1.Role and pathogenesis of pyroptosis and inflammatory factors in osteoporosis
Jiamu XU ; Cheng YANG ; Weimin LI ; Chunqing WANG
Chinese Journal of Tissue Engineering Research 2026;30(3):691-700
BACKGROUND:Studies have shown that there is a close relationship between pyroptosis,inflammatory factors and osteoporosis.OBJECTIVE:To review the effects of pyroptosis and inflammatory factors on the pathogenesis of osteoporosis from the perspectives of osteogenic differentiation and osteoclastic differentiation,based on an overview of pyroptosis in relation to the interaction of relevant inflammatory factors.METHODS:The first author used the computer to search the literature published by each database until 2024,and searched CNKI,WanFang,VIP and PubMed databases with the search terms of"pyroptosis,inflammatory factors,osteoporosis,osteoblast,osteoclast,bone metabolism,signaling pathway,review"in Chinese and English.A total of 79 papers were finally included according to the inclusion criteria.RESULTS AND CONCLUSION:The progression of osteoporosis is closely related to inflammation,in which pyroptosis plays a key role.Immune cells induce pyroptosis through apoptosis pathway,promote the secretion of inflammatory factors such as interleukin-18,interleukin-1β and NLRP3,build an inflammatory immune microenvironment,and regulate bone metabolism through complex signaling pathways,resulting in enhanced bone absorption and reduced bone formation,thereby leading to osteoporosis.Previous studies have shown that inhibiting pyroptosis is anti-inflammatory and slows the progression of osteoporosis,and it has been shown to improve inflammatory bone loss in vitro and in animal models.At present,research on pyroptosis and osteoporosis is limited.On the one hand,the exact mechanism of osteoporosis and the pathogenesis of pyroptosis are unknown,and the specific pathways and regulatory mechanisms remain to be understood.On the other hand,therapeutic strategies targeting pyroptosis are still theoretical,not clinically proven,and drug side effects are unknown.In the future,the research focus is to further explore the pathogenesis,especially the mechanism of pyroptosis,identify potential therapeutic targets,further study the pyroptosis signaling pathway and Gasdermin protein,and develop new drugs to improve the therapeutic effect in patients with osteoporosis.
2.Role and pathogenesis of pyroptosis and inflammatory factors in osteoporosis
Jiamu XU ; Cheng YANG ; Weimin LI ; Chunqing WANG
Chinese Journal of Tissue Engineering Research 2026;30(3):691-700
BACKGROUND:Studies have shown that there is a close relationship between pyroptosis,inflammatory factors and osteoporosis.OBJECTIVE:To review the effects of pyroptosis and inflammatory factors on the pathogenesis of osteoporosis from the perspectives of osteogenic differentiation and osteoclastic differentiation,based on an overview of pyroptosis in relation to the interaction of relevant inflammatory factors.METHODS:The first author used the computer to search the literature published by each database until 2024,and searched CNKI,WanFang,VIP and PubMed databases with the search terms of"pyroptosis,inflammatory factors,osteoporosis,osteoblast,osteoclast,bone metabolism,signaling pathway,review"in Chinese and English.A total of 79 papers were finally included according to the inclusion criteria.RESULTS AND CONCLUSION:The progression of osteoporosis is closely related to inflammation,in which pyroptosis plays a key role.Immune cells induce pyroptosis through apoptosis pathway,promote the secretion of inflammatory factors such as interleukin-18,interleukin-1β and NLRP3,build an inflammatory immune microenvironment,and regulate bone metabolism through complex signaling pathways,resulting in enhanced bone absorption and reduced bone formation,thereby leading to osteoporosis.Previous studies have shown that inhibiting pyroptosis is anti-inflammatory and slows the progression of osteoporosis,and it has been shown to improve inflammatory bone loss in vitro and in animal models.At present,research on pyroptosis and osteoporosis is limited.On the one hand,the exact mechanism of osteoporosis and the pathogenesis of pyroptosis are unknown,and the specific pathways and regulatory mechanisms remain to be understood.On the other hand,therapeutic strategies targeting pyroptosis are still theoretical,not clinically proven,and drug side effects are unknown.In the future,the research focus is to further explore the pathogenesis,especially the mechanism of pyroptosis,identify potential therapeutic targets,further study the pyroptosis signaling pathway and Gasdermin protein,and develop new drugs to improve the therapeutic effect in patients with osteoporosis.
3.Ferroptosis and osteoporosis
Cheng YANG ; Weimin LI ; Dongcheng RAN ; Jiamu XU ; Wangxiang WU ; Jiafu XU ; Jingjing CHEN ; Guangfu JIANG ; Chunqing WANG
Chinese Journal of Tissue Engineering Research 2025;29(3):554-562
BACKGROUND:It has also been confirmed that ferroptosis is closely related to a variety of musculoskeletal diseases,such as rheumatoid arthritis,osteosarcoma,and osteoporosis.The pathophysiological mechanisms of ferroptosis and osteoporosis need to be further studied and elucidated to broaden our understanding of iron metabolism and osteoporosis.It will provide research ideas for the future elucidation of new mechanisms of osteoporosis and the development of new technologies and drugs for the treatment of osteoporosis. OBJECTIVE:To provide an overview of the current status of research on ferroptosis in osteoporosis,to provide a new direction for future research on the specific molecular mechanisms of osteoporosis,and to provide more effective and better options for osteoporosis treatment strategies. METHODS:The first author used the computer to search the literature published from 2000 to 2024 in CNKI,WanFang,VIP,and PubMed databases with search terms"ferroptosis,iron metabolism,osteoporosis,osteoblast,osteoclast,bone metabolism,signal pathway,musculoskeletal,review"in Chinese and English.A total of 68 articles were finally included according to the selection criteria. RESULTS AND CONCLUSION:(1)Ferroptosis is a new type of cell death discovered in recent years,which is usually accompanied by a large amount of iron accumulation and lipid peroxidation during cell death,and its occurrence is iron-dependent.This is distinctly different from several types of cell death that are currently being hotly studied(e.g.,cellular pyroptosis,necrotic apoptosis,cuproptosis,and autophagy).(2)Intracellular iron homeostasis is manifested as a balance between iron uptake,export,utilization,and storage.The body's iron regulatory system includes systemic and intracellular regulation.The main factor of systemic regulation is hepcidin produced by hepatic secretion,and cellular regulation depends on the iron regulatory protein/iron response element system.Of course,intracellular iron homeostasis can be controlled by other factors,such as hypoxia,cytokines,and hormones.(3)Lipid peroxidation causes oxidative damage to biological membranes(plasma membrane and internal organelle membranes),lipoproteins,and other lipid-containing molecules.Polyunsaturated fatty acid-containing phospholipids are important targets of lipid peroxidation.Free polyunsaturated fatty acid is an important substrate for lipid oxidation and can bind to the phospholipid bilayer,leading to over-oxidation and thus triggering lipid apoptosis.(4)Several studies have shown that osteoblasts are overloaded with iron in different ways,resulting in the accumulation of unstable ferrous iron and the generation of reactive oxygen species and lipid peroxides,causing ferroptosis of osteoblasts and ultimately a decrease in bone formation,affecting bone homeostasis and the development of osteoporosis.(5)Osteoclasts are large multinucleated cells formed by the fusion of mononuclear macrophage cell lines or bone marrow mesenchymal stem cells induced by nuclear factor-κB ligand receptor activator,and they have the function of bone resorption.Iron ions can promote osteoclast differentiation and bone resorption through the production of intracellular lipid reactive oxygen species,while iron chelators can inhibit osteoclast formation in vitro and thus affect the occurrence and development of osteoporosis.
4.Research progress of suprapatellar vs. infrapatellar approaches in tibial intramedullary nailing for tibial fractures
Journal of Chinese Physician 2025;27(11):1741-1746
Tibial shaft fractures are clinically common, mostly caused by traffic accidents, heavy object impacts, and other injuries. Treatment methods include open reduction and internal fixation, minimally invasive plate osteosynthesis, external fixators, and intramedullary nails. Among these, intramedullary fixation is the gold standard, as it can protect soft tissues and blood supply. Traditional intramedullary nails are inserted through an infrapatellar incision at the anterior knee, which has shortcomings such as the need for knee flexion during operation and difficulty in reduction. In recent years, suprapatellar approach nail placement in the semi-extended knee position has been widely applied. This review focuses on recent studies, comparing the suprapatellar and infrapatellar approaches of tibial intramedullary nailing for tibial fractures in terms of surgical operation, therapeutic efficacy, and complications. It aims to provide literature support for clinical decision-making and help doctors better select appropriate treatment plans.
5.Long noncoding RNAs related to osteoporosis:current research status and developmental trends
Wangxiang WU ; Dongcheng RAN ; Jiamu XU ; Jiafu XU ; Jingjing CHEN ; Chunqing WANG
Chinese Journal of Tissue Engineering Research 2025;29(29):6360-6368
BACKGROUND:Studies have indicated that long noncoding RNAs play a crucial role in the pathogenesis and progression of osteoporosis.Thus,it is essential to comprehend the current research status,hotspots,and developmental trajectories of long noncoding RNAs in the field of osteoporosis research.OBJECTIVE:To explore the research status,development trends,and hotspots in the field of osteoporosis-related long noncoding RNAs by conducting bibliometric statistics and visualization analysis of the relevant literature.METHODS:Using the search string"(TS=(Osteoporosis OR Osteoporoses)AND TS=(Long non coding RNA OR LncRNA OR Lnc RNA OR Long noncoding RNA)),"a subject term search was conducted in the Web of Science Core Collection database for articles published from January 2015 to September 2024.After manual filtering of the obtained raw data,visualization analysis of authors,institutions,countries,and keywords was performed using Cite Space 6.2.R4 software and Microsoft 365(Office).RESULTS AND CONCLUSION:A total of 265 articles were included from the Web of Science Core Collection database.Since 2015,there has been an overall upward trend in the number of publications in this field,with China being the leading country in terms of publication volume and research centrality,while Beihang University holds the highest institutional centrality.After keywords directly related to the article's theme were excluded,the terms"osteogenic differentiation,""expression,""bone formation,"and"mesenchymal stem cells"emerged as core topics based on co-occurrence frequency and centrality.A comprehensive analysis of the keyword cluster map,keyword burst map,and keyword timeline map reveals that investigating the mechanisms by which long non-coding RNAs influence the formation and differentiation of osteoblasts,as well as the differentiation of osteoclasts and bone resorption,constitutes both a current research hotspot and a future research trend in this field.
6.Long noncoding RNAs related to osteoporosis:current research status and developmental trends
Wangxiang WU ; Dongcheng RAN ; Jiamu XU ; Jiafu XU ; Jingjing CHEN ; Chunqing WANG
Chinese Journal of Tissue Engineering Research 2025;29(29):6360-6368
BACKGROUND:Studies have indicated that long noncoding RNAs play a crucial role in the pathogenesis and progression of osteoporosis.Thus,it is essential to comprehend the current research status,hotspots,and developmental trajectories of long noncoding RNAs in the field of osteoporosis research.OBJECTIVE:To explore the research status,development trends,and hotspots in the field of osteoporosis-related long noncoding RNAs by conducting bibliometric statistics and visualization analysis of the relevant literature.METHODS:Using the search string"(TS=(Osteoporosis OR Osteoporoses)AND TS=(Long non coding RNA OR LncRNA OR Lnc RNA OR Long noncoding RNA)),"a subject term search was conducted in the Web of Science Core Collection database for articles published from January 2015 to September 2024.After manual filtering of the obtained raw data,visualization analysis of authors,institutions,countries,and keywords was performed using Cite Space 6.2.R4 software and Microsoft 365(Office).RESULTS AND CONCLUSION:A total of 265 articles were included from the Web of Science Core Collection database.Since 2015,there has been an overall upward trend in the number of publications in this field,with China being the leading country in terms of publication volume and research centrality,while Beihang University holds the highest institutional centrality.After keywords directly related to the article's theme were excluded,the terms"osteogenic differentiation,""expression,""bone formation,"and"mesenchymal stem cells"emerged as core topics based on co-occurrence frequency and centrality.A comprehensive analysis of the keyword cluster map,keyword burst map,and keyword timeline map reveals that investigating the mechanisms by which long non-coding RNAs influence the formation and differentiation of osteoblasts,as well as the differentiation of osteoclasts and bone resorption,constitutes both a current research hotspot and a future research trend in this field.
7.Research progress of suprapatellar vs. infrapatellar approaches in tibial intramedullary nailing for tibial fractures
Journal of Chinese Physician 2025;27(11):1741-1746
Tibial shaft fractures are clinically common, mostly caused by traffic accidents, heavy object impacts, and other injuries. Treatment methods include open reduction and internal fixation, minimally invasive plate osteosynthesis, external fixators, and intramedullary nails. Among these, intramedullary fixation is the gold standard, as it can protect soft tissues and blood supply. Traditional intramedullary nails are inserted through an infrapatellar incision at the anterior knee, which has shortcomings such as the need for knee flexion during operation and difficulty in reduction. In recent years, suprapatellar approach nail placement in the semi-extended knee position has been widely applied. This review focuses on recent studies, comparing the suprapatellar and infrapatellar approaches of tibial intramedullary nailing for tibial fractures in terms of surgical operation, therapeutic efficacy, and complications. It aims to provide literature support for clinical decision-making and help doctors better select appropriate treatment plans.

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