Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Osteoarthritis Cartilage. 2013 Sep;21(9):1308-15. doi: 10.1016/j.joca.2013.06.013.
Osteoarthritis (OA) is a complex and painful disease of the whole joint. At present there are no satisfying agents for treating OA. To promote OA research and improved treatment, this review summarizes current preclinical evidence on the development of OA.
Preclinical OA research was searched and key findings are summarized and commented.
Mechanisms of OA-associated pain have been studied in rodent knee OA models produced by intra-knee injection of the chondrocyte glycolytic inhibitor mono-iodoacetate (MIA), surgery, or spontaneous development in some species. These models are clinically relevant in terms of histological damage and functional changes, and are used to study mechanisms underlying mechanical, thermal, ambulatory, body weight supporting-evoked, and ongoing OA pain. Recent peripheral, spinal, and supraspinal biochemical and electrophysiological studies in these models suggest that peripheral pro-inflammatory mediators and neuropeptides sensitize knee nociceptors. Spinal cytokines and neuropeptides promote OA pain, and peripheral and spinal cannabinoids inhibit OA pain respectively through cannabinoid-1 (CB1) and CB1/CB2 receptors. TRPV1 and metalloproteinases contribute and supraspinal descending facilitation of 5-hydroxytryptamine (5-HT)/5-HT 3 receptors may also contribute to OA pain. Conditioned place preference tests demonstrate that OA pain induces aversive behaviors, suggesting the involvement of brain. During OA, brain functional connectivity is enhanced, but at present it is unclear how this change is related to OA pain.
Animal studies demonstrate that peripheral and central sensitization contributes to OA pain, involving inflammatory cytokines, neuropeptides, and a variety of chemical mediators. Interestingly, brainstem descending facilitation of 5-HT/5-HT3 receptors plays a role OA pain.
骨关节炎(OA)是一种复杂且疼痛的关节疾病。目前尚无治疗 OA 的满意药物。为了促进 OA 研究和改善治疗效果,本综述总结了目前关于 OA 发展的临床前证据。
搜索了临床前 OA 研究,并总结和评论了关键发现。
在通过膝关节内注射软骨细胞糖酵解抑制剂单碘乙酸(MIA)、手术或某些物种自发性发展产生的啮齿动物膝关节 OA 模型中,研究了与 OA 相关的疼痛机制。这些模型在组织学损伤和功能变化方面具有临床相关性,用于研究机械、热、步态、承重诱发和持续性 OA 疼痛的机制。最近在这些模型中的外周、脊髓和脊髓上生化和电生理学研究表明,外周促炎介质和神经肽使膝关节伤害感受器敏感。脊髓细胞因子和神经肽促进 OA 疼痛,而外周和脊髓大麻素分别通过大麻素 1(CB1)和 CB1/CB2 受体抑制 OA 疼痛。TRPV1 和金属蛋白酶有贡献,5-羟色胺(5-HT)/5-HT3 受体的脊髓上下行促进也可能有助于 OA 疼痛。条件性位置偏爱测试表明,OA 疼痛会引起厌恶行为,表明大脑的参与。在 OA 期间,大脑功能连接增强,但目前尚不清楚这种变化与 OA 疼痛有何关系。
动物研究表明,外周和中枢敏化有助于 OA 疼痛,涉及炎症细胞因子、神经肽和多种化学介质。有趣的是,脑干对 5-HT/5-HT3 受体的下行促进作用在 OA 疼痛中发挥作用。