Pelletier Jean-Pierre
Head, Arthritis Division and Director, Osteoarthritis Research Unit, Centre Hospitalier de l'Université de Montréal (CHUM)-Hôpital Notre-Dame, Montréal, Québec H2L 4M1 Canada.
Osteoarthritis Cartilage. 2004;12 Suppl A:S63-8. doi: 10.1016/j.joca.2003.09.014.
This paper summarizes our current stand on potential pathophysiological targets for osteoarthritis (OA) therapies. Although OA is a complicated disease, involving the cartilage, synovial membrane, and subchondral bone, a number of interactive pathways have been found to explain the structural changes in the disease process. Study of these three tissues has yielded a list of targets to examine for their potential to affect disease progression. At the cartilage level, therapeutic agents, such as growth factors, could be targeted to increase chondrocyte anabolism. At the synovial level, cytokines and cytokine receptor antagonists are potential targets for therapy. In the subchondral bone, cytokines, growth factors and eicosanoids, and locally synthesized factors affecting bone metabolism are also potential targets of therapy. Recent progress in the understanding of the pathophysiology of OA has led to exploration of several interesting new approaches toward the treatment of this disease. New classes of molecules that inhibit one or more OA disease processes are under evaluation for their potential to alter the degenerative process. The prospect of finding a cure for OA is more promising than ever. Based on the discovery of major pathophysiological pathways leading to the structural changes observed in OA, novel ways to treat the progression of OA lesions are emerging.
本文总结了我们目前对于骨关节炎（OA）治疗潜在病理生理靶点的立场。尽管OA是一种复杂的疾病，涉及软骨、滑膜和软骨下骨，但已发现许多相互作用的途径来解释疾病过程中的结构变化。对这三种组织的研究已得出一系列有待研究其影响疾病进展潜力的靶点。在软骨层面，生长因子等治疗药物可作为靶点，以增加软骨细胞的合成代谢。在滑膜层面，细胞因子和细胞因子受体拮抗剂是潜在的治疗靶点。在软骨下骨，细胞因子、生长因子、类二十烷酸以及影响骨代谢的局部合成因子也是潜在的治疗靶点。对OA病理生理学理解的最新进展促使人们探索几种治疗该疾病的有趣新方法。抑制一种或多种OA疾病进程的新型分子正在评估其改变退变过程的潜力。治愈OA的前景比以往任何时候都更具希望。基于对导致OA中观察到的结构变化的主要病理生理途径的发现，治疗OA病变进展的新方法正在不断涌现。
