Abstract：
With the change in lifestyle and aging of the population, osteoarthritis (OA) is emerging as a major medical burden globally. OA is a chronic inflammatory and degenerative disease initially manifesting with joint pain and eventually leading to permanent disability. To date, there are no drugs available for the definitive treatment of osteoarthritis and most therapies have been palliative in nature by alleviating symptoms rather than curing the disease. This coupled with the vague understanding of the early symptoms and methods of diagnosis so that the disease continues as a global problem and calls for concerted research efforts. A cascade of events regulates the onset and progression of osteoarthritis starting with the production of proinflammatory cytokines, including interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α; catabolic enzymes, such as matrix metalloproteinases (MMPs)-1, -3, and -13, culminating into cartilage breakdown, loss of lubrication, pain, and inability to load the joint. Although intra-articular injections of small and macromolecules are often prescribed to alleviate symptoms, low residence times within the synovial cavity severely impair their efficacy. This review will briefly describe the factors dictating the onset and progression of the disease, present the current clinically approved methods for its treatment and diagnosis, and finally elaborate on the main challenges and opportunities for the application of nano/micromedicines in the treatment of osteoarthritis. Thus, future treatment regimens will benefit from simultaneous consideration of the mechanobiological, the inflammatory, and tissue degradation aspects of the disease. This article is categorized under: Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement.
摘要：
随着生活方式的改变和人口老龄化,骨关节炎（OA）正在成为全球范围内的主要医疗负担。OA是一种慢性炎症和退行性疾病,最初表现为关节疼痛并最终导致永久性残疾。迄今为止,目前还没有可用于骨关节炎的明确治疗的药物，大多数疗法都是通过缓解症状而不是治愈疾病的。再加上对早期症状和诊断方法的模糊认识，这种疾病仍然是一个全球性问题，需要协调一致的研究努力。一系列事件从促炎细胞因子的产生开始调节骨关节炎的发作和进展，包括白细胞介素（IL）-1β，IL-6,肿瘤坏死因子(TNF)-α;分解代谢酶,如基质金属蛋白酶（MMP）-1，-3和-13，最终导致软骨破坏，失去润滑，疼痛,无法加载关节。虽然小分子和大分子的关节内注射通常是为了缓解症状，在滑膜腔内的低停留时间严重损害其功效。这篇综述将简要描述决定疾病发作和进展的因素，介绍目前临床上批准的治疗和诊断方法，最后阐述了纳米/微米药物在骨关节炎治疗中应用的主要挑战和机遇。因此，未来的治疗方案将受益于同时考虑机械生物学，炎症，和组织退化方面的疾病。本文分为：纳米技术生物学方法>生物学中的纳米级系统可植入材料和外科技术>纳米技术在组织修复和替换。
