Research progress of molecular signaling pathways in thoracic ossification of ligamentum flavum / 中华骨科杂志

ABSTRACT

Thoracic ossification of ligament flavum (TOLF) is a chronic progressive disease presenting the heterotopic ossification of the ligamentum flavum of the thoracic spine, which leads to a series of symptoms and signs of thoracic spinal cord, nerveor vascular compression, with a high incidence in East Asian countries such as China and Japan. The pathology of TOLF is endochondral ossification in nature and surgical intervention is currently the only effective treatment due to conservative treatment does not work. The older age, the insidious onset, the various clinical manifestations of TOLF patients make the localization diagnosis and surgery management difficult and even bring about the high incidence of postoperative complications. Therefore, it is particularly important to study the mechanism of osteogenic differentiation of TOLF to find a way of early diagnosis and prevention. A variety of factors related to osteogenic differentiation of TOLF have been found, such as genetics, mechanical stimuli, molecular biological factors, metabolic and trace element abnormalities and so on. Moreover, molecular signaling pathways play a crucial role in regulating cell proliferation and directed differentiation. Therefore, this article reviews the confirmed relevant signaling pathways in the process of ligamentum flavum ossification, including bone morphogenetic protein (BMP) signaling pathway, mitogen-activated protein kinase (MAPK) signaling pathway, Wnt signaling pathway, Notch signaling pathway, STAT3 signaling pathway and other signaling pathways and factors, and also summarizes the promotion and inhibition of these signaling pathways in the osteogenic differentiation of ligamentum flavum cells, aiming at establishing a basis for the further research of the molecular biological mechanism of TOLF, and providing a possible direction for exploration of effective preventive and therapeutic targets.