Myostatin, a member of the transforming growth factor-β (TGF-β) superfamily, is a key autocrine/paracrine inhibitor of skeletal muscle growth. Recently, researchers have postulated that myostatin is a negative regulator of bone formation and metabolism. Reportedly, myostatin is highly expressed in the fracture area, affecting the endochondral ossification process during the early stages of fracture healing. Furthermore, myostatin is highly expressed in the synovium of patients with rheumatoid arthritis (RA) and is an effective therapeutic target for interfering with osteoclast formation and joint destruction in RA. Thus, myostatin is a potent anti-osteogenic factor and a direct modulator of osteoclast differentiation. Evaluation of the molecular pathway revealed that myostatin can activate SMAD and mitogen-activated protein kinase signaling pathways, inhibiting the Wnt/β-catenin pathway to synergistically regulate muscle and bone growth and metabolism. In summary, inhibition of myostatin or the myostatin signaling pathway has therapeutic potential in the treatment of orthopedic diseases. This review focused on the effects of myostatin on bone formation and metabolism and discussed the potential therapeutic effects of inhibiting myostatin and its pathways in related orthopedic diseases.

中文翻译：

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肌肉生长抑制素对骨科疾病骨形成和代谢的分子基础和治疗潜力

肌生长抑制素是转化生长因子-β (TGF-β) 超家族的成员，是骨骼肌生长的关键自分泌/旁分泌抑制剂。最近，研究人员假设肌生长抑制素是骨形成和新陈代谢的负调节剂。据报道，肌肉生长抑制素在骨折区域高表达，影响骨折愈合早期的软骨内骨化过程。此外，肌肉生长抑制素在类风湿性关节炎 (RA) 患者的滑膜中高表达，是干扰 RA 破骨细胞形成和关节破坏的有效治疗靶点。因此，肌肉生长抑制素是一种有效的抗成骨因子和破骨细胞分化的直接调节剂。分子通路评估表明，肌肉生长抑制素可以激活 SMAD 和丝裂原活化蛋白激酶信号通路，抑制 Wnt/β-catenin 通路，协同调节肌肉和骨骼的生长和代谢。总之，抑制肌肉生长抑制素或肌肉生长抑制素信号通路在骨科疾病的治疗中具有治疗潜力。本文综述了肌肉生长抑制素对骨形成和代谢的影响，并讨论了抑制肌肉生长抑制素及其通路在相关骨科疾病中的潜在治疗作用。