乳腺癌骨转移（breast cancer bone metastasis，BCBM）是乳腺癌常见并发症，容易引起骨痛、病理性骨折和高钙血症等。骨保护素（osteoprotegerin，OPG）/核因子-κB受体活化因子（receptor activator of nuclear factor-κB，RANK）/RANK配体（RANK ligand，RANKL）信号通路在BCBM的发生发展中具有重要作用。研究表明，该信号通路与破骨细胞活化密切相关；BCBM的临床治疗策略包括骨改良药物、分子靶向治疗、免疫疗法等；中药单体及复方制剂能够上调OPG表达抑制破骨细胞活化，并阻断RANKL介导的核因子-κB信号通路激活，从而抑制BCBM病理进程。然而中药的临床应用仍受限于药动学特征的不确定性、质量标准不完善及疗效差异等因素。通过阐述BCBM中OPG/RANK/RANKL信号通路的调控机制，为中药治疗策略的制定提供理论依据。

Breast cancer bone metastasis (BCBM) is a common complication of breast cancer, which often induces bone pain, pathologic fractures, hypercalcemia, etc. The osteoprotegerin (OPG)/receptor activator of nuclear factor-κB (RANK)/RANK ligand (RANKL) signaling pathway plays a crucial role in development and progression of BCBM. Results has shown that this signaling pathway is closely related to osteoclast activation. The clinical treatment strategies for BCBM include bone-modifying drugs, molecularly targeted therapies, and immunotherapies. Both traditional Chinese medicine (TCM) monomers and compound preparations are able to upregulate OPG expression to inhibit osteoclast activation and block the RANKL-mediated nuclear factor-κB signaling pathway activation, thereby suppressing the pathological progression of BCBM. However, the clinical application of TCM is still limited by factors such as uncertain pharmacokinetic characteristics, incomplete quality standards, and variations in therapeutic efficacy. Elucidating the regulatory mechanisms of the OPG/RANK/RANKL signaling pathway in BCBM may therefore provide a theoretical foundation for developing TCM-based treatment strategies.

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国家自然科学基金资助项目（82474144）；浙江省万人计划科技创新领军人才项目（2022R52031）；浙江中医药大学科研资助项目（2025JKZDZC04）