Micro-RNA与椎间盘退行性变的研究进展

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下腰疼痛正在成为目前影响人们生活质量的重要因素,其发病的年龄越来越趋于年轻化,每年因下腰痛带来的社会经济损失巨大。椎间盘退变(intervertebral disc degeneration,IDD)是引起下腰疼的重要原因,在多重因素作用下,椎间盘组织出现生物力学和结构的变化,发生纤维环破裂、髓核组织突出,使脊髓和神经根受压,从而引起患者出现下腰疼。微小RNA(Micro-RNA,miRNA)是一类长度为18~24个核苷酸序列的单链非编码小分子RNA,其在真核生物中广泛存在,作为基因表达的重要调控分子之一,已被证明在许多种疾病起始及进展阶段发挥着关键作用,故认为其可能在椎间盘退变中也发挥着重要的作用。目前,临床上针对IDD的治疗手段主要以手术治疗缓解临床症状为主,即使当前手术治疗可以取得良好的疗效,但是手术治疗会给患者带来更大的身体创伤和经济负担。miRNA在椎间盘退变过程中的作用是当前学术界研究的热点之一,研究表明miRNA在退变的椎间盘组织中呈现异常的表达模式,参与IDD的多种病理过程。目前,一些miRNA已被证明与椎间盘退变过程中的多种病理过程有关,包括髓核细胞凋亡和增殖、细胞外基质的降解、细胞自噬、炎症反应及软骨终板的退变等。基因芯片对比研究显示一些miRNA在退变髓核细胞中的表达与正常髓核细胞存在明显差异,这些差异表达的miRNA通过调控其各自的上、下游通路可能参与髓核细胞退变的进程,调控通路多有交叉并行,构建出一个庞大的miRNA调控网。了解miRNA在发病过程中的靶基因和机制,能够在疾病的起源、发展和预后等方面提供重要参考。因此,综述了miRNA在椎间盘退变过程中的重要作用和潜在的临床治疗意义。随着对miRNA研究的深入,通过了解椎间盘退变的分子生物学机制,可以为IDD的诊断和治疗提供新思路,非常有可能成为IDD生物学治疗的新策略。“,”Low back pain is becoming an important factor affecting people's quality of life, while the age of its onset is getting younger and younger, and the social and economic losses caused by low back pain are huge every year. Intervertebral disc degeneration (IDD) is an important cause of low back pain. Due to multiple factors, biomechanical and structural changes occur in intervertebral disc tissue, including rupture of annulus fibrosus, protrusion of nucleus pulposus, which cause compression of spinal cord and nerve root, and lower back pain. Micro-RNA (miRNA) is a kind of single-stranded non-coding small molecule RNA, with 18-24 nucleotides in length, which exists widely in eukaryotes. As one of the important regulatory molecules of gene expression, it has been proved to play a key role in the initiation and progression of many diseases, and it may also play an important role in intervertebral disc degeneration. At present, the clinical treatment for IDD is mainly surgical treatment to alleviate clinical symptoms. Even if surgical treatment can achieve good results, it will bring great physical trauma and economic burden to patients. The role of miRNA in IDD is one of the hotspots in the current academic research. Studies have shown that miRNA has abnormal expression patterns in degenerative intervertebral disc tissues and participates in a variety of pathological processes of IDD. At present, some miRNAs have been proved to be related to a variety of pathological processes in IDD, including nucleus pulposus cell apoptosis and proliferation, extracellular matrix degradation, autophagy, inflammation and cartilage endplate degeneration. The comparative study of gene chip showed that there were significant differences in the expression of some miRNAs between degenerative and normal nucleus pulposus cells. These differentially expressed miRNAs may be involved in the process of nucleus pulposus cell degeneration by regulating their respective upstream or downstream pathways. Most of the regulatory pathways are crossed and parallel, thus constructing a huge miRNA regulatory network. Understanding the target genes and mechanisms of miRNA in the pathogenic process can provide an important reference for the origin, development and prognosis of IDD. In this article, the important role of miRNA in IDD and the potential significance of clinical treatment are reviewed. With the in-depth study of miRNA and the molecular biological mechanism can provide new ideas for the diagnosis and treatment of IDD, which is likely to become a new strategy for biological treatment of IDD.
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