The Third Affiliated Hospital of Xinxiang Medical University, Institutes of Health Central Plain, Clinical Medical Center of Tissue Engineering and Regeneration, Xinxiang Medical University, Xinxiang, China.
Department of Trauma Medicine, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
Int Immunopharmacol. 2023 Mar;116:109790. doi: 10.1016/j.intimp.2023.109790. Epub 2023 Feb 1.
Osteoarthritis (OA) is a chronic osteoarthropathy characterized by the progressive degeneration of articular cartilage and synovial inflammation. Early OA clinical treatments involve intra-articular injection of glucocorticoids, oral acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), which are used for anti-inflammation and pain relief. However, long-term use of these agents will lead to inevitable side effects, even aggravate cartilage loss. At present, there are no disease-modifying OA drugs (DMOADs) yet approved by regulatory agencies. Polarization regulation of synovial macrophages is a new target for OA treatment. Inhibiting M1 polarization and promoting M2 polarization of synovial macrophages can alleviate synovial inflammation, relieve joint pain and inhibit articular cartilage degradation, which is a promising strategy for OA treatment. In this study, we describe the molecular mechanisms of macrophage polarization and its key role in the development of OA. Subsequently, we summarize the latest progress of strategies for OA treatment through macrophage reprogramming, including small molecule compounds (conventional western medicine and synthetic compounds, monomer compounds of traditional Chinese medicine), biomacromolecules, metal/metal oxides, cells, and cell derivatives, and interprets the molecular mechanisms, hoping to provide some information for DMOADs development.
骨关节炎（OA）是一种慢性骨关节病，其特征为关节软骨的进行性退化和滑膜炎症。早期 OA 的临床治疗包括关节内注射糖皮质激素、口服对乙酰氨基酚和非甾体抗炎药（NSAIDs），这些药物用于抗炎和缓解疼痛。然而，这些药物的长期使用会导致不可避免的副作用，甚至会加重软骨的损失。目前，还没有得到监管机构批准的治疗 OA 的疾病修饰药物（DMOADs）。滑膜巨噬细胞的极化调节是 OA 治疗的一个新靶点。抑制滑膜巨噬细胞的 M1 极化和促进 M2 极化可以减轻滑膜炎症，缓解关节疼痛，抑制软骨降解，这是一种很有前途的 OA 治疗策略。在本研究中，我们描述了巨噬细胞极化的分子机制及其在 OA 发展中的关键作用。随后，我们总结了通过巨噬细胞重编程治疗 OA 的最新进展，包括小分子化合物（常规西药和合成化合物、中药单体化合物）、生物大分子、金属/金属氧化物、细胞及其衍生物，并解释了其分子机制，希望能为 DMOADs 的开发提供一些信息。
