OSTEOARTHRITIS AS AN ORGAN DISEASE: FROM THE CRADLE TO THE GRAVE

被引:38
作者
Aspden, R. M. [1 ]
Saunders, F. R. [1 ]
机构
[1] Univ Aberdeen, Aberdeen Ctr Arthrit & Musculoskeletal Hlth, Aberdeen, Scotland
基金
英国工程与自然科学研究理事会; 英国医学研究理事会;
关键词
Osteoarthritis; joint; systemic disease; metabolic disease; aetiology; growth; hyperplasia; development; OLIGOMERIC MATRIX PROTEIN; HUMAN ARTICULAR-CARTILAGE; CRUCIATE LIGAMENT INTEGRITY; SUBCHONDRAL BONE PLATE; SINGLE IMPACT LOAD; ILIAC CREST BONE; BODY-MASS INDEX; KNEE OSTEOARTHRITIS; FEMORAL-HEAD; HIP SHAPE;
D O I
10.22203/eCM.v037a06
中图分类号
Q813 [细胞工程];
学科分类号
摘要
Considered for decades as a cartilage disease, recent studies of osteoarthritis (OA) take us back to the concepts discussed at the naming of the disorder as "bone-joint-inflammation". By describing the joint as an organ, can OA be called an organ disease - similar to heart disease? Is there a systemic (which system?) involvement? Would this help with diagnosis or therapy? Hyperplasia of the joint tissues is one of the most notable early features of the disease: articular cartilage thickens, chondrocytes proliferate and increase matrix biosynthesis, but not its incorporation; the subchondral bone densifies but is hypomineralised and there is an increase in bone marrow fat content. Associations between OA and hypertension, hypercholesterolaemia and blood glucose suggest systemic and metabolic components are involved. The source of pain is still unknown but there is evidence for peripheral and central sensitisation. Joint deformity is difficult to quantify, but statistical shape modelling provides a tool to use as an imaging biomarker. A genome-wide association study meta-analysis has identified novel genes associated with hip shape with many genes related to tissue growth and development. There are associations between hip shapes and age of first walking as well as with obesity through adulthood. These life-course events and a recapitulation in old age of developmental processes suggest that the cradle may affect our path to the grave. These observations suggest that tissue regeneration approaches, treating only the cartilage in OA joints, may only be of limited benefit.
引用
收藏
页码:74 / 87
页数:14
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