中医药调控miRNA在股骨头坏死中作用的研究进展
Research Progress on the Role of Traditional Chinese Medicine in Regulating miRNA in Femoral Head Necrosis
DOI: 10.12677/acm.2025.1572008, PDF,   
作者: 王春蕾*：黑龙江中医药大学第一临床医学院，黑龙江 哈尔滨；李洪涛#：黑龙江中医药大学附属第一医院骨伤一科，黑龙江 哈尔滨
关键词: 股骨头坏死；miRNA；中医药；自噬；Osteonecrosis of the Femoral Head； miRNA； Traditional Chinese Medicine； Autophagy
摘要: 股骨头坏死(ONFH)是一种因血液供应不足导致细胞死亡、骨折及区域塌陷的进行性疾病。2023年全球约有3000万患者，我国超812万，约94%的患者5年内会出现股骨头塌陷、行走功能障碍，最终需行人工全髋关节置换术。其病因复杂，与创伤、高脂血症、糖皮质激素使用及酒精等因素相关，发病机制涉及血管内皮损伤、骨细胞凋亡、炎症反应和骨代谢紊乱等。microRNA (miRNA)是一类内源性非编码RNA，通过与靶mRNA的3'-末端非翻译区结合负向调控基因表达，在多种生理过程及骨科疾病发病机制中发挥重要作用。研究ONFH中的miRNA对揭示病理机制、早期诊断及治疗意义重大。本文旨在综合分析文献，探讨中药调控miRNA与ONFH的潜在联系，分析其作为诊断治疗工具的潜力，为读者呈现中医药调控miRNA在ONFH中的重要性的全面视角，推动相关研究和临床应用。
Abstract: Osteonecrosis of the femoral head (ONFH) is a progressive disease caused by insufficient blood supply leading to cell death, fractures, and regional collapse. In 2023, there were approximately 30 million patients worldwide, with over 8.12 million in China. About 94% of patients will experience femoral head collapse and walking dysfunction within five years, eventually requiring total hip arthroplasty. The etiology is complex, related to trauma, hyperlipidemia, glucocorticoid use, and alcohol consumption, among others. The pathogenesis involves vascular endothelial injury, osteocyte apoptosis, inflammatory response, and bone metabolism disorders. MicroRNA (miRNA) is an endogenous non-coding RNA that negatively regulates gene expression by binding to the 3'-untranslated region of target mRNA and plays a significant role in various physiological processes and the pathogenesis of orthopedic diseases. Studying miRNA in ONFH is of great significance for revealing the pathological mechanism, early diagnosis, and treatment. This article aims to comprehensively analyze the literature, explore the potential connection between miRNA regulated by traditional Chinese medicine and ONFH, and analyze its potential as a diagnostic and therapeutic tool, presenting a comprehensive perspective on the importance of traditional Chinese medicine regulating miRNA in ONFH to readers and promoting related research and clinical application.
文章引用：王春蕾, 李洪涛. 中医药调控miRNA在股骨头坏死中作用的研究进展[J]. 临床医学进展, 2025, 15(7): 449-454. https://doi.org/10.12677/acm.2025.1572008

参考文献

[1] Meng, K., Liu, Y., Ruan, L., Chen, L., Chen, Y. and Liang, Y. (2023) Suppression of Apoptosis in Osteocytes, the Potential Way of Natural Medicine in the Treatment of Osteonecrosis of the Femoral Head. Biomedicine & Pharmacotherapy, 162, Article ID: 114403. [Google Scholar] [CrossRef] [PubMed]
[2] Cohen-Rosenblum, A. and Cui, Q. (2019) Osteonecrosis of the Femoral Head. Orthopedic Clinics of North America, 50, 139-149. [Google Scholar] [CrossRef] [PubMed]
[3] Zheng, J., Yao, Z., Xue, L., Wang, D. and Tan, Z. (2022) The Role of Immune Cells in Modulating Chronic Inflammation and Osteonecrosis. Frontiers in Immunology, 13, Article 1064245. [Google Scholar] [CrossRef] [PubMed]
[4] Zhang, J., Cao, J., Liu, Y. and Zhao, H. (2024) Advances in the Pathogenesis of Steroid-Associated Osteonecrosis of the Femoral Head. Biomolecules, 14, Article 667. [Google Scholar] [CrossRef] [PubMed]
[5] Youm, Y., Lee, S. and Lee, S. (2010) Apoptosis in the Osteonecrosis of the Femoral Head. Clinics in Orthopedic Surgery, 2, 250-255. [Google Scholar] [CrossRef] [PubMed]
[6] 王正业, 刘万林, 赵振群. miRNA在激素诱导股骨头坏死机制中的研究进展[J]. 中国组织工程研究, 2026, 30(5): 1207-1214.
[7] Tyc, K.M., Wong, A., Scott, R.T., Tao, X., Schindler, K. and Xing, J. (2021) Analysis of DNA Variants in miRNAs and Mirna 3ʼUTR Binding Sites in Female Infertility Patients. Laboratory Investigation, 101, 503-512. [Google Scholar] [CrossRef] [PubMed]
[8] Li, N., Long, B., Han, W., Yuan, S. and Wang, K. (2017) MicroRNAs: Important Regulators of Stem Cells. Stem Cell Research & Therapy, 8, Article No. 110. [Google Scholar] [CrossRef] [PubMed]
[9] Stelcer, E., Kulcenty, K., Rucinski, M., Jopek, K., Richter, M., Trzeciak, T., et al. (2019) The Role of MicroRNAs in Early Chondrogenesis of Human Induced Pluripotent Stem Cells (hiPSCs). International Journal of Molecular Sciences, 20, Article 4371. [Google Scholar] [CrossRef] [PubMed]
[10] Ying, W., Riopel, M., Bandyopadhyay, G., Dong, Y., Birmingham, A., Seo, J.B., et al. (2017) Adipose Tissue Macrophage-Derived Exosomal miRNAs Can Modulate in Vivo and in Vitro Insulin Sensitivity. Cell, 171, 372-384.e12. [Google Scholar] [CrossRef] [PubMed]
[11] Yang, C., Liu, X., Zhao, K., Zhu, Y., Hu, B., Zhou, Y., et al. (2019) miRNA-21 Promotes Osteogenesis via the PTEN/ PI3K/Akt/HIF-1α Pathway and Enhances Bone Regeneration in Critical Size Defects. Stem Cell Research & Therapy, 10, Article No. 65. [Google Scholar] [CrossRef] [PubMed]
[12] 方锐, 邹全. 王继先辨治股骨头无菌性坏死经验初探[J]. 上海中医药杂志, 2009, 43(6): 1-2.
[13] 艾力江·阿斯拉, 梁治权, 李雷疆, 等. 补肾生骨汤对股骨头无菌性坏死大鼠的影响[J]. 中国中医骨伤科杂志, 2023, 31(1): 7-12.
[14] 杨建军. 祛痰逐瘀汤治疗不稳定型心绞痛的疗效观察[J]. 中国医药指南, 2012, 10(23): 311-312.
[15] 洪郭驹, 魏秋实, 韩晓蕊, 等. 祛痰逐瘀方经miR-628/Pten/Runx2调控酒精性股骨头坏死骨稳态代谢机制研究[J]. 广东医学, 2019, 40(2): 185-190.
[16] Jean-Baptiste, L., Julie, R., Lacerda, T.L.S., et al. (2021) The Brucella Effector BspL Targets the ER-Associated Degradation ERAD Pathway and Delays Bacterial Egress from Infected Cells. Proceedings of the National Academy of Sciences of the United States of America, 118, e2105324118.
[17] Grumati, P., Dikic, I. and Stolz, A. (2018) ER-Phagy at a Glance. Journal of Cell Science, 131, jcs217364. [Google Scholar] [CrossRef] [PubMed]
[18] Zhang, Z., Gao, W., Zhou, L., Chen, Y., Qin, S., Zhang, L., et al. (2019) Repurposing Brigatinib for the Treatment of Colorectal Cancer Based on Inhibition of ER-Phagy. Theranostics, 9, 4878-4892. [Google Scholar] [CrossRef] [PubMed]
[19] Liu, W., Xu, C., Ran, D., Wang, Y., Zhao, H., Gu, J., et al. (2018) Camkⅱ Mediates Cadmium Induced Apoptosis in Rat Primary Osteoblasts through MAPK Activation and Endoplasmic Reticulum Stress. Toxicology, 406, 70-80. [Google Scholar] [CrossRef] [PubMed]
[20] 袁颖嘉, 陈海诚, 陈聪. 高能量体外冲击波配合袁氏生脉成骨片治疗早期股骨头坏死34例[J]. 海南医学, 2018, 29(8): 1088-1090.
[21] 李鹏飞, 孙楠, 樊粤光, 等. 袁氏生脉成骨片对激素干预后大鼠成骨细胞的差异表达miRNA的实验研究[J]. 中华中医药学刊, 2017, 35(1): 91-94, 260.
[22] Li, M., Gao, P. and Zhang, J. (2016) Crosstalk between Autophagy and Apoptosis: Potential and Emerging Therapeutic Targets for Cardiac Diseases. International Journal of Molecular Sciences, 17, Article 332. [Google Scholar] [CrossRef] [PubMed]
[23] Kroemer, G., Mariño, G. and Levine, B. (2010) Autophagy and the Integrated Stress Response. Molecular Cell, 40, 280-293. [Google Scholar] [CrossRef] [PubMed]
[24] Liu, F., Fang, F., Yuan, H., Yang, D., Chen, Y., Williams, L., et al. (2013) Suppression of Autophagy by FIP200 Deletion Leads to Osteopenia in Mice through the Inhibition of Osteoblast Terminal Differentiation. Journal of Bone and Mineral Research, 28, 2414-2430. [Google Scholar] [CrossRef] [PubMed]
[25] Zhang, L., Guo, Y., Liu, Y., Liu, Y., Xiong, D., Liu, X., et al. (2010) Pathway-Based Genome-Wide Association Analysis Identified the Importance of Regulation-Of-Autophagy Pathway for Ultradistal Radius BMD. Journal of Bone and Mineral Research, 25, 1572-1580. [Google Scholar] [CrossRef] [PubMed]
[26] Zhou, M. (2020) Effects of Osteoblast Autophagy on Glucocorticoid-Induced Femoral Head Necrosis. Joint Diseases and Related Surgery, 31, 411-418. [Google Scholar] [CrossRef] [PubMed]
[27] 姜涛, 凌翠敏, 陈庆真, 等. 淫羊藿苷通过提高自噬促进成骨细胞分化防治骨质疏松[J]. 中国组织工程研究, 2021, 25(17): 2643-2649.
[28] 訾慧, 郑洪新, 蒋宁, 等. 淫羊藿素通过BMP/Runx2/Osx信号通路促进大鼠骨髓间充质干细胞成骨分化研究[J]. 中华中医药学刊, 2020, 38(7): 212-215, 270.
[29] 张庆宇, 高福强, 程立明, 等. 淫羊藿苷对骨微血管内皮细胞自噬及外泌体产生的影响[J]. 中国修复重建外科杂志, 2019, 33(5): 568-577.
[30] Cao, R., Li, H., Liu, G., Yan, P., Zhang, J., Chen, Y., et al. (2025) Aging and Autophagic Phenotypic Changes in Bone Marrow Mesenchymal Stem Cells in Glucocorticoid-Induced Osteonecrosis. International Immunopharmacology, 152, Article ID: 114389. [Google Scholar] [CrossRef] [PubMed]
[31] Yang, A., Yu, C., Lu, Q., Li, H., Li, Z. and He, C. (2019) Mechanism of Action of Icariin in Bone Marrow Mesenchymal Stem Cells. Stem Cells International, 2019, Article ID: 5747298. [Google Scholar] [CrossRef] [PubMed]
[32] Zhao, J., He, W., Zheng, H., Zhang, R. and Yang, H. (2022) Bone Regeneration and Angiogenesis by Co-Transplantation of Angiotensin II—Pretreated Mesenchymal Stem Cells and Endothelial Cells in Early Steroid-Induced Osteonecrosis of the Femoral Head. Cell Transplantation, 31. [Google Scholar] [CrossRef] [PubMed]
[33] Li, J., Ge, Z., Ji, W., Yuan, N. and Wang, K. (2020) The Proosteogenic and Proangiogenic Effects of Small Extracellular Vesicles Derived from Bone Marrow Mesenchymal Stem Cells Are Attenuated in Steroid‐Induced Osteonecrosis of the Femoral Head. BioMed Research International, 2020, Article ID: 4176926. [Google Scholar] [CrossRef] [PubMed]
[34] Huo, Y., Huo, H. and Zhang, J. (2014) The Contribution of Deer Velvet Antler Research to the Modern Biological Medicine. Chinese Journal of Integrative Medicine, 20, 723-728. [Google Scholar] [CrossRef] [PubMed]
[35] Li, C., Zhao, H., Liu, Z. and McMahon, C. (2014) Deer Antler—A Novel Model for Studying Organ Regeneration in Mammals. The International Journal of Biochemistry & Cell Biology, 56, 111-122. [Google Scholar] [CrossRef] [PubMed]
[36] Liu, Y., Oey, I., Bremer, P., Carne, A. and Silcock, P. (2017) Bioactive Peptides Derived from Egg Proteins: A Review. Critical Reviews in Food Science and Nutrition, 58, 2508-2530. [Google Scholar] [CrossRef] [PubMed]
[37] 孟晨阳, 薛飞, 贾燕飞, 等. 鹿茸血清调控miR-141影响地塞米松对骨髓间充质干细胞的促增殖作用[J]. 中国组织工程研究, 2020, 24(19): 2991-2996.
[38] Li, J., Cao, F., Yin, H., Huang, Z., Lin, Z., Mao, N., et al. (2020) Ferroptosis: Past, Present and Future. Cell Death & Disease, 11, Article No. 88. [Google Scholar] [CrossRef] [PubMed]
[39] Mou, Y., Wang, J., Wu, J., He, D., Zhang, C., Duan, C., et al. (2019) Ferroptosis, a New Form of Cell Death: Opportunities and Challenges in Cancer. Journal of Hematology & Oncology, 12, Article No. 34. [Google Scholar] [CrossRef] [PubMed]
[40] 段莹莹, 张伟, 张月红, 等. 重构本草——三七[J]. 吉林中医药, 2023, 43(2): 225-228.
[41] 田照, 曾平, 刘金富, 等. 三七总皂苷介导PI3K/AKT/Bcl-2信号通路调节MC3T3-E1自噬和凋亡治疗激素性股骨头坏死[J]. 时珍国医国药, 2024, 35(6): 1361-1365.
[42] 陶红成, 曾平, 刘金富, 等. 三七总皂苷调控破骨细胞外泌体中差异miRNA表达抑制成骨细胞铁死亡[J]. 中国组织工程研究, 2025, 29(19): 4011-4021.
[43] 王大伟, 史宝明, 李小峰, 等. 三七总皂苷干预股骨头缺血性坏死兔成骨细胞护骨素基因的表达[J]. 中国组织工程研究与临床康复, 2011, 15(20): 3728-3732.
[44] Sun, F., Zhou, J.L., Liu, Z.L., Jiang, Z.W. and Peng, H. (2022) Dexamethasone Induces Ferroptosis via P53/SLC7A11/ GPX4 Pathway in Glucocorticoid-Induced Osteonecrosis of the Femoral Head. Biochemical and Biophysical Research Communications, 602, 149-155. [Google Scholar] [CrossRef] [PubMed]

为你推荐