Centre for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Institute of Bone and Joint Research, Faculty of Medicine and Health University of Sydney, Royal North Shore Hospital, St. Leonards, NSW, Australia.
Front Immunol. 2021 Nov 4;12:763702. doi: 10.3389/fimmu.2021.763702. eCollection 2021.
Synovial joints are complex structures that enable normal locomotion. Following injury, they undergo a series of changes, including a prevalent inflammatory response. This increases the risk for development of osteoarthritis (OA), the most common joint disorder. In healthy joints, macrophages are the predominant immune cells. They regulate bone turnover, constantly scavenge debris from the joint cavity and, together with synovial fibroblasts, form a protective barrier. Macrophages thus work in concert with the non-hematopoietic stroma. In turn, the stroma provides a scaffold as well as molecular signals for macrophage survival and functional imprinting: "a macrophage niche". These intricate cellular interactions are susceptible to perturbations like those induced by joint injury. With this review, we explore how the concepts of local tissue niches apply to synovial joints. We introduce the joint micro-anatomy and cellular players, and discuss their potential interactions in healthy joints, with an emphasis on molecular cues underlying their crosstalk and relevance to joint functionality. We then consider how these interactions are perturbed by joint injury and how they may contribute to OA pathogenesis. We conclude by discussing how understanding these changes might help identify novel therapeutic avenues with the potential of restoring joint function and reducing post-traumatic OA risk.
滑膜关节是复杂的结构,使正常的运动成为可能。损伤后,它们会经历一系列变化,包括普遍的炎症反应。这增加了发展为骨关节炎(OA)的风险,OA 是最常见的关节疾病。在健康的关节中,巨噬细胞是主要的免疫细胞。它们调节骨转换,不断从关节腔中清除碎片,与滑膜成纤维细胞一起形成保护屏障。因此,巨噬细胞与非造血基质协同工作。反过来,基质为巨噬细胞的存活和功能印记提供支架和分子信号:“巨噬细胞生态位”。这些复杂的细胞相互作用容易受到关节损伤等因素的干扰。通过这篇综述,我们探讨了局部组织生态位的概念如何适用于滑膜关节。我们介绍了关节的微观解剖结构和细胞成分,并讨论了它们在健康关节中的潜在相互作用,重点讨论了它们相互作用的分子线索及其与关节功能的相关性。然后,我们考虑这些相互作用如何受到关节损伤的干扰,以及它们如何导致 OA 的发病机制。最后,我们讨论了理解这些变化如何帮助确定具有恢复关节功能和降低创伤后 OA 风险的潜在新的治疗途径。
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