Orlowsky Eric W, Kraus Virginia Byers
From the Department of Medicine, Duke Molecular Physiology Institute, and the Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina, USA.E.W. Orlowsky, MD, Postdoctoral Fellow, Division of Rheumatology, Duke University School of Medicine; V.B. Kraus, MD, PhD, Professor of Medicine, Department of Medicine, Duke Molecular Physiology Institute, and Division of Rheumatology, Duke University School of Medicine.
J Rheumatol. 2015 Mar;42(3):363-71. doi: 10.3899/jrheum.140382. Epub 2015 Jan 15.
Although osteoarthritis (OA) has existed since the dawn of humanity, its pathogenesis remains poorly understood. OA is no longer considered a "wear and tear" condition but rather one driven by proteases where chronic low-grade inflammation may play a role in perpetuating proteolytic activity. While multiple factors are likely active in this process, recent evidence has implicated the innate immune system, the older or more primitive part of the body's immune defense mechanisms. The roles of some of the components of the innate immune system have been tested in OA models in vivo including the roles of synovial macrophages and the complement system. This review is a selective overview of a large and evolving field. Insights into these mechanisms might inform our ability to identify patient subsets and give hope for the advent of novel OA therapies.
尽管骨关节炎（OA）自人类诞生以来就已存在，但其发病机制仍未得到充分理解。OA不再被认为是一种“磨损”性疾病，而是一种由蛋白酶驱动的疾病，其中慢性低度炎症可能在维持蛋白水解活性中起作用。虽然在此过程中可能有多种因素起作用，但最近的证据表明，先天性免疫系统，即人体免疫防御机制中较古老或更原始的部分，与之相关。先天性免疫系统的一些组成部分在体内OA模型中的作用已经得到测试，包括滑膜巨噬细胞和补体系统的作用。本综述是对一个庞大且不断发展的领域的选择性概述。对这些机制的深入了解可能有助于我们识别患者亚群，并为新型OA疗法的出现带来希望。
