Bernetti Andrea, Agostini Francesco, Paoloni Marco, Raele Maria Vittoria, Farì Giacomo, Megna Marisa, Mangone Massimiliano
Department of Biological and Environmental Sciences and Technologies (DiSTeBA), Università del Salento, 73100 Lecce, Italy.
Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00189 Rome, Italy.
Biomedicines. 2023 Oct 22;11(10):2858. doi: 10.3390/biomedicines11102858.
Knee osteoarthritis (KOA) is one of the most common causes of disability in elderly patients and tends to be a major burden on social and health care spending. Despite its severe socioeconomic impact, KOA remains, to date, an incurable disease. Due to its proper characteristics, KOA represents a favorable disease model for experimenting with senotherapeutics, a group of treatments that counteract the development of age-related disorders and chronic diseases. In recent years, the use of intra-articular hyaluronic acid (IAHA) in the treatment of diseases related to the wear and tear of the articular cartilage has been gaining popularity. Given its ability in joint lubrification, shock absorption, and cell signaling, our aim is to investigate, through the existing scientific literature, its potential role as a senomorphic agent, emphasizing its crucial function in KOA patients. Indeed, senomorphics are a particular group of senotherapeutics capable of modulating the functions and morphology of senescent cells to those of young cells or delaying the progression of young cells to senescent cells in tissues.
A search in the scientific literature (PubMed, Cochrane Library, and Google Scholar) was carried out from 2019 to 2023, thus the last 5 years.
One hundred thirty-eight articles were found concerning the role of hyaluronic acid injections in KOA patients. In these studies, its therapeutic efficacy, its anti-inflammatory properties, and its low risk of side effects emerged.
IAHA injections are a valuable treatment option for KOA while they can provide pain relief, improve joint function, and slow the progression of joint degeneration. The inhibitory effect of HA on MMP13 and its action as a senomorphic agent suggests that it may have additional benefits beyond its lubricating and shock-absorbing properties. In order to clarify its mechanisms of action and to optimize its clinical use, further studies are definitely needed.
膝关节骨关节炎（KOA）是老年患者致残的最常见原因之一，往往给社会和医疗保健支出带来重大负担。尽管其具有严重的社会经济影响，但迄今为止，KOA仍是一种无法治愈的疾病。由于其自身特性，KOA是用于试验衰老疗法的理想疾病模型，衰老疗法是一类可对抗与年龄相关疾病和慢性病发展的治疗方法。近年来，关节腔内注射透明质酸（IAHA）在治疗与关节软骨磨损相关疾病方面越来越受欢迎。鉴于其在关节润滑、减震和细胞信号传导方面的能力，我们的目的是通过现有科学文献研究其作为一种衰老形态调节剂的潜在作用，强调其在KOA患者中的关键功能。实际上，衰老形态调节剂是衰老疗法中的一个特殊类别，能够将衰老细胞的功能和形态调节为年轻细胞的功能和形态，或延缓组织中年轻细胞向衰老细胞的进展。
对2019年至2023年（即过去5年）的科学文献（PubMed、Cochrane图书馆和谷歌学术）进行了检索。
共找到138篇关于透明质酸注射在KOA患者中作用的文章。在这些研究中，其治疗效果、抗炎特性以及低副作用风险得以显现。
IAHA注射是KOA的一种有价值的治疗选择，因为它们可以缓解疼痛、改善关节功能并减缓关节退变的进展。HA对MMP13的抑制作用及其作为衰老形态调节剂的作用表明，它可能具有超出其润滑和减震特性的额外益处。为了阐明其作用机制并优化其临床应用，肯定需要进一步的研究。
