Tracking Treatable Tissues: Change in qMRI Biomarkers and Future Cartilage Loss

项目概要/摘要 骨关节炎（OA）是一种复杂的异质性疾病，是一个主要的公共卫生问题， 这是老龄化人口中残疾的常见原因，并与巨大的经济负担有关。的 OA的病理生理学影响整个关节，伴随软骨的破坏， 软骨下骨和邻近的软组织，导致衰弱的症状，如疼痛。随着年龄的增长， 肥胖的人群和流行，OA，特别是膝关节OA对公众健康的影响， 继续急剧增加，但不幸的是，没有FDA批准的疾病修饰OA药物 （DMOAD），即，旨在阻止或防止OA相关的软骨和骨结构变化的药物。 这是由于缺乏对OA特征和疾病之间关系的了解 进展然而，MRI提高了我们对组织病理学之间关系的理解， 软骨、软骨下骨和关节周围软组织的变化和结构变化 在OA。因此，MRI代表了对普通膝关节X线片的改进，普通膝关节X线片既不敏感， 非特异性关节结构的关键变化的发展和进展的OA。 这项工作的目的是了解BML和ES的轨迹对下游临床的影响。 结果，包括软骨损失和残疾，在短期内（即，两年后）和长期（即， 六年后）。对生物地雷和爆炸物轨迹的分析将考虑到 基线和体积随时间的定量变化。 本研究的具体目的是：评价MRI检测骨髓轨迹的影响 病变（BML）和渗出性滑膜炎（ES）对随后的软骨损失的影响;并评估 MRI检测的BML和ES对膝关节特定残疾的轨迹。

PROJECT SUMMARY/ABSTRACT Osteoarthritis (OA) is a complex, heterogeneous condition that is a major public health problem, the most common cause of disability in the aging population and is associated with a large economic burden. The pathophysiology of OA affects the whole joint, with breakdown of cartilage, associated changes in the subchondral bone and adjacent soft tissue that leads to debilitating symptoms such as pain. With the aging of the population and the epidemic of obesity, the public health impact of OA, especially knee OA, has and will continue to increase dramatically, but unfortunately, there are no FDA-approved disease-modifying OA drugs (DMOADs), i.e., drugs designed to impede or prevent the OA-related structural changes to cartilage and bone. This has been due to a lack of understanding of the relationship between features of OA and disease progression. MRI, however, has improved our understanding of the relationship between histopathologic changes and the structural changes to cartilage, subchondral bone and the surrounding soft tissues of the joint in OA. As such MRI represents an improvement over plain knee radiographs, which are both insensitive and nonspecific to critical changes in joint structure in the development and progression of OA. The objective of this work is to understand the impact of the trajectory of BMLs and ES on downstream clinical outcomes, including cartilage loss and disability, over the short-term (i.e., two years later) and long-term (i.e., six years later). Analysis of the trajectory of BMLs and ES will take into account the quantitative volume at baseline and the quantitative change in volume over time. The specific aims of this study are: To evaluate the impact of the trajectory of MRI-detected bone marrow lesions (BMLs) and effusion synovitis (ES) on subsequent cartilage loss; and to evaluate the impact of the trajectory of MRI-detected BMLs and ES on knee-specific disability.