中国中医骨伤科杂志2026，Vol.34Issue(1)：51-60,10.DOI:10.20085/j.cnki.issn1005-0205.260108
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
Exosome-Mediated Intercellular Communication:to Explore the Comorbidity Mechanism of Postmenopausal Osteoporosis and Knee Osteoarthritis Based on the Theory of"Kidney Governing Bone"
摘要
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 postm-enopausal women,suggesting shared pathological substrates and systemic regulatory networks.According to the tradition-al 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 repro-gramming,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 KO A,strongly corroborating the traditional theory of the"kidney gov-erning 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.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Key words
kidney governs bones/exosomes/postmenopausal osteoporosis/knee osteoarthritis/intercellular communica-tion/comorbidity mechanism分类
医药卫生引用本文复制引用
陈莉莉,吴高贤,张明生,辛晨睿,周晓红,熊勇..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(1):51-60,10.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) （82405573）
