The CNS theory of osteoarthritis: opportunities beyond the joint

Morris, Jodie L., Letson, Hayley L., Gillman, Rhys, Hazratwala, Kaushik, Wilkinson, Matthew, McEwen, Peter, and Dobson, Geoffrey P. (2019) The CNS theory of osteoarthritis: opportunities beyond the joint. Seminars in Arthritis and Rheumatism, 49 (3). pp. 331-336.

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Osteoarthritis (OA) is a leading cause of global disability that affects more than half of the population over 65. It is not a single disease but a progressive, inflammatory- and immune-altering multi-disease that affects the whole joint. OA has many risk factors including age, obesity, gender, lifestyle, joint morphology, metabolic dysfunction and genetic disposition. A major stumbling block in treating clinical OA has been the inability to detect its early onset and disease progression. This gap in understanding may arise from our failure to recognize that the OA patient exhibits a vulnerability to dysregulation of central feedback circuits that control sympathetic tone, inflammation, circadian rhythms (central and peripheral clocks), gut microbiome, metabolic redox and whole joint pathology. Early detection of OA and slowing its progression may come from discoveries outside the joint targeting these potentially modifiable upstream targets. We argue that future treatments may benefit from moving from a knee-centric viewpoint to a more systems-based, whole-body approach. The challenge, however, will be to better characterize these key circuits and apply this knowledge to develop new therapies and interventions.

Item ID: 58719
Item Type: Article (Research - C1)
ISSN: 0049-0172
Keywords: CNS; circadian rhythm; inflammation; microbiome; osteoarthritis; sympathetic
Copyright Information: © 2019 Elsevier Inc. All rights reserved.
Date Deposited: 09 Jul 2019 04:52
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320216 Orthopaedics @ 80%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320223 Rheumatology and arthritis @ 20%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920116 Skeletal System and Disorders (incl. Arthritis) @ 100%
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