A new understanding of this common disease may lead to better treatments.
Virtually all of us experience osteoarthritis, the most common form of arthritis, by the time we turn 70.
Until recently experts thought this condition, a breakdown of the cartilage that cushions our joints, resulted exclusively from wear and tear: carrying extra weight, suffering an injury, simply living six or seven decades (not to mention nine or 10). But over the past several years, researchers have discovered that the condition is more complicated than it seemed. In addition to mechanical breakdown, it often involves low-grade inflammation.
Carla Scanzello, MD, a rheumatologist at Rush University Medical Center, is one of a group of researchers working to understand why this inflammation occurs and how it affects people with osteoarthritis. While still in its beginning stages, their research could eventually help lead to earlier diagnoses, more individualized treatments and, as a result, an improved outlook for people with osteoarthritis.
Pathways to Inflammation
"Laboratory studies are really asking two questions," Scanzello says. "What's causing this inflammation and why does it vary so much from patient to patient?"
In one study recently published in the journal Arthritis and Rheumatism, she and her colleagues examined patients with knee meniscus injuries, which are closely linked to osteoarthritis. Some of the patients had high levels of a molecule called CD14 within their joints that could make them more prone to inflammation than those who have lower levels. "CD14 can influence how other cells within the joint respond to stimuli that cause inflammation," Scanzello explains. "We think it may help explain why inflammation varies in severity from one osteoarthritis patient to the next."
Effects of Inflammation
Researchers want to understand why and how inflammation occurs in osteoarthritis because clinical studies suggest that it has an impact on symptoms.
Scanzello serves as a co-investigator for one such study, which is examining patients who have undergone surgery to remove damaged meniscus in the knee. According to preliminary results, those with more inflammation had more symptoms before the procedure. Patients in the study are being followed to determine whether inflammation is associated with a greater risk of developing recurrent symptoms after surgery.
The Future of Treatment
Scanzello and her colleagues hope that by studying inflammation's role in osteoarthritis they can develop new therapies and better determine which treatments will work best for which patients. They also aim to discover new ways of gauging osteoarthritis risk and diagnosing the disease in its earliest stages.
"Right now we have criteria to define osteoarthritis, but by the time patients meet these criteria they often have significant joint damage," she says. "Treating osteoarthritis early offers much more hope for altering the progression of the disease."
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Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.
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