肠道炎症状态下骨代谢调节的稳态与失衡

Homeostasis and Imbalance of the Bone Metabolism Regulation in the State of Intestinal Inflammation

摘要: 肠道炎症性疾患(Inflammatory Bowel Disease)是一种慢性全身性炎症疾病，主要包括溃疡性结肠炎(Ulcerative Colitis, UC)以及克罗恩病(Crohn’s Disease, CD)特征是肠道黏膜受到广泛的炎症破坏。此外，其可涉及全身各个系统，形成系统性合并症，骨骼系统便是其中之一。肠道炎症患者或各式各样的动物模型中均可观察到骨质破坏以及骨量丧失的现象，而这其中的病因机制却涉及各个方面，包括营养状况、炎症因子、肠道激素类信号分子以及肠道菌群等。总的来说骨代谢的平衡主要依赖于成骨与破骨作用之间的平衡，外界或内部因素倘若打破这一平衡，便会引起宏观方面的骨骼系统的变化，肠道炎症状态下亦是如此。本文将从肠道炎症状态出发，对这一病理环境下骨代谢异常的表现以及病因机制以及相关治疗策略做一综述。

Abstract: Inflammatory Bowel Disease, as a chronic systemic inflammatory disease that includes Ulcerative Colitis (UC) and Crohn’s disease (CD), is characterized by extensive inflammatory destruction of the intestinal mucosa. In addition, it involves various systems throughout the body, leading to systemic comorbidities, especially the skeletal system. Bone destruction and bone loss have been observed in patients with intestinal inflammation or in various animal models, and the etiological mechanism of this phenomenon involves various aspects, including nutritional status, inflammatory factors, intestinal hormone signaling molecules, and intestinal flora. In general, the balance of bone metabolism mainly depends on the balance between osteogenesis and osteoclastogenesis. If external or internal factors break this balance, it would cause changes in the skeletal system in the macro aspect, and this is also the case in the state of intestinal inflammation. Starting from the state of intestinal inflammation, this article will review the manifestations, etiological mechanisms and related treatment strategies of abnormal bone metabolism in this pathological environment.