Metabolic triggered inflammation
|Key components||Roles in OA|
|Body fat is associated with more knee cartilage loss; lean mass has an opposite effect; body composition measures were better than BMI in predicting OA|
|Leptin, resistin and visfatin have emerged as pro-inflammatory and pro-catabolic factors in OA; circulating leptin is associated with increased knee cartilage loss and joint pain; adiponectin may have an anti-inflammatory effect and thus be beneficial on OA|
|Cytokines can be produced by adipose tissue; circulating or local cytokines (IL-6, TNF-α, IL-17, IL-18) were associated with ROA, cartilage loss and/or knee pain. Intervention such as exercise can increase anti-inflammatory cytokine IL-10 in OA.|
|Acute-phase inflammatory components|
|CRP is associated with decreased knee cartilage volume and increased knee pain. Complements such as C1s, C4A, factor B, C3, C5, MAC and transcripts that encoding complements effectors are all abnormally expressed in OA. COMP-C3b complexes can be found in OA.|
|Lipids accumulate in cartilage with increasing histological lesion severity; serum cholesterol and triglyceride levels were associated increased risk of osteoarthritic changes, but HDL was associated with decreased risk; statin use in high doses may reduce OA risk.|
Hyperglycaemia has detrimental effects on cartilage; diabetes could be an independent risk factor for OA, leading to the concept of a diabetes-induced OA phenotype.
|Vitamin D deficiency|
|Vitamin D deficiency can be a result of metabolic triggered inflammation; low serum levels of 25-(OH)D were associated with increased progression of knee ROA and increased cartilage loss.|
|Reactive nitrogen and oxygen species|
|Nitric oxide (NO) and reactive oxygen species are increased in OA, and associated with increased inflammatory cytokines. IL-1-induced OA cartilage damage is inhibited by a NO synthase 2 inhibitor or by superoxide dismutase, but a recent RCT failed to show positive effects of iNOS inhibition on symptoms and disease progression of knee OA.|
|MiRNAs is involved in meta-inflammation and the regulation of cartilage development and homeostasis; nine miRNAs up-regulated (i.e., miR-22 and miR-103) and seven down-regulated (i.e., miR29a, miR-140 and miR-25) in osteoarthritic cartilage; the various functions of miRNAs include suppression of inflammatory cytokines, ADAMTS, COX-2, iNOS and MMPs|
Direct evidence of meta-inflammation in OA
Body fat may be better than body mass index (BMI) in predicting OA
- Stannus O.P.
- Cao Y.
- Antony B.
- Blizzard L.
- Cicuttini F.
- Jones G.
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- Stannus O.P.
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Acute-phase inflammatory components: hs-CRP and complements
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Complementary evidence of meta-inflammation in OA
Vitamin D deficiency
MicroRNAs in OA
Modification of meta-inflammation in OA
Weight loss and exercise
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Vitamin D supplementation
Modification of miRNAs
Conflict of interest
Data sharing statement
Provenance and peer review
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