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优化膝骨关节炎再生医学疗效的营养、代谢和遗传因素考量

Nutritional, metabolic and genetic considerations to optimise regenerative medicine outcome for knee osteoarthritis.

作者信息

Hafsi Kholoud, McKay Janine, Li Jinjie, Lana José Fábio, Macedo Alex, Santos Gabriel Silva, Murrell William D

机构信息

Emirates Integra Medical and Surgery Centre, Dubai, United Arab Emirates.

Instituto do Osso e da Cartilagem, Indaiatuba, State of São Paulo, Brazil.

出版信息

J Clin Orthop Trauma. 2019 Jan-Feb;10(1):2-8. doi: 10.1016/j.jcot.2018.10.004. Epub 2018 Oct 15.

Abstract

Knee osteoarthritis (KOA) is a multifactorial degenerative disorder of joints, affecting the world's population over the age of 65 and with a higher prevalence in females. KOA is responsible for many age associated joint problems such as stiffness and pain. Conventional methods for managing KOA such as nonsteroidal anti-inflammatory drugs (NSAID) may not improve pain or alter the disease progression and may have adverse side effects. Non-pharmacological management of OA is fundamental to management of functional limitations and provides effective symptom relief but has not shown that disease progression can be altered. Regenerative medicine is a relatively new approach which aims to induce cellular regeneration and promote self-healing through minimally invasive methods. The use of regenerative medicine slowed the progression of KOA and revealed significant improvements, yet further investigations are required to optimize the outcomes. Nutritional and metabolic aspects such as supplementations, vitamins and minerals were proven to have an impact on the progression of KOA. Genetic variations are rapidly inspected to identify any potential influence of these variations in the predisposition and diagnosis of KOA. Further supporting evidence suggests the potential influence of metabolic, nutritional and genetic aspects in optimizing the outcomes of regenerative medicine in the management of KOA.

摘要

膝骨关节炎(KOA)是一种多因素导致的关节退行性疾病,影响全球65岁以上人群,女性患病率更高。KOA引发了许多与年龄相关的关节问题,如僵硬和疼痛。治疗KOA的传统方法,如非甾体抗炎药(NSAID),可能无法缓解疼痛或改变疾病进展,还可能有不良副作用。骨关节炎的非药物治疗对于功能受限的管理至关重要,能有效缓解症状,但尚未表明可以改变疾病进展。再生医学是一种相对较新的方法,旨在通过微创方法诱导细胞再生并促进自我修复。使用再生医学减缓了KOA的进展并显示出显著改善,但仍需要进一步研究以优化治疗效果。营养和代谢方面,如补充剂、维生素和矿物质,已被证明对KOA的进展有影响。人们正在迅速检查基因变异,以确定这些变异在KOA易感性和诊断中的任何潜在影响。进一步的支持证据表明,代谢、营养和基因方面在优化再生医学治疗KOA的效果方面具有潜在影响。

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