Institute of Life Course and Medical Sciences, Musculoskeletal and Ageing Science, William Henry Duncan Building, 6 West Derby Street, Liverpool L7 8TX, UK.
Br Med Bull. 2021 Mar 25;137(1):28-41. doi: 10.1093/bmb/ldaa037.
Osteoarthritis is a common degenerative musculoskeletal disease of synovial joints. It is characterized by a metabolic imbalance resulting in articular cartilage degradation, reduced elastoviscosity of synovial fluid and an altered chondrocyte phenotype. This is often associated with reduced mobility, pain and poor quality of life. Subsequently, with an ageing world population, osteoarthritis is of increasing concern to public health. Nuclear magnetic resonance (NMR) spectroscopy can be applied to characterize the metabolomes of biofluids, determining changes associated with osteoarthritis pathology, identifying potential biomarkers of disease and alterations to metabolic pathways.
A comprehensive search of PubMed and Web of Science databases using combinations of the following keywords: 'NMR Spectroscopy', 'Blood', 'Plasma', 'Serum', 'Urine', 'Synovial Fluid' and 'Osteoarthritis' for articles published from 2000 to 2020.
The number of urine metabolomics studies using NMR spectroscopy to investigate osteoarthritis is low, whereas the use of synovial fluid is significantly higher. Several differential metabolites have previously been identified and mapped to metabolic pathways involved in osteoarthritis pathophysiology.
Conclusions are sometimes conservative or overinflated, which may reflect the variation in reporting standards. NMR metabolic experimental design may require further consideration, as do the animal models used for such studies.
There are various aspects which require improvement within the field. These include stricter adherence to the Metabolomics Standards Initiative, inclusive of the standardization of metabolite identifications; increased utilization of integrating NMR metabolomics with other 'omic' disciplines; and increased deposition of raw experimental files into open access online repositories, allowing greater transparency and enabling additional future analyses.
Overall, this research area could be improved by the inclusion of more heterogeneous cohorts, reflecting varying osteoarthritis phenotypes, and larger group sizes ensuring studies are not underpowered. To correlate local and systemic environments, the use of blood for diagnostic purposes, over the collection of synovial fluid, requires increased attention. This will ultimately enable biomarkers of disease to be determined that may provide an earlier diagnosis, or provide potential therapeutic targets for osteoarthritis, ultimately improving patient prognosis.
骨关节炎是一种常见的关节滑膜退行性疾病。其特征是代谢失衡，导致关节软骨降解，滑液弹性和粘性降低，以及软骨细胞表型改变。这通常会导致活动能力下降、疼痛和生活质量下降。随着世界人口老龄化，骨关节炎对公共健康的影响越来越大。核磁共振（NMR）光谱可用于分析生物流体的代谢组，确定与骨关节炎病理相关的变化，识别疾病的潜在生物标志物以及代谢途径的改变。
使用以下关键词的组合，在 PubMed 和 Web of Science 数据库中进行全面搜索：“NMR 光谱”、“血液”、“血浆”、“血清”、“尿液”、“滑液”和“骨关节炎”，以搜索 2000 年至 2020 年发表的文章。
使用 NMR 光谱研究骨关节炎的尿液代谢组学研究数量较少，而使用滑液的研究数量则明显更多。先前已经确定了一些差异代谢物，并将其映射到涉及骨关节炎病理生理学的代谢途径中。
研究结果有时过于保守或夸大，这可能反映了报告标准的差异。可能需要进一步考虑 NMR 代谢实验设计，以及此类研究中使用的动物模型。
该领域有许多需要改进的地方。这包括更严格地遵守代谢组学标准倡议，包括对代谢物鉴定的标准化；增加将 NMR 代谢组学与其他“组学”学科相结合的应用；以及增加将原始实验文件存入开放获取在线存储库，以提高透明度并能够进行额外的未来分析。
总的来说，通过纳入更多反映不同骨关节炎表型的异质队列，以及增加样本量以确保研究不缺乏效力，可以改善该研究领域。为了关联局部和全身环境，需要更加关注血液（用于诊断目的）的使用，而不是收集滑液。这最终将确定疾病的生物标志物，从而可能实现更早的诊断，或为骨关节炎提供潜在的治疗靶点，从而改善患者的预后。
