Amirsaadat Soumayeh, Amirazad Halimeh, Hashemihesar Ramin, Zarghami Nosratollah
Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Medical Biotechnology, Faculty of Advanced Medical Science, Tabriz University of Medical Sciences, Tabriz, Iran.
Front Bioeng Biotechnol. 2023 Feb 16;11:1128856. doi: 10.3389/fbioe.2023.1128856. eCollection 2023.
Osteoarthritis (OA) is the most common progressive condition affecting joints. It mainly affects the knees and hips as predominant weight-bearing joints. Knee osteoarthritis (KOA) accounts for a large proportion of osteoarthritis and presents numerous symptoms that impair quality of life, such as stiffness, pain, dysfunction, and even deformity. For more than two decades, intra-articular (IA) treatment options for managing knee osteoarthritis have included analgesics, hyaluronic acid (HA), corticosteroids, and some unproven alternative therapies. Before effective disease-modifying treatments for knee osteoarthritis, treatments are primarily symptomatic, mainly including intra-articular corticosteroids and hyaluronic acid, so these agents represent the most frequently used class of drugs for managing knee osteoarthritis. But research suggests other factors, such as the placebo effect, have an essential role in the effectiveness of these drugs. Several novel intra-articular therapies are currently in the clinical trial processes, such as biological therapies, gene and cell therapies. Besides, it has been shown that the development of novel drug nanocarriers and delivery systems could improve the effectiveness of therapeutic agents in osteoarthritis. This review discusses the various treatment methods and delivery systems for knee osteoarthritis and the new agents that have been introduced or are in development.
骨关节炎（OA）是影响关节的最常见的进行性疾病。它主要影响膝关节和髋关节，因为这两个关节是主要的负重关节。膝关节骨关节炎（KOA）在骨关节炎中占很大比例，会出现许多损害生活质量的症状，如僵硬、疼痛、功能障碍，甚至畸形。二十多年来，用于治疗膝关节骨关节炎的关节内（IA）治疗选择包括镇痛药、透明质酸（HA）、皮质类固醇以及一些未经证实的替代疗法。在出现有效的膝关节骨关节炎疾病改善治疗方法之前，治疗主要是对症治疗，主要包括关节内注射皮质类固醇和透明质酸，因此这些药物是治疗膝关节骨关节炎最常用的药物类别。但研究表明，其他因素，如安慰剂效应，在这些药物的疗效中起着至关重要的作用。目前有几种新型关节内疗法正处于临床试验阶段，如生物疗法、基因和细胞疗法。此外，已经表明新型药物纳米载体和递送系统的开发可以提高治疗剂在骨关节炎中的疗效。本综述讨论了膝关节骨关节炎的各种治疗方法和递送系统以及已推出或正在研发的新型药物。
