Aigner T, Sachse A, Gebhard P M, Roach H I
Institute of Pathology, University of Leipzig, Liebigstrasse 26, 04103 Leipzig, Germany.
Adv Drug Deliv Rev. 2006 May 20;58(2):128-49. doi: 10.1016/j.addr.2006.01.020. Epub 2006 Mar 6.
Osteoarthritis is first and foremost the ongoing destruction of the articular cartilages of joints. Therefore, the extracellular matrix and the cells of the articular cartilages are the primary targets of osteoarthritis therapy. This tries to inhibit enzymatic destruction of the extracellular cartilage matrix as well as the modification of the cellular phenotype of the chondrocytes: cell degeneration and cell death are alongside anabolic activation and stabilization of the cellular phenotype of major interest. However, apart from the cartilage and its cells, other tissues of the joints are also important for the symptoms of the disease, which basically all originate outside the articular cartilage. In addition, changes in the subchondral bone as well as the synovial capsule and membrane are important at least for the progression of the disease process. All the named tissues offer different directions and ways for therapeutic intervention.
骨关节炎首先是关节软骨的持续破坏。因此,关节软骨的细胞外基质和细胞是骨关节炎治疗的主要靶点。治疗旨在抑制细胞外软骨基质的酶促破坏以及软骨细胞的细胞表型改变:细胞退变和细胞死亡与合成代谢激活以及细胞表型的稳定同样是主要关注的方面。然而,除了软骨及其细胞外,关节的其他组织对疾病症状也很重要,而这些症状基本上都起源于关节软骨之外。此外,至少对于疾病进程的进展而言,软骨下骨以及滑膜囊和滑膜的变化也很重要。所有上述组织都为治疗干预提供了不同的方向和途径。