进行总结分析。现有的研究分别从不同角度独立地阐明了OPLL发病的可能机制,不同的致病因素通过相应分子通路引起局部间质干细胞向成骨细胞分化,启动成骨过程,导致异位骨化物形成。但这些研究均未能阐明OPLL完整的发病过程。大部分的研究集中在遗传学领域,近年来筛选出大量与OPLL发病相关的易感基因或位点,但均有样本量不足、种族地区差异、结果可重复性差等缺点。
Ossification of the posterior longitudinal ligament (OPLL)is a degenerative disease with a series of clinical manifestations caused by compression of the spinal cord and nerve roots.The disease is prevalent in East Asian countries,and the average prevalence rate of Chinese people is 3.08%.Disease progression can lead to paraplegia,but there is no effective prevention and cure.The pathogenesis of OPLL is still unclear.Most scholars suggest it may be related to genes,hormones,environment, lifestyle and other factors,but all stay in the stage of hypothesis and theory.In this paper,we searched Pubmed,Embase,CNKI and Wanfang database.According to the included literatures,the pathogenesis of OPLL was divided into the following parts:extracellular microenvironment,intracellular cytokines,genetic factors,biomechanical factors,and endocrine and living habits.We summarized and analyzed these literatures.These existing studies independently elucidated the possible mechanisms of OPLL from different angles.Different pathogenic factors promote mesenchymal stem cells to differentiate into osteoblasts through corresponding molecular pathways,initiate osteogenesis,and lead to the formation of ectopic ossification.However,none of these studies have clarified the complete pathogenesis of OPLL.Most of the studies focused on the field of genetics.In recent years,a large number of susceptible genes or loci related to the pathogenesis of OPLL have been screened,but they have shortcomings such as insufficient sample size,ethnic regional differences,and poor reproducibility.
作者
唐一钒
陈雄生
Tang Yifan;Chen Xiongsheng(Department of Spine Surgery,Changzheng Hospital,Naval Military Medical University,Shanghai 200003,China)
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2018年第24期1545-1552,共8页
Chinese Journal of Orthopaedics
基金
国家自然科学基金(81171753)
上海市科委实验动物项目(15140903800).
