Sun Antonia RuJia, Friis Thor, Sekar Sunderajhan, Crawford Ross, Xiao Yin, Prasadam Indira
Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave., Kelvin Grove, QLD, 4059, Australia.
Department of Orthopedics, Prince Charles Hospital, Chermside, QLD, 4032, Australia.
Curr Rheumatol Rep. 2016 Sep;18(9):57. doi: 10.1007/s11926-016-0605-9.
Osteoarthritis (OA) is the most common musculoskeletal disease, affecting nearly 25 % of the world population (WHO reports), leading to pain and disability. There are as yet no clinically proven therapies to halt OA onset or progression; the development of such therapies is, therefore, a national as well as international research priority. Obesity-related metabolic syndrome has been identified as the most significant, but also an entirely preventable risk factor for OA; however, the mechanisms underlying this link remain unclear. We have examined the available literature linking OA and metabolic syndrome. The two conditions have a shared pathogenesis in which chronic low-grade inflammation of affected tissues is recognized as a major factor that is associated with systemic inflammation. In addition, the occurrence of metabolic syndrome appears to alter systemic and local pro-inflammatory cytokines that are also related to the development of OA-like pathologies. Recent findings highlight the importance not only of the elevated number of macrophage in inflamed synovium but also the activation and amplification of the inflammatory state and other pathological changes. The role of local inflammation on the synovium is now considered to be a pharmacological target against which to aim disease-modifying drugs. In this review, we evaluate evidence linking OA, synovitis and metabolic syndrome and discuss the merits of targeting macrophage activation as a valid treatment option for OA.
骨关节炎（OA）是最常见的肌肉骨骼疾病，据世界卫生组织报告，影响着近25%的世界人口，会导致疼痛和残疾。目前尚无经临床验证的疗法来阻止OA的发病或进展；因此，开发此类疗法是国家乃至国际的研究重点。肥胖相关代谢综合征已被确定为OA最重要但完全可预防的风险因素；然而，这一关联背后的机制仍不清楚。我们研究了将OA与代谢综合征联系起来的现有文献。这两种情况有共同的发病机制，其中受影响组织的慢性低度炎症被认为是与全身炎症相关的主要因素。此外，代谢综合征的发生似乎会改变全身和局部促炎细胞因子，这些细胞因子也与OA样病变的发展有关。最近的研究结果不仅突出了炎症滑膜中巨噬细胞数量增加的重要性，还强调了炎症状态的激活和放大以及其他病理变化。滑膜局部炎症的作用现在被认为是一种药理学靶点，针对该靶点可研发改善病情的药物。在本综述中，我们评估了将OA、滑膜炎和代谢综合征联系起来的证据，并讨论了将巨噬细胞激活作为OA有效治疗选择的优点。
