Department of Personalised Medicine, State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, Lithuania.
Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, Lithuania.
Medicina (Kaunas). 2024 Nov 5;60(11):1819. doi: 10.3390/medicina60111819.
Fibroblast-like synoviocytes (FLSs) are among the main disease-driving players in most cases of monoarthritis (MonoA), oligoarthritis, and polyarthritis. In this review, we look at the characteristics and therapeutic challenges at the onset of arthritis and during follow-up management. In some cases, these forms of arthritis develop into autoimmune polyarthritis, such as rheumatoid arthritis (RA), whereas local eradication of the RA synovium could still be combined with systemic treatment using immunosuppressive agents. Currently, the outcomes of local synovectomies are well studied; however, there is still a lack of a comprehensive analysis of current local intra-articular treatments highlighting their advantages and disadvantages. Therefore, the aim of this study is to review local intra-articular therapy strategies. According to publications from the last decade on clinical studies focused on intra-articular treatment with anti-inflammatory molecules, a range of novel slow-acting forms of steroidal drugs for the local treatment of synovitis have been investigated. As pain is an essential symptom, caused by both inflammation and cartilage damage, various molecules acting on pain receptors are being investigated in clinical trials as potential targets for local intra-articular treatment. We also overview the new targets for local treatment, including surface markers and intracellular proteins, non-coding ribonucleic acids (RNAs), etc.
成纤维样滑膜细胞（FLS）是大多数单关节炎（MonoA）、寡关节炎和多关节炎病例中主要的疾病驱动因素之一。在这篇综述中，我们研究了关节炎发病和随访管理期间的特征和治疗挑战。在某些情况下，这些形式的关节炎发展为自身免疫性多关节炎，如类风湿关节炎（RA），而 RA 滑膜的局部清除仍可与使用免疫抑制剂的全身治疗相结合。目前，局部滑膜切除术的结果得到了很好的研究；然而，仍然缺乏对当前局部关节内治疗的全面分析，突出其优缺点。因此，本研究旨在综述局部关节内治疗策略。根据过去十年中关于针对炎症分子进行关节内治疗的临床研究的出版物，已经研究了一系列用于局部治疗滑膜炎的新型慢作用甾体药物。由于疼痛是由炎症和软骨损伤引起的重要症状，因此正在临床试验中研究作用于疼痛受体的各种分子，作为局部关节内治疗的潜在靶点。我们还概述了局部治疗的新靶点，包括表面标志物和细胞内蛋白、非编码核糖核酸（RNAs）等。
