骨关节炎发病机制及药物调控新进展

The latest research progress on pathogenesis and drug regulation of osteoarthritis

骨关节炎(osteoarthritis,OA)是十大致残性疾病之一,其发病率极高,涉及整个关节的病变,其病变组织涉及软骨、软骨下骨及滑膜。目前认为其发病机制主要集中于:(1)衰老、创伤、肥胖、生物力学、生物节律改变等因素导致的软骨代谢稳态失衡导致的软骨损伤。(2)软骨下骨异常骨重构导致的软骨下骨硬化及骨刺的产生。(3)软骨碎片作用于滑膜巨噬细胞和T细胞等导致的滑膜炎症。目前,已出现了多种针对以上症状的靶向药物在进行临床及临床前研究。该综述侧重于当前对OA潜在的发病机制的理解,并强调软骨细胞、巨噬细胞和破骨细胞在其中的重要作用及现阶段药物治疗的最新研究进展。

Osteoarthritis(OA)is one of the most disabling diseases with high incidence,which involves the entire joint and its diseased tissues include cartilage,subchondral bone and synovium.For the exploration of its pathogenesis,the current research focuses on:(1)cartilage damage caused by cartilage metabolism imbalance.The reasons include aging,trauma,obesity,biological rhythm changes,biological mechanics and other factors;(2)abnormal bone remodeling of subchondral bone,resulting in subchondral bone sclerosis and bone spurs;(3)cartilage debris leads to synovial inflammation caused by synovial macrophages and T cells.At present,there have been clinical and pre-clinical studies of a variety of targeted small molecule drugs for the above symptoms.This review focuses on the current understanding of the underlying pathogenesis of OA,and emphasizes the important role of chondrocytes,macrophages,and osteoclasts,as well as the latest research progress in drug therapy at this stage.