Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA.
Department of Neurology, Yale University School of Medicine, New Haven, CT, USA.
Nat Rev Rheumatol. 2024 Sep;20(9):545-564. doi: 10.1038/s41584-024-01146-0. Epub 2024 Aug 9.
Osteoarthritis (OA) is a highly prevalent joint disease that causes substantial disability, yet effective approaches to disease prevention or to the delay of OA progression are lacking. Emerging evidence has pinpointed ion channels as pivotal mediators in OA pathogenesis and as promising targets for disease-modifying treatments. Preclinical studies have assessed the potential of a variety of ion channel modulators to modify disease pathways involved in cartilage degeneration, synovial inflammation, bone hyperplasia and pain, and to provide symptomatic relief in models of OA. Some of these modulators are currently being evaluated in clinical trials. This review explores the structures and functions of ion channels, including transient receptor potential channels, Piezo channels, voltage-gated sodium channels, voltage-dependent calcium channels, potassium channels, acid-sensing ion channels, chloride channels and the ATP-dependent P2XR channels in the osteoarthritic joint. The discussion spans channel-targeting drug discovery and potential clinical applications, emphasizing opportunities for further research, and underscoring the growing clinical impact of ion channel biology in OA.
骨关节炎(OA)是一种高发的关节疾病,会导致严重的残疾,然而,目前缺乏有效的疾病预防或延缓 OA 进展的方法。新出现的证据表明,离子通道是 OA 发病机制中的关键介质,也是治疗疾病的有前途的靶点。临床前研究已经评估了多种离子通道调节剂在软骨退变、滑膜炎症、骨增生和疼痛相关疾病途径中的潜在作用,并为 OA 模型提供了症状缓解作用。其中一些调节剂目前正在临床试验中进行评估。这篇综述探讨了离子通道的结构和功能,包括瞬时受体电位通道、Piezo 通道、电压门控钠离子通道、电压依赖性钙通道、钾通道、酸感应离子通道、氯离子通道和 ATP 依赖性 P2XR 通道在骨关节炎关节中的作用。讨论涵盖了针对通道的药物发现和潜在的临床应用,强调了进一步研究的机会,并强调了离子通道生物学在 OA 中的临床影响日益增加。