Osteoarthritis.
Osteoarthritis.
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DOI：
10.1038/nrdp.2016.73
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发表时间：
2016-10-13
期刊：
影响因子：
--
通讯作者：
Pelletier, Jean-Pierre
中科院分区：
文献类型：
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作者：
Martel-Pelletier, Johanne;Barr, Andrew J;Pelletier, Jean-Pierre
骨关节炎（OA）是最常见的关节疾病，与人口老龄化造成的日益严重的社会经济影响有关，主要影响关节。原发性OA由多种风险因素共同作用而产生，其中年龄增长和肥胖最为突出。病理生理学的概念仍在不断发展，从被视为软骨局限性疾病到影响整个关节的多因素疾病。局部和全身因素之间的复杂关系调节其临床和结构表现，导致关节破坏的共同最终途径。药理学治疗主要与缓解症状有关，目前还没有获得监管机构批准的缓解疾病的OA药物（即，除了减缓或阻止疾病进展外，还将减轻症状的治疗）。识别患者的表型将能够在疾病的早期阶段检测到疾病，并区分疾病进展风险较高的个体，这反过来又可用于指导临床决策，并允许设计更有效和更具体的治疗干预措施。这本书是关于OA流行病学、生活质量、病理生理机制、诊断、筛查、预防和疾病管理领域的最新进展。
Osteoarthritis (OA) is the most common joint disorder, is associated with an increasing socioeconomic impact owing to the ageing population and mainly affects the diarthrodial joints. Primary OA results from a combination of risk factors, with increasing age and obesity being the most prominent. The concept of the pathophysiology is still evolving, from being viewed as cartilage-limited to a multifactorial disease that affects the whole joint. An intricate relationship between local and systemic factors modulates its clinical and structural presentations, leading to a common final pathway of joint destruction. Pharmacological treatments are mostly related to relief of symptoms and there is no disease-modifying OA drug (that is, treatment that will reduce symptoms in addition to slowing or stopping the disease progression) yet approved by the regulatory agencies. Identifying phenotypes of patients will enable the detection of the disease in its early stages as well as distinguish individuals who are at higher risk of progression, which in turn could be used to guide clinical decision making and allow more effective and specific therapeutic interventions to be designed. This Primer is an update on the progress made in the field of OA epidemiology, quality of life, pathophysiological mechanisms, diagnosis, screening, prevention and disease management.