目的探讨仙灵骨葆胶囊治疗绝经后骨质疏松症(PMOP)的临床疗效及其对血清护骨素/细胞核因子κB受体活化因子配体(RANKL)的影响。方法患者随机分为2组,对照组口服元素钙600 mg·d-1和维生素D 0.25μg·d-1,在对照组基础上,试验组...目的探讨仙灵骨葆胶囊治疗绝经后骨质疏松症(PMOP)的临床疗效及其对血清护骨素/细胞核因子κB受体活化因子配体(RANKL)的影响。方法患者随机分为2组,对照组口服元素钙600 mg·d-1和维生素D 0.25μg·d-1,在对照组基础上,试验组加用仙灵骨葆胶囊(1.5 g bid,口服)。疗程均为6个月。观察2组的临床疗效,测定骨密度,检测血清护骨素、RANKL水平。结果试验组,临床总有效率(93.30%)明显优于对照组(70.00%,P<0.05)。试验组,骨密度的提高(0.97±0.10,0.79±0.10)明显优于对照组(0.77±0.10,0.62±0.10)(P<0.05)。试验组,血清护骨素水平明显高于对照组(142.24±6.54vs 119.18±5.71),而RANKL水平明显低于对照组(6.62±1.04 vs 8.46±1.63,P<0.05)。结论仙灵骨葆胶囊治疗PMOP具有良好的临床疗效,其作用机制可能与上调血清护骨素的表达、下调RANKL的表达有关。展开更多
Osteoporosis is a common bone disease characterized by reduced bone and increased risk of fracture. In postmenopausal women, osteoporosis results from bone loss attributable to estrogen deficiency. Osteoclast differen...Osteoporosis is a common bone disease characterized by reduced bone and increased risk of fracture. In postmenopausal women, osteoporosis results from bone loss attributable to estrogen deficiency. Osteoclast differentiation and activation is mediated by receptor activator of nuclear factor-κB ligand(RANKL), its receptor receptor activator of nuclear factor-κB(RANK), and a decoy receptor for RANKL, osteoprotegerin(OPG). The OPG/RANKL/RANK system plays a pivotal role in osteoclast biology. Currently, a fully human antiRANKL monoclonal antibody named denosumab is being clinically used for the treatment of osteoporosis and cancer-related bone disorders. This review describes recent advances in RANKL-related research, a story from bench to bedside. First, the discovery of the key factors, OPG/RANKL/RANK, revealed the molecular mechanism of osteoclastogenesis. Second, we established three animal models:(1) a novel and rapid bone loss model by administration of glutathione-S transferase-RANKL fusion protein to mice;(2) a novel mouse model of hypercalcemia with anorexia by overexpression of soluble RANKL using an adenovirus vector; and(3) a novel mouse model of osteopetrosis by administration of a denosumab-like anti-mouse RANKL neutralizing monoclonal antibody. Lastly, anti-human RANKL monoclonal antibody has been successfully applied to the treatment of osteoporosis and cancer-related bone disorders in many countries. This is a real example of applying basic science to clinical practice.展开更多
基金This work was supported by the National Natural Science Foundation of China (No. 30300171)the Science and Technology Development Program for High Education Schools of Tianjin Municipality (No. 020108).
文摘目的探讨仙灵骨葆胶囊治疗绝经后骨质疏松症(PMOP)的临床疗效及其对血清护骨素/细胞核因子κB受体活化因子配体(RANKL)的影响。方法患者随机分为2组,对照组口服元素钙600 mg·d-1和维生素D 0.25μg·d-1,在对照组基础上,试验组加用仙灵骨葆胶囊(1.5 g bid,口服)。疗程均为6个月。观察2组的临床疗效,测定骨密度,检测血清护骨素、RANKL水平。结果试验组,临床总有效率(93.30%)明显优于对照组(70.00%,P<0.05)。试验组,骨密度的提高(0.97±0.10,0.79±0.10)明显优于对照组(0.77±0.10,0.62±0.10)(P<0.05)。试验组,血清护骨素水平明显高于对照组(142.24±6.54vs 119.18±5.71),而RANKL水平明显低于对照组(6.62±1.04 vs 8.46±1.63,P<0.05)。结论仙灵骨葆胶囊治疗PMOP具有良好的临床疗效,其作用机制可能与上调血清护骨素的表达、下调RANKL的表达有关。
文摘Osteoporosis is a common bone disease characterized by reduced bone and increased risk of fracture. In postmenopausal women, osteoporosis results from bone loss attributable to estrogen deficiency. Osteoclast differentiation and activation is mediated by receptor activator of nuclear factor-κB ligand(RANKL), its receptor receptor activator of nuclear factor-κB(RANK), and a decoy receptor for RANKL, osteoprotegerin(OPG). The OPG/RANKL/RANK system plays a pivotal role in osteoclast biology. Currently, a fully human antiRANKL monoclonal antibody named denosumab is being clinically used for the treatment of osteoporosis and cancer-related bone disorders. This review describes recent advances in RANKL-related research, a story from bench to bedside. First, the discovery of the key factors, OPG/RANKL/RANK, revealed the molecular mechanism of osteoclastogenesis. Second, we established three animal models:(1) a novel and rapid bone loss model by administration of glutathione-S transferase-RANKL fusion protein to mice;(2) a novel mouse model of hypercalcemia with anorexia by overexpression of soluble RANKL using an adenovirus vector; and(3) a novel mouse model of osteopetrosis by administration of a denosumab-like anti-mouse RANKL neutralizing monoclonal antibody. Lastly, anti-human RANKL monoclonal antibody has been successfully applied to the treatment of osteoporosis and cancer-related bone disorders in many countries. This is a real example of applying basic science to clinical practice.