The D-BOARD FP7 Consortium.
The APPROACH IMI Consortium.
Curr Opin Rheumatol. 2019 Jan;31(1):80-89. doi: 10.1097/BOR.0000000000000567.
This review focuses on the molecular taxonomy of osteoarthritis from the perspective of molecular biomarkers. We discuss how wet biochemical markers may be used to understand disease pathogenesis and progression and define molecular endotypes of osteoarthritis and how these correspond to clinical phenotypes.
Emerging evidence suggests that osteoarthritis is a heterogeneous and multifaceted disease with multiple causes, molecular endotypes and corresponding clinical phenotypes. Biomarkers may be employed as tools for patient stratification in clinical trials, enhanced disease management in the primary care centres of the future and for directing more rational and targeted osteoarthritis drug development. Proximal molecular biomarkers (e.g synovial fluid) are more likely to distinguish between molecular endotypes because there is less interference from systemic sources of biomarker noise, including comorbidities.
In this review, we have focused on the molecular biomarkers of four distinct osteoarthritis subtypes including inflammatory, subchondral bone remodelling, metabolic syndrome and senescent age-related endotypes, which have corresponding phenotypes. Progress in the field of osteoarthritis endotype and phenotype research requires a better understanding of molecular biomarkers that may be used in conjunction with imaging, pain and functional assessments for the design of more effective, stratified and individualized osteoarthritis treatments.
目的综述：本综述从分子生物标志物的角度聚焦骨关节炎的分子分类学。我们讨论了湿生化标志物如何用于理解疾病发病机制和进展，以及定义骨关节炎的分子内型，以及这些如何与临床表型相对应。
最近发现：新出现的证据表明，骨关节炎是一种具有多种病因、分子内型和相应临床表型的异质性和多方面疾病。生物标志物可用作临床试验中的患者分层工具、未来初级保健中心中增强疾病管理的工具，以及指导更合理、更有针对性的骨关节炎药物开发的工具。与系统性生物标志物噪声（包括合并症）来源相比，更接近分子内型的近端分子生物标志物（如滑液）更有可能区分分子内型。
总结：在本综述中，我们重点介绍了四种不同骨关节炎亚型的分子生物标志物，包括炎症型、软骨下骨重塑型、代谢综合征型和衰老相关的年龄相关内型，它们具有相应的表型。骨关节炎内型和表型研究领域的进展需要更好地了解分子生物标志物，这些标志物可与影像学、疼痛和功能评估结合使用，以设计更有效、分层和个体化的骨关节炎治疗方法。
