[1]陈莉莉,吴高贤,张明生,等.外泌体介导的细胞间通信:基于“肾主骨”理论探讨绝经后骨质疏松症与膝骨关节炎的共病机制[J].中国中医骨伤科杂志,2026,34(01):51-60.[doi:10.20085/j.cnki.issn1005-0205.260108]
　CHEN Lili,WU Gaoxian,ZHANG Mingsheng,et al.Exosome-Mediated Intercellular Communication:to Explore the Comorbidity Mechanism of Postmenopausal Osteoporosis and Knee Osteoarthritis Based on the Theory of “Kidney Governing Bone”[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(01):51-60.[doi:10.20085/j.cnki.issn1005-0205.260108]
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外泌体介导的细胞间通信:基于“肾主骨”理论探讨绝经后骨质疏松症与膝骨关节炎的共病机制()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第34卷
期数:
2026年01期
页码:
51-60
栏目:
关节损伤疾病
出版日期:
2026-01-15

文章信息/Info

Title:
Exosome-Mediated Intercellular Communication:to Explore the Comorbidity Mechanism of Postmenopausal Osteoporosis and Knee Osteoarthritis Based on the Theory of “Kidney Governing Bone”
文章编号:
1005-0205(2026)01-0051-10
作者:
陈莉莉1; 吴高贤1; 张明生2; 辛晨睿2; 周晓红2; 熊勇2; 3△
1中国人民解放军中部战区总医院(武汉,430070)
2湖北中医药大学针灸骨伤学院
3湖北时珍实验室
Author(s):
CHEN Lili1; WU Gaoxian1; ZHANG Mingsheng2; XIN Chenrui2; ZHOU Xiaohong2; XIONG Yong2; 3△
1General Hospital of Central Theater Command of the People's Liberation Army of China,Wuhan 430070,China; 2School of Acupuncture and Orthopedics,Hubei University of Chinese Medicine,Wuhan 430061,China; 3Hubei Shizhen Laboratory,Wuhan 430061,China.
关键词:
肾主骨;  外泌体;  绝经后骨质疏松症;  膝骨关节炎;  细胞间通信;  共病机制
Keywords:
kidney governs bones;  exosomes;  postmenopausal osteoporosis;  knee osteoarthritis;  intercellular communication;  comorbidity mechanism
分类号:
R684.3
DOI:
10.20085/j.cnki.issn1005-0205.260108
文献标志码:
A
摘要:
绝经后骨质疏松症(PMOP)与膝骨关节炎(KOA)是老年女性常见的退行性疾病,二者长期被视为病理机制相对独立的疾病类型。然而,流行病学研究显示二者在绝经后女性中具有显著的共病特征,提示存在共同的病理基础与系统性调控网络。中医“肾主骨”理论认为,肾精亏虚是导致骨与关节系统衰退的根本原因; 现代研究发现,外泌体介导的细胞间通信在骨-软骨耦合与系统代谢调控中发挥关键作用。基于“肾主骨”理论,系统阐释其在现代生物学中的对应关系,包括肾精与内分泌稳态、干细胞生物学、氧化还原平衡及线粒体能量代谢之间的映射机制,并提出外泌体是“肾精”信息传递的微观载体,其 miRNA 组合谱有望成为绝经后骨质疏松症与膝骨关节炎共病的系统性分子标志物。外泌体通过跨组织信号传递,构建了“骨-软骨轴”的动态信息网络,实现了“肾主骨”的远程调控功能。在“肾虚”状态下,骨髓间充质干细胞(BMSCs)、破骨细胞、软骨细胞及脂肪细胞来源外泌体的分泌谱发生重编程,促成骨与破骨、合成与分解之间的信号通路失衡,导致骨质流失与软骨退变的协同进展,同时为绝经后骨质疏松症与膝骨关节炎共病的早期筛查、分层诊断及中医证候分型提供了潜在的分子基础。由此可见,外泌体介导的细胞间通信失衡是绝经后骨质疏松症与膝骨关节炎共病的重要分子基础,其机制深刻印证了“肾主骨、生髓通络”的传统理论,并为开发以外泌体为核心的成骨促修复与护软骨干预策略及中西医整合诊疗路径提供了新的理论框架与干预思路。
Abstract:
Postmenopausal osteoporosis(PMOP)and knee osteoarthritis(KOA)are common degenerative disorders in elderly women and have long been regarded as disease entities with relatively independent pathophysiological mechanisms.However,epidemiological studies have revealed a pronounced pattern of comorbidity between PMOP and KOA in postmenopausal women,suggesting shared pathological substrates and systemic regulatory networks.According to the traditional Chinese medicine(TCM)theory of the “kidney governing bone”,deficiency of kidney essence is considered the fundamental cause of the concurrent decline of bone and joint systems,while modern studies have shown that exosome-mediated intercellular communication plays a pivotal role in bone-cartilage coupling and systemic metabolic regulation.Based on the “kidney governing bone” theory,this paper systematically elucidates its correspondence with modern biology,including the mapping relationships between kidney essence and endocrine homeostasis,stem cell biology,redox balance,and mitochondrial energy metabolism,and proposes that exosomes act as a microscopic carriers for the transmission of “kidney essence”-related information,whose miRNA signatures may serve as systemic molecular biomarkers of PMOP-KOA comorbidity.By mediating cross-tissue signal transfer,exosomes construct a dynamic informational “bone-cartilage axis” and thereby realize the long-range regulatory function implied in the “kidney governing bone”.Under kidney-deficiency conditions,the exosomal secretion profiles of bone marrow mesenchymal stem cells(BMSCs),osteoclasts,chondrocytes,and adipocytes undergo pathological reprogramming,driving an imbalance between osteogenesis and bone resorption as well as between anabolic and catabolic processes,which in turn promotes the coordinated progression of bone loss and cartilage degeneration,while at the same time providing a potential molecular basis for early screening,risk stratification,and TCM pattern differentiation in PMOP-KOA comorbidity.In summary,dysregulated exosome-mediated intercellular communication represents a key molecular basis for the comorbidity of PMOP and KOA,strongly corroborating the traditional theory of the “kidney governing bone and nourishing marrow to connect the collaterals”,and offering a novel theoretical framework and intervention perspective for the development of exosome-centered pro-osteogenic and chondroprotective strategies and integrated TCM-Western medicine therapeutic pathways.

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(收稿日期:2025-11-11)

备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(82405573)
湖北省自然科学基金中医药创新发展联合基金项目(2025AFD487)
△通信作者 E-mail:xiongyong1978@163.com
更新日期/Last Update: 2026-01-15