Aberrant anabolism hinders constructive metabolism of chondrocytes by pharmacotherapy in osteoarthritis

Osteoarthritis (OA) is a highly prevalent and disabling disease with an unmet therapeutic need. The characteristic cartilage loss and alteration of other joint structures result from a complex interaction of multiple risk factors, with mechanical overload consistently playing a central role. This ov...

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Main Authors: Raquel Largo, Aranzazu Mediero, Cristina Villa-Gomez, Ismael Bermejo-Alvarez, Gabriel Herrero-Beaumont
Format: Article
Language:English
Published: The British Editorial Society of Bone & Joint Surgery 2025-03-01
Series:Bone & Joint Research
Subjects:
Online Access:https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.143.BJR-2024-0241.R1
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author Raquel Largo
Aranzazu Mediero
Cristina Villa-Gomez
Ismael Bermejo-Alvarez
Gabriel Herrero-Beaumont
author_facet Raquel Largo
Aranzazu Mediero
Cristina Villa-Gomez
Ismael Bermejo-Alvarez
Gabriel Herrero-Beaumont
author_sort Raquel Largo
collection DOAJ
description Osteoarthritis (OA) is a highly prevalent and disabling disease with an unmet therapeutic need. The characteristic cartilage loss and alteration of other joint structures result from a complex interaction of multiple risk factors, with mechanical overload consistently playing a central role. This overload generates an inflammatory response in the cartilage due to the activation of the innate immune response in chondrocytes, which occurs through various cellular mechanisms. Moreover, risk factors associated with obesity, being overweight, and metabolic syndrome enhance the inflammatory response both locally and systemically. OA chondrocytes, the only cells present in articular cartilage, are therefore inflamed and initiate an anabolic process in an attempt to repair the damaged tissue, which ultimately results in an aberrant and dysfunctional process. Under these circumstances, where the cartilage continues to be subjected to chronic mechanical stress, proposing a treatment that stimulates the chondrocytes’ anabolic response to restore tissue structure does not appear to be a therapeutic target with a high likelihood of success. In fact, anabolic drugs proposed for the treatment of OA have yet to demonstrate efficacy. By contrast, multiple therapeutic strategies focused on pharmacologically managing the inflammatory component, both at the joint and systemic levels, have shown promise. Therefore, prioritizing the control of chronic innate pro-inflammatory pathways presents the most viable and promising therapeutic strategy for the effective management of OA. As research continues, this approach may offer the best opportunity to alleviate the burden of this incapacitating disease. Cite this article: Bone Joint Res 2025;14(3):199–207.
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spelling doaj-art-e993bdd47a92449d8933dbec3470e0b32025-08-20T03:44:17ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Research2046-37582025-03-0114319920710.1302/2046-3758.143.BJR-2024-0241.R1Aberrant anabolism hinders constructive metabolism of chondrocytes by pharmacotherapy in osteoarthritisRaquel Largo0https://orcid.org/0000-0001-6525-2944Aranzazu Mediero1https://orcid.org/0000-0002-5368-574XCristina Villa-Gomez2https://orcid.org/0000-0002-7520-1603Ismael Bermejo-Alvarez3https://orcid.org/0000-0003-2563-7908Gabriel Herrero-Beaumont4https://orcid.org/0000-0002-3241-991XJoint and Bone Research Unit, Service of Rheumatology, IIS Fundación Jiménez Díaz UAM, Madrid, SpainJoint and Bone Research Unit, Service of Rheumatology, IIS Fundación Jiménez Díaz UAM, Madrid, SpainJoint and Bone Research Unit, Service of Rheumatology, IIS Fundación Jiménez Díaz UAM, Madrid, SpainJoint and Bone Research Unit, Service of Rheumatology, IIS Fundación Jiménez Díaz UAM, Madrid, SpainJoint and Bone Research Unit, Service of Rheumatology, IIS Fundación Jiménez Díaz UAM, Madrid, SpainOsteoarthritis (OA) is a highly prevalent and disabling disease with an unmet therapeutic need. The characteristic cartilage loss and alteration of other joint structures result from a complex interaction of multiple risk factors, with mechanical overload consistently playing a central role. This overload generates an inflammatory response in the cartilage due to the activation of the innate immune response in chondrocytes, which occurs through various cellular mechanisms. Moreover, risk factors associated with obesity, being overweight, and metabolic syndrome enhance the inflammatory response both locally and systemically. OA chondrocytes, the only cells present in articular cartilage, are therefore inflamed and initiate an anabolic process in an attempt to repair the damaged tissue, which ultimately results in an aberrant and dysfunctional process. Under these circumstances, where the cartilage continues to be subjected to chronic mechanical stress, proposing a treatment that stimulates the chondrocytes’ anabolic response to restore tissue structure does not appear to be a therapeutic target with a high likelihood of success. In fact, anabolic drugs proposed for the treatment of OA have yet to demonstrate efficacy. By contrast, multiple therapeutic strategies focused on pharmacologically managing the inflammatory component, both at the joint and systemic levels, have shown promise. Therefore, prioritizing the control of chronic innate pro-inflammatory pathways presents the most viable and promising therapeutic strategy for the effective management of OA. As research continues, this approach may offer the best opportunity to alleviate the burden of this incapacitating disease. Cite this article: Bone Joint Res 2025;14(3):199–207.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.143.BJR-2024-0241.R1osteoarthritismechanical overloadinginflammationaberrant anabolismtreatmentosteoarthritis (oa)chondrocytescartilage tissueosteoarthritic chondrocytesobesitypharmacotherapyarticular cartilagemechanical stressoverweightmetabolic syndrome
spellingShingle Raquel Largo
Aranzazu Mediero
Cristina Villa-Gomez
Ismael Bermejo-Alvarez
Gabriel Herrero-Beaumont
Aberrant anabolism hinders constructive metabolism of chondrocytes by pharmacotherapy in osteoarthritis
Bone & Joint Research
osteoarthritis
mechanical overloading
inflammation
aberrant anabolism
treatment
osteoarthritis (oa)
chondrocytes
cartilage tissue
osteoarthritic chondrocytes
obesity
pharmacotherapy
articular cartilage
mechanical stress
overweight
metabolic syndrome
title Aberrant anabolism hinders constructive metabolism of chondrocytes by pharmacotherapy in osteoarthritis
title_full Aberrant anabolism hinders constructive metabolism of chondrocytes by pharmacotherapy in osteoarthritis
title_fullStr Aberrant anabolism hinders constructive metabolism of chondrocytes by pharmacotherapy in osteoarthritis
title_full_unstemmed Aberrant anabolism hinders constructive metabolism of chondrocytes by pharmacotherapy in osteoarthritis
title_short Aberrant anabolism hinders constructive metabolism of chondrocytes by pharmacotherapy in osteoarthritis
title_sort aberrant anabolism hinders constructive metabolism of chondrocytes by pharmacotherapy in osteoarthritis
topic osteoarthritis
mechanical overloading
inflammation
aberrant anabolism
treatment
osteoarthritis (oa)
chondrocytes
cartilage tissue
osteoarthritic chondrocytes
obesity
pharmacotherapy
articular cartilage
mechanical stress
overweight
metabolic syndrome
url https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.143.BJR-2024-0241.R1
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AT cristinavillagomez aberrantanabolismhindersconstructivemetabolismofchondrocytesbypharmacotherapyinosteoarthritis
AT ismaelbermejoalvarez aberrantanabolismhindersconstructivemetabolismofchondrocytesbypharmacotherapyinosteoarthritis
AT gabrielherrerobeaumont aberrantanabolismhindersconstructivemetabolismofchondrocytesbypharmacotherapyinosteoarthritis