骨髓脂肪细胞（BMAs）是骨髓中最丰富的细胞，通过产生脂肪酸、细胞因子和脂肪细胞因子来作为一个内分泌器官发挥功能。因此，BMAs可以与肿瘤细胞相互作用，影响肿瘤生长以及骨转移的发生和进展。本综述旨在系统评估BMAs在骨转移的发展和进展中的作用。我们按照偏好报告项目系统评价和荟萃分析（PRISMA）陈述标准，通过对PubMed、Web of Science和Scopus电子数据库进行全面搜索，筛选了从2013年3月到2023年6月发表的研究。两位独立的审阅者评估和筛选了这些文献，提取数据并评估研究的质量。采用非随机干预研究的ROBINS-I工具和体内研究的系统评价中心（SYRCLE）工具评估了研究证据的质量。使用描述性方法综合分析了结果。搜索结果共得到463篇研究文章，最终纳入分析的有17篇研究，其中包括15篇临床前研究和2篇非随机临床研究。对临床前研究的分析表明，BMAs在骨转移中起着重要作用，尤其是前列腺癌，其次是乳腺癌和恶性黑色素瘤。BMAs主要通过诱导糖酵解表型和释放或上调可溶性因子、趋化因子、细胞因子、脂肪细胞因子、肿瘤源性脂肪酸结合蛋白（FABP）以及核受体超家族成员（如趋化因子（C-C）配体7（CCL7））CXCL1、CXCL2、白细胞介素（IL）-1β、IL-6、FABP4和过氧化物酶体增殖物激活受体γ（PPARγ）来影响癌细胞。这些因子还有助于脂肪细胞脂肪分解和调节BMAs的炎性表型。然而，临床研究数量有限，无法得出确切结论。综述的临床前研究表明BMAs在前列腺癌、乳腺癌和恶性黑色素瘤骨转移中可能起到关键作用。然而，需要进一步的临床前研究和临床研究，以更好地了解BMAs与骨微环境中癌细胞之间复杂的作用和关系。以BMAs为靶标结合标准治疗为骨转移提供潜在的治疗策略。版权所有 © 2023年Salamanna、Contartese、Errani、Sartori、Borsari和Giavaresi。

Bone marrow adipocytes (BMAs) are the most plentiful cells in the bone marrow and function as an endocrine organ by producing fatty acids, cytokines, and adipokines. Consequently, BMAs can interact with tumor cells, influencing both tumor growth and the onset and progression of bone metastasis. This review aims to systematically evaluate the role of BMAs in the development and progression of bone metastasis.A comprehensive search was conducted on PubMed, Web of Science, and Scopus electronic databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards, to identify studies published from March 2013 to June 2023. Two independent reviewers assessed and screened the literature, extracted the data, and evaluated the quality of the studies. The body of evidence was evaluated and graded using the ROBINS-I tool for non-randomized studies of interventions and the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool for in vivo studies. The results were synthesized using descriptive methods.The search yielded a total of 463 studies, of which 17 studies were included in the final analysis, including 15 preclinical studies and two non-randomized clinical studies. Analysis of preclinical studies revealed that BMAs play a significant role in bone metastasis, particularly in prostate cancer followed by breast and malignant melanoma cancers. BMAs primarily influence cancer cells by inducing a glycolytic phenotype and releasing or upregulating soluble factors, chemokines, cytokines, adipokines, tumor-derived fatty acid-binding protein (FABP), and members of the nuclear receptor superfamily, such as chemokine (C-C motif) ligand 7 (CCL7), C-X-C Motif Chemokine Ligand (CXCL)1, CXCL2, interleukin (IL)-1β, IL-6, FABP4, and peroxisome proliferator-activated receptor γ (PPARγ). These factors also contribute to adipocyte lipolysis and regulate a pro-inflammatory phenotype in BMAs. However, the number of clinical studies is limited, and definitive conclusions cannot be drawn.The preclinical studies reviewed indicate that BMAs may play a crucial role in bone metastasis in prostate, breast, and malignant melanoma cancers. Nevertheless, further preclinical and clinical studies are needed to better understand the complex role and relationship between BMAs and cancer cells in the bone microenvironment. Targeting BMAs in combination with standard treatments holds promise as a potential therapeutic strategy for bone metastasis.Copyright © 2023 Salamanna, Contartese, Errani, Sartori, Borsari and Giavaresi.