Osteoarthritis: New Insight on Its Pathophysiology.

inflammation osteoarthritis physiopathology subchondral bone synovium

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
12 Oct 2022
Historique:
received: 12 08 2022
revised: 19 09 2022
accepted: 08 10 2022
entrez: 27 10 2022
pubmed: 28 10 2022
medline: 28 10 2022
Statut: epublish

Résumé

Understanding of the basis of osteoarthritis (OA) has seen some interesting advancements in recent years. It has been observed that cartilage degeneration is preceded by subchondral bone lesions, suggesting a key role of this mechanism within the pathogenesis and progression of OA, as well as the formation of ectopic bone and osteophytes. Moreover, low-grade, chronic inflammation of the synovial lining has gained a central role in the definition of OA physiopathology, and central immunological mechanisms, innate but also adaptive, are now considered crucial in driving inflammation and tissue destruction. In addition, the role of neuroinflammation and central sensitization mechanisms as underlying causes of pain chronicity has been characterized. This has led to a renewed definition of OA, which is now intended as a complex multifactorial joint pathology caused by inflammatory and metabolic factors underlying joint damage. Since this evidence can directly affect the definition of the correct therapeutic approach to OA, an improved understanding of these pathophysiological mechanisms is fundamental. To this aim, this review provides an overview of the most updated evidence on OA pathogenesis; it presents the most recent insights on the pathophysiology of OA, describing the interplay between immunological and biochemical mechanisms proposed to drive inflammation and tissue destruction, as well as central sensitization mechanisms. Moreover, although the therapeutic implications consequent to the renewed definition of OA are beyond this review scope, some suggestions for intervention have been addressed.

Identifiants

pubmed: 36294334
pii: jcm11206013
doi: 10.3390/jcm11206013
pmc: PMC9604603
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

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Auteurs

Stefano Coaccioli (S)

European League Against Pain, 8000 Zurich, Switzerland.

Piercarlo Sarzi-Puttini (P)

Milano University, 20090 Milano, Italy.

Panagiotis Zis (P)

Attikon University Hospital, National & Kapodistrian University, 157 72 Athens, Greece.
Medical School, University of Cyprus, Nicosia 1678, Cyprus.

Giuseppe Rinonapoli (G)

Perugia University, 06126 Perugia, Italy.

Giustino Varrassi (G)

Paolo Procacci Foundation, 00193 Rome, Italy.

Classifications MeSH