Hügle Thomas, Geurts Jeroen, Nüesch Corina, Müller-Gerbl Magdalena, Valderrabano Victor
Osteoarthritis Research Center, Department of Orthopaedic Surgery, University Hospital Basel, Basel University, Spitalstrasse 21, 4031 Basel, Switzerland.
J Aging Res. 2012;2012:950192. doi: 10.1155/2012/950192. Epub 2012 Jun 7.
Osteoarthritis (OA) is a major health burden of our time. Age is the most prominent risk factor for the development and progression of OA. The mechanistic influence of aging on OA has different facets. On a molecular level, matrix proteins such as collagen or proteoglycans are modified, which alters cartilage function. Collagen cross-linking within the bone results in impaired plasticity and increased stiffness. Synovial or fat tissue, menisci but also ligaments and muscles play an important role in the pathogenesis of OA. In the elderly, sarcopenia or other causes of muscle atrophy are frequently encountered, leading to a decreased stability of the joint. Inflammation in form of cellular infiltration of synovial tissue or subchondral bone and expression of inflammatory cytokines is more and more recognized as trigger of OA. It has been demonstrated that joint movement can exhibit anti-inflammatory mechanisms. Therefore physical activity or physiotherapy in the elderly should be encouraged, also in order to increase the muscle mass. A reduced stem cell capacity in the elderly is likely associated with a decrease of repair mechanisms of the musculoskeletal system. New treatment strategies, for example with mesenchymal stem cells (MSC) are investigated, despite clear evidence for their efficacy is lacking.
骨关节炎（OA）是我们这个时代的一项重大健康负担。年龄是OA发生和发展的最突出风险因素。衰老对OA的机制性影响具有不同方面。在分子水平上，诸如胶原蛋白或蛋白聚糖等基质蛋白会发生改变，这会改变软骨功能。骨内的胶原蛋白交联会导致可塑性受损和硬度增加。滑膜或脂肪组织、半月板以及韧带和肌肉在OA的发病机制中都起着重要作用。在老年人中，经常会出现肌肉减少症或其他肌肉萎缩的原因，导致关节稳定性下降。滑膜组织或软骨下骨的细胞浸润形式的炎症以及炎性细胞因子的表达越来越被认为是OA的触发因素。已经证明关节运动可以表现出抗炎机制。因此，应该鼓励老年人进行体育活动或物理治疗，也是为了增加肌肉量。老年人干细胞能力的降低可能与肌肉骨骼系统修复机制的下降有关。尽管缺乏其疗效的确切证据，但仍在研究新的治疗策略，例如使用间充质干细胞（MSC）。
