Blaney Davidson E N, van der Kraan P M, van den Berg W B
Experimental Rheumatology and Advanced Therapeutics, Radboud University Nijmegen Medical Centre, The Netherlands.
Osteoarthritis Cartilage. 2007 Jun;15(6):597-604. doi: 10.1016/j.joca.2007.02.005. Epub 2007 Mar 27.
Cartilage damage is a major problem in osteoarthritis (OA). Growth factors like transforming growth factor-beta (TGF-beta) have great potential in cartilage repair. In this review, we will focus on the potential therapeutic intervention in OA with TGF-beta, application of the growth factor TGF-beta in cartilage repair and on the side effects of TGF-beta treatment that could occur.
This review summarizes peer-reviewed articles published in the PubMed database before November 2006. In addition, this review is supplemented with recent data of our own group on the use of TGF-beta as a cartilage reparative factor in OA.
TGF-beta is crucial for cartilage maintenance and lack there of results in OA-like changes. Moreover, TGF-beta supplementation can enhance cartilage repair and is therefore a potential therapeutic tool. However, application of TGF-beta supplementation provides problems in other tissues of the joint and results in fibrosis and osteophyte formation. This can potentially be overcome by local inhibition of TGF-beta at sites of unwanted side-effects or by blocking downstream mediators of TGF-beta that are important for the induction of fibrosis or osteophyte formation.
Current understanding of TGF-beta suggests that it essential for cartilage integrity and that it is a powerful tool to prevent or repair cartilage damage. The side-effects that occur with TGF-beta supplementation can be overcome by local inhibition of TGF-beta itself or downstream mediators.
软骨损伤是骨关节炎(OA)的一个主要问题。诸如转化生长因子-β(TGF-β)等生长因子在软骨修复方面具有巨大潜力。在本综述中,我们将聚焦于TGF-β对OA的潜在治疗干预、生长因子TGF-β在软骨修复中的应用以及TGF-β治疗可能出现的副作用。
本综述总结了2006年11月之前发表在PubMed数据库中的同行评审文章。此外,本综述还补充了我们自己团队关于使用TGF-β作为OA软骨修复因子的最新数据。
TGF-β对软骨维持至关重要,其缺乏会导致类似OA的变化。此外,补充TGF-β可增强软骨修复,因此是一种潜在的治疗工具。然而,补充TGF-β在关节的其他组织中会引发问题,并导致纤维化和骨赘形成。这可能通过在出现不良副作用的部位局部抑制TGF-β或通过阻断对纤维化或骨赘形成诱导起重要作用的TGF-β下游介质来潜在地克服。
目前对TGF-β的理解表明,它对软骨完整性至关重要,并且是预防或修复软骨损伤的有力工具。补充TGF-β时出现的副作用可通过局部抑制TGF-β本身或其下游介质来克服。