Future directions for research and treatment of osteoarthritis.

Future directions for research and treatment of osteoarthritis.
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骨关节炎研究和治疗的未来方向。

DOI:
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发表时间:
1999
期刊:
Frontiers in Bioscience
影响因子:
--
通讯作者:
V. Goldberg
V. Goldberg
中科院分区:
--
文献类型:
--
作者:
C. Malemud;V. Goldberg

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骨关节炎 (OA) 的研究和治疗的未来方向将基于控制 OA 发生和进展的病理生理学事件的新情况。导致 OA 关节软骨破坏的基本事件是合成代谢和分解代谢途径之间的不平衡。软骨的细胞外基质(ECM)被细胞因子诱导的基质金属蛋白酶(MMP)降解。细胞因子还会削弱恢复退化 ECM 完整性所需的软骨细胞代偿合成途径。抑制 MMP、其激活剂和诱导 MMP 基因上调的细胞因子似乎是 OA 治疗药物开发的丰富靶点。通过组织工程策略恢复受损的关节表面似乎是可行的,该策略可以利用适合移植到软骨表面的生物基质中的软骨祖细胞。通过采用基因转移原理,使用合适的载体建立抑制 MMP 的基因的长期稳定表达,同时支持软骨 ECM 生物合成,也可以减少细胞因子介导的 MMP 基因表达上调以及增强软骨 ECM 生物合成。
Future directions in the research and treatment of osteoarthritis (OA) will be based on the emerging picture of pathophysiological events that govern the initiation and progression of OA. The fundamental event resulting in the destruction of articular cartilage in OA arises from an imbalance between anabolic and catabolic pathways. The extracellular matrix (ECM) of cartilage is degraded by matrix metalloproteinases (MMPs) induced by cytokines. Cytokines also blunt chondrocyte compensatory synthesis pathways required to restore the integrity of the degraded ECM. Inhibition of the MMPs, their activators, and cytokines that induce MMP gene up-regulation would appear to be fertile targets for drug development in the treatment of OA. Restoration of damaged articular surfaces via tissue engineering strategies which could employ chondroprogenitor cells in biomatrices appropriate for transplantation to cartilage surfaces appears feasible. A reduction in cytokine-mediated up-regulation of MMP gene expression as well as augmentation of cartilage ECM biosynthesis may also be possible by employing the principles of gene transfer using suitable vectors that establish long-term stable expression of genes which suppress MMPs while at the same time supporting cartilage ECM biosynthesis.
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