Abstract
BackgroundNeuroimmune axis is central in the physiopathology of hip osteoarthritis (OA), but its specific pathways are still unclear. This systematic review aims to assess the nervous and immune system profile of patients with hip osteoarthritis (OA) when compared to healthy controls.MethodsA systematic review followed PRISMA guidelines was conducted. A two-step selection process was completed, and from 609 references 17 were included. The inclusion criteria were: original articles on adult patients with hip OA, with assessment of neuroimmune expression. Articles with other interventions prior to analysis and those without a control group were excluded.ResultsThirty-nine relevant neuroimmune markers were identified, with assessments in bone, cartilage, synovial membrane, synovial fluid, whole blood, serum and/or immune cells. GM-CSF, IFN-γ, IL-1α, IL-6, IL-8, IL-1 and TNF-α presented variable expression among tissues studied when compared between hip OA and controls. VEGFs and TGF-ß isoforms showed similar tendencies among tissues and studies. On nervous expression, CGRP, Tuj-1 and SP were increased in synovial membrane. Overall, patients with hip OA presented a higher number of overexpressed markers.ConclusionsFor the first time a systematic review on neuroimmune expression in patients with hip OA found an upregulation of neuroimmune markers, with deregulated balance between pro and anti-inflammatory cytokines. However, no clear systematic pattern was found, and few information is available on nervous expression. This highlights the importance of future research with clear methodologies to guide the management of these patients.
Highlights
Neuroimmune axis is central in the physiopathology of hip osteoarthritis (OA), but its specific pathways are still unclear
The complex and multifactorial nature of hip OA is nowadays under the spotlight, and recent studies proposed a switch of the paradigm from a simple “wear and tear” to a much more complex mechanism, in which inflammatory mediators play a pivot role in initiation and progression of the pathologic process [1, 2]
Immune cells and secreted cytokines have been established as important players in OA [4]
Summary
Neuroimmune axis is central in the physiopathology of hip osteoarthritis (OA), but its specific pathways are still unclear. This systematic review aims to assess the nervous and immune system profile of patients with hip osteoarthritis (OA) when compared to healthy controls. Neuroimmune axis is known to control the development and perpetuation of multiple inflammatory diseases [1, 3]. The understanding of the role of the nervous system, immune cells and cytokines in the pathophysiology of OA of the hip joint, and their association with the different clinical features of the disease is still limited [4, 9]
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