Department of Kinesiology, Temple University, 002 Pearson Hall, 1800 N. Broad Street, Philadelphia, PA 19122, USA.
Clin Rheumatol. 2010 Feb;29(2):123-31. doi: 10.1007/s10067-009-1301-1. Epub 2009 Nov 19.
Osteoarthritis is a heterogeneous disease characterized by variable clinical features, biochemical/genetic characteristics, and responses to treatments. To optimize palliative effects of current treatments and develop efficacious disease-modifying interventions, treatments may need to be tailored to the individual or a subset of osteoarthritic joints. The purpose of this review is to explore the current literature on the clinical and physiological variability in osteoarthritis and potential for stratifying patients. Several stratifications have been reported, including mechanism of onset, stage of disease progression, involved joints, inflammatory levels, and effusion. Most of these methods revealed two to three unique subsets of osteoarthritis. Osteoarthritic joints may be stratified by an array of variables, some transient and others consistent throughout the disease process. Future research needs to continue to explore stratification techniques since these may be the key to optimizing palliative interventions and developing disease-modifying interventions for subsets within this heterogeneous disease.
骨关节炎是一种异质性疾病，其临床特征、生化/遗传特征和对治疗的反应各不相同。为了优化现有治疗的姑息效果并开发有效的疾病修饰干预措施，可能需要根据个体或亚组的骨关节炎关节来调整治疗方法。本文旨在探讨骨关节炎的临床和生理变异性以及分层患者的潜力的现有文献。已经报道了几种分层方法，包括发病机制、疾病进展阶段、受累关节、炎症水平和渗出液。这些方法中的大多数揭示了骨关节炎的两个到三个独特亚组。可以通过一系列变量对骨关节炎关节进行分层，其中一些是短暂的，而另一些则在整个疾病过程中保持不变。未来的研究需要继续探索分层技术，因为这些技术可能是优化姑息干预措施和开发针对这种异质性疾病亚组的疾病修饰干预措施的关键。
