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Arthritis and the role of endogenous glucocorticoids

机译:关节炎和内源性糖皮质激素的作用

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Rheumatoid arthritis and osteoarthritis, the most common forms of arthritis, are chronic, painful, and disabling conditions. Although both diseases differ in etiology, they manifest in progressive joint destruction characterized by pathological changes in the articular cartilage, bone, and synovium. While the potent anti-inflammatory properties of therapeutic (i.e., exogenous) glucocorticoids have been heavily researched and are widely used in clinical practice, the role of endogenous glucocorticoids in arthritis susceptibility and disease progression remains poorly understood. Current evidence from mouse models suggests that local endogenous glucocorticoid signaling is upregulated by the pro-inflammatory microenvironment in rheumatoid arthritis and by aging-related mechanisms in osteoarthritis. Furthermore, these models indicate that endogenous glucocorticoid signaling in macrophages, mast cells, and chondrocytes has anti-inflammatory effects, while signaling in fibroblast-like synoviocytes, myocytes, osteoblasts, and osteocytes has pro-inflammatory actions in rheumatoid arthritis. Conversely, in osteoarthritis, endogenous glucocorticoid signaling in both osteoblasts and chondrocytes has destructive actions. Together these studies provide insights into the role of endogenous glucocorticoids in the pathogenesis of both inflammatory and degenerative joint disease.
机译:类风湿性关节炎和骨关节炎,最常见的关节炎形式,是慢性,痛苦和致残条件。虽然这两种疾病在病因中有所不同,但它们在渐进的联合破坏中表现出关节软骨,骨骼和滑膜的病理变化。虽然治疗性(即外源性)糖皮质激素的有效的抗炎性质已经大量研究并且被广泛用于临床实践中,但内源性糖皮质激素在关节炎易感性和疾病进展中的作用仍然明白。来自小鼠模型的当前证据表明,局部内源性糖皮质激素通过类风湿性关节炎的促炎微环境和骨关节炎的衰老机制上调。此外,这些模型表明在巨噬细胞,肥大细胞和软骨细胞中的内源性糖皮质激素信号传导具有抗炎作用,而在成纤维细胞样的滑膜,肌细胞,成骨细胞和骨细胞中的信号传导具有类风湿性关节炎的促炎作用。相反,在骨关节炎中,成骨细胞和软骨细胞中的内源性糖皮质激素信号传导具有破坏性的作用。这些研究共同为内源性糖皮质激素在炎症和退行性关节病的发病机制中提供了见解。

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