Neural and immune roles in osteoarthritis pain: Mechanisms and intervention strategies
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Pain is the leading symptom for most individuals with osteoarthritis (OA), a complex condition marked by joint discomfort. Recently, the dynamic interplay between the nervous and immune systems has become a focal point for understanding pain regulation. Despite this, there is still a substantial gap in our comprehensive understanding of the neuroimmune interactions and their effects on pain in OA. This review examines the bidirectional influences between immune cells and nerves in OA progression. It explores current approaches that target neuroimmune pathways, including promoting M2 macrophage polarization and specific neuronal receptor targeting, for effective pain reduction. Translational potential statement: This review provides a comprehensive overview of the mechanisms underlying the interplay between the immune system and nervous system during the progression of OA, as well as their contributions to pain. Additionally, it compiles existing intervention strategies targeting neuroimmunity for the treatment of OA pain. This information offers valuable insights for researchers seeking to address the challenge of OA pain.
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Sensory nerve endings lie in close apposition to synovial cells, and their reciprocal interactions shape pain perception and the balance between inflammation and resolution.
“Sensory nerve endings lie in close apposition to synovial cells, and their reciprocal interactions shape not only the perception of pain but also the balance between inflammation and resolution.”
From Interorgan Communications in Skeletal Pathophysiology: From Molecular Pathways to Multidisciplinary Therapies (2026) · cites this paper as [63]
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Cited by
Sorted by citations
Mallia, I., Fioravanti, A., & Guiducci, S. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms262110408 · Cited by 14 · see citing works
Gan, D., Qin, L., & Xiao, G. (2026) · Research · doi:10.34133/research.1319 · Cited by 1 · see citing works
“Viewing OA pain through a neu-roimmunological lens has therefore provided a conceptual framework for “treating pain through immune modulation” [ 63 ].”
- Authors
- Zou, Y., Liu, C., Wang, Z., Li, G., & Xiao, J.
- Affiliations
- Tongji Hospital (CN)
- Corresponding author
- Li, Guanghui
- Xiao, Jun
- Venue
- Journal of Orthopaedic Translation
- Publisher
- Elsevier BV
- Published
- 2024-09
- Volume
- 48
- Pages
- 123-132
- ISSN
- 2214-031X (ISSN-L)
- PMC
- PMC11363721
- OpenAlex
- W4401386012
- Cited by
- 26
- References
- 4
- Citations by year
- 2026: 11 · 2025: 13 · 2024: 2
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Orthopaedic Translation (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- osteoarthritis pain, neuroimmunity, neuroimmune interactions, M2 macrophage polarization, neuronal receptors, pain modulation
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