Abstract
Osteoarthritis (OA) is a degenerative joint disease in the musculoskeletal system with a relatively high incidence and disability rate in the elderly. It is characterized by the degradation of articular cartilage, inflammation of the synovial membrane, and abnormal structure in the periarticular and subchondral bones. Although progress has been made in uncovering the molecular mechanism, the etiology of OA is still complicated and unclear. Nevertheless, there is no treatment method that can effectively prevent or reverse the deterioration of cartilage and bone structure. In recent years, in the field of pharmacology, research focus has shifted to disease prevention and early treatment rather than disease modification in OA. Biologic agents become more and more attractive as their direct or indirect intervention effects on the initiation or development of OA. In this review, we will discuss a wide spectrum of biologic agents ranging from DNA, noncoding RNA, exosome, platelet-rich plasma (PRP), to protein. We searched for key words such as OA, DNA, gene, RNA, exosome, PRP, protein, and so on. From the pharmacological aspect, stem cell therapy is a very special technique, which is not included in this review. The literatures ranging from January 2016 to August 2021 were included and summarized. In this review, we aim to help readers have a complete and precise understanding of the current pharmacological research progress in the intervention of OA from the biological aspect and provide an indication for the future translational studies.
Highlights
Osteoarthritis (OA) is a degenerative chronic joint disease mainly affects the elderly, causing pain and loss of movement function
In a traditional point of view, cartilage degradation was purely caused by Abbreviations: CircRNA, circular RNA; FGF, fibroblast growth factor; HA and PRP (HA–PRP), hyaluronic acid–platelet-rich plasma; IGFBP, insulin-like growth factor–binding proteins; lncRNA, long noncoding RNA; leukocyte-poor PRP (LP-PRP), leukocyte-poor–platelet-rich plasma; LRPRP, leukocyte-rich–platelet-rich plasma; miRNA, microRNA; OA, osteoarthritis; PRP, platelet-rich plasma; TGF-β, transforming growth factor β
In order to analyze the research trends in the field of OA treatment using the biologic agent in recent years, we have reviewed relevant literature on DNA, RNA, protein, and exosome in the past 5 years on PubMed and subdivided RNA into circular RNA (circRNA), lncRNA, and miRNA
Summary
Osteoarthritis (OA) is a degenerative chronic joint disease mainly affects the elderly, causing pain and loss of movement function. Pharmacological Treatment of Musculoskeletal Diseases mechanical imbalance (Francisco et al, 2018). Increasing evidence shows that OA is a complex condition, in which the whole joints, including cartilage, subchondral bone, and synovium probably, are all involved in the pathogenesis (Goldring and Goldring, 2016), among which degradation of cartilage caused by matrix proteases plays a pivotal role (PérezGarcía et al, 2019). OA is a disease resulting from an imbalance between catabolic and anabolic events. Biologic agents become more and more attractive as they either target specific catabolic events, such as inflammation or matrix degradation, or promote anabolic events, such as antiinflammation or chondrogenesis. We provide an update of the current treatment strategies and recent research progress in the pharmacological intervention of OA from the biology aspect (Figure 1)
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