Carlos J Cruz, L Savannah Dewberry, Kevin J Otto, Kyle D Allen
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引用次数: 0
Abstract
Purpose of review: The following review discusses the therapeutic potential of targeting the autonomic nervous system (ANS) for osteoarthritis (OA) treatment and encourages the field to consider the candidacy of bioelectronic medicine as a novel OA treatment strategy.
Recent findings: The study of OA pathogenesis has focused on changes occurring at the joint level. As such, treatments for OA have been aimed at the local joint environment, intending to resolve local inflammation and decrease pain. However, OA pathogenesis has shown to be more than joint wear and tear. Specifically, OA-related peripheral and central sensitization can prompt neuroplastic changes in the nervous system beyond the articular joint. These neuroplastic changes may alter physiologic systems, like the neuroimmune axis. In this way, OA and related comorbidities may share roots in the form of altered neuroimmune communication and autonomic dysfunction. ANS modulation may be able to modify OA pathogenesis or reduce the impact of OA comorbidities. Moreover, blocking chronic nociceptive drive from the joint may help to prevent maladaptive nervous system plasticity in OA.
综述的目的:以下综述讨论了针对自律神经系统(ANS)的骨关节炎(OA)治疗潜力,并鼓励该领域考虑将生物电子医学作为一种新型 OA 治疗策略:最近的研究结果:对 OA 发病机制的研究主要集中在关节层面发生的变化。因此,治疗 OA 的方法主要针对局部关节环境,目的是消除局部炎症和减轻疼痛。然而,OA 的发病机制已被证明不仅仅是关节磨损和撕裂。具体来说,与 OA 相关的外周和中枢敏感化会促使关节以外的神经系统发生神经可塑性变化。这些神经可塑性变化可能会改变生理系统,如神经免疫轴。因此,OA 和相关合并症的共同根源可能是神经免疫交流的改变和自律神经功能失调。调节自律神经系统可能能够改变 OA 的发病机制或减少 OA 并发症的影响。此外,阻断来自关节的慢性痛觉驱动可能有助于防止适应不良的神经系统在 OA 中的可塑性。
期刊介绍:
This journal aims to review the most important, recently published research in the field of rheumatology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of rheumatologic conditions.
We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas such as the many forms of arthritis, osteoporosis and metabolic bone disease, and systemic lupus erythematosus. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also occasionally provided.