Ripmeester Ellen G J, Timur Ufuk Tan, Caron Marjolein M J, Welting Tim J M
Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University Medical Center, Maastricht, Netherlands.
Front Bioeng Biotechnol. 2018 Mar 19;6:18. doi: 10.3389/fbioe.2018.00018. eCollection 2018.
Osteoarthritis (OA) is an extremely prevalent age-related condition. The economic and societal burden due to the cost of symptomatic treatment, inability to work, joint replacement, and rehabilitation is huge and increasing. Currently, there are no effective medical therapies that delay or reverse the pathological manifestations of OA. Current treatment options are, without exception, focused on slowing down progression of the disease to postpone total joint replacement surgery for as long as possible and keeping the associated pain and joint immobility manageable. Alterations in the articular cartilage chondrocyte phenotype might be fundamental in the pathological mechanisms of OA development. In many ways, the changing chondrocyte phenotype in osteoarthritic cartilage resembles the process of endochondral ossification as seen, for instance, in developing growth plates. However, the relative contribution of endochondral ossification to the changing chondrocyte phenotype in the development and progression of OA remains poorly described. In this review, we will discuss the current knowledge regarding the cartilage endochondral phenotypic changes occurring during OA development and progression, as well as the molecular and environmental effectors driving these changes. Understanding how these molecular mechanisms determine the chondrocyte cell fate in OA will be essential in enabling cartilage regenerative approaches in future treatments of OA.
骨关节炎（OA）是一种极为常见的与年龄相关的病症。由于对症治疗成本、无法工作、关节置换及康复等造成的经济和社会负担巨大且不断增加。目前，尚无有效的医学疗法能够延缓或逆转OA的病理表现。当前所有的治疗选择无一例外都聚焦于减缓疾病进展，以尽可能推迟全关节置换手术，并使相关疼痛和关节活动障碍处于可控状态。关节软骨软骨细胞表型的改变可能是OA发病病理机制的根本所在。在许多方面，骨关节炎软骨中不断变化的软骨细胞表型类似于例如发育中的生长板中所见的软骨内成骨过程。然而，软骨内成骨在OA发生发展过程中对软骨细胞表型变化的相对贡献仍描述甚少。在本综述中，我们将讨论有关OA发生发展过程中软骨内表型变化的现有知识，以及驱动这些变化的分子和环境效应物。了解这些分子机制如何决定OA中软骨细胞的细胞命运对于在未来OA治疗中实现软骨再生方法至关重要。
