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白藜芦醇防治椎间盘退变的研究进展OA

Research progress of resveratrol against intervertebral disc degeneration

中文摘要英文摘要

椎间盘退变(intervertebral disc degeneration,IVDD)是导致腰背痛的主要原因,目前缺乏有效的药物疗法.白藜芦醇(resveratrol,RSV)作为一种天然多酚,在延缓IVDD方面展现出巨大潜力.本综述系统阐述了RSV通过调控多条信号通路,对椎间盘核心功能细胞——髓核细胞发挥保护作用的多维分子机制.具体而言,RSV能够通过抑制NF-κB等通路,减轻机械应激与氧化应激诱导的髓核细胞衰老;通过调节细胞外信息调节激酶1/2(extracellular signal-regulated,ERK1/2)、磷脂酰肌醇3-激酶/蛋白激酶B(phosphatidylinositol 3-kinase/V-Akt,PI3K/Akt)等通路,抑制由炎症、高糖等因素引起的细胞凋亡;通过激活Nrf2/ARE等通路增强细胞自噬,清除受损组分;并通过调控炎性因子表达,维持细胞外基质(extracellular matrix,ECM)合成与降解的平衡,从而改善椎间盘内环境.尽管现有研究主要集中于体外和动物模型,且对纤维环、终板等结构关注不足,但证据表明RSV通过多靶点、多通路协同作用,在干预IVDD关键病理环节中具有显著效果.未来研究需进一步模拟体内低氧微环境,深入探索RSV对其他椎间盘组分的影响,并推动其临床转化,为开发IVDD的靶向药物疗法提供新的理论依据和策略.

Intervertebral disc degeneration(IVDD)is a leading cause of low back pain,yet effective pharmacotherapeutic options remain limited.Resveratrol(RSV),a natural polyphenol,has demonstrated considerable potential in mitigating IVDD progression.This review systematically summarizes the multi-dimensional molecular mechanisms by which RSV exerts protec-tive effects on nucleus pulposus(NP)cells,the central functional cells within discs,through the regulation of multiple signal-ing pathways.Specifically,RSV alleviates mechanical and oxidative stress-induced NP cell senescence by inhibiting pathways such as NF-κB;suppresses inflammation and high glucose-triggered apoptosis via modulating ERK1/2 and PI3K/Akt path-ways;enhances cytoprotective autophagy through activating pathways like Nrf2/ARE to clear damaged cellular components;and maintains the synthesis-degradation balance of the extracellular matrix(ECM)by regulating inflammatory cytokine expres-sion,thereby improving the disc microenvironment.Although current research is primarily based on in vitro and animal mod-els,with insufficient focus on structures like the annulus fibrosus and cartilaginous endplate,evidence strongly suggests that RSV acts synergistically on multiple targets and pathways to intervene in key pathological processes of IVDD.Future studies should better mimic the in vivo hypoxic niche,investigate RSV's effects on other disc components,and facilitate its clinical translation,offering novel theoretical foundations and strategies for developing targeted pharmacotherapies against IVDD.

程孟婷;索默然;王开众;李忠海

大连医科大学附属第一医院骨科,辽宁 大连 116011||大连医科大学,辽宁 大连 116000大连医科大学附属第一医院骨科,辽宁 大连 116011大连医科大学附属第一医院骨科,辽宁 大连 116011大连医科大学附属第一医院骨科,辽宁 大连 116011

医药卫生

椎间盘退变白藜芦醇髓核细胞外基质综述

Intervertebral disc degenerationResveratrolNucleus pulposusExtracellular matrixReview

《中国骨伤》 2026 (2)

212-216,5

10.12200/j.issn.1003-0034.20240841

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