Department of Orthopaedics & Trauma, Imperial College Healthcare NHS Trust, United Kingdom.
Division of Computational and Systems Medicine, Department of Surgery and Cancer, Imperial College London, United Kingdom.
Osteoarthritis Cartilage. 2019 Apr;27(4):560-570. doi: 10.1016/j.joca.2018.08.024. Epub 2018 Oct 1.
To perform a systematic review of the small molecule metabolism studies of osteoarthritis utilising nuclear magnetic resonance (NMR) or mass spectroscopy (MS) analysis (viz., metabolomics or metabonomics), thereby providing coherent conclusions and reference material for future study.
We applied PRISMA guidelines (PROSPERO 95068) with the following MESH terms: 1. "osteoarthritis" AND ("metabolic" OR "metabonomic" OR "metabolomic" OR "metabolism") 2. ("synovial fluid" OR "cartilage" OR "synovium" OR "serum" OR "plasma" OR "urine") AND ("NMR" or "Mass Spectroscopy"). Databases searched were "Medline" and "Embase". Studies were searched in English and excluded review articles not containing original research. Study outcomes were significant or notable metabolites, species (human or animal) and the Newcastle-Ottawa Score.
In the 27 studies meeting the inclusion criteria, there was a shift towards anaerobic and fatty acid metabolism in OA disease, although whether this represents the inflammatory state remains unclear. Lipid structure and composition was altered within disease subclasses including phosphatidyl choline (PC) and the sphingomyelins. Macromolecular proteoglycan destruction was described, but the correlation to disease factors was not demonstrated. Collated results suggested arachidonate signalling pathways and androgen sex hormones as future metabolic pathways for investigation.
Our meta-analysis demonstrates significant small molecule differences between sample types, between species (such as human and bovine), with potential OA biomarkers and targets for local or systemic therapies. Studies were limited by numbers and a lack of disease correlation. Future studies should use NMR and MS analysis to further investigate large population subgroups including inflammatory arthropathy, OA subclasses, age and joint differences.
利用核磁共振（NMR）或质谱分析（即代谢组学或代谢组学）对骨关节炎的小分子代谢研究进行系统评价，为未来的研究提供连贯的结论和参考资料。
我们应用 PRISMA 指南（PROSPERO 95068），并使用以下 MESH 术语：1. “骨关节炎”和（“代谢”或“代谢组学”或“代谢组学”或“代谢”）2. （“滑液”或“软骨”或“滑膜”或“血清”或“血浆”或“尿液”）和（“NMR”或“质谱”）。搜索的数据库是“Medline”和“Embase”。研究是用英文搜索的，不包括没有原始研究的综述文章。研究结果是有意义或显著的代谢物、物种（人类或动物）和纽卡斯尔-渥太华评分。
在符合纳入标准的 27 项研究中，OA 疾病中出现了向厌氧和脂肪酸代谢的转变，尽管这是否代表炎症状态尚不清楚。疾病亚类中的脂质结构和组成发生了变化，包括磷脂酰胆碱（PC）和神经鞘磷脂。描述了大分子蛋白聚糖的破坏，但未证明与疾病因素的相关性。汇总结果表明，花生四烯酸信号通路和雄激素性激素是未来代谢途径的研究方向。
我们的荟萃分析表明，样本类型之间、物种之间（如人类和牛）、潜在的 OA 生物标志物和局部或全身治疗靶点之间存在显著的小分子差异。这些研究受到数量和缺乏疾病相关性的限制。未来的研究应使用 NMR 和 MS 分析进一步研究包括炎症性关节炎、OA 亚类、年龄和关节差异在内的大人群亚组。
