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Role of proinflammatory cytokines in the pathophysiology of osteoarthritis
Abstract
Osteoarthritis (OA) is associated with cartilage destruction, subchondral bone remodeling and inflammation of the synovial membrane, although the etiology and pathogenesis underlying this debilitating disease are poorly understood. Secreted inflammatory molecules, such as proinflammatory cytokines, are among the critical mediators of the disturbed processes implicated in OA pathophysiology. Interleukin (IL)-1β and tumor necrosis factor (TNF), in particular, control the degeneration of articular cartilage matrix, which makes them prime targets for therapeutic strategies. Animal studies provide support for this approach, although only a few clinical studies have investigated the efficacy of blocking these proinflammatory cytokines in the treatment of OA. Apart from IL-1β and TNF, several other cytokines including IL-6, IL-15, IL-17, IL-18, IL-21, leukemia inhibitory factor and IL-8 (a chemokine) have also been shown to be implicated in OA and could possibly be targeted therapeutically. This Review discusses the current knowledge regarding the role of proinflammatory cytokines in the pathophysiology of OA and addresses the potential of anticytokine therapy in the treatment of this disease.
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“Because TNF-α signaling primarily via TNFR1 binds TRADD and RIPK1 to generate complexes that activate NF-κB, MAPKs, and caspases, IL-1β and TNF-α cooperate to enhance chronic inflammation in degenerative joint disease [42,43].”
From Biomarker-Guided Imaging and AI-Augmented Diagnosis of Degenerative Joint Disease (2025) · cites this paper as [42]
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“These mediators may be produced by a variety of cell types, including macrophages, chondrocytes and synovial fibroblasts [51].”
BackgroundDamage-associated molecular patterns in inflammatory diseases
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“However, emerging evidence suggests that DAMPs-induced inflammation plays an important role in the pathogenesis of OA (14,52,53).”
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Synovial inflammation in osteoarthritis progression
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“Both are powerful proinflammatory cytokines that have been implicated in a large number of infectious and noninfectious inflammatory diseases, the latter including atherosclerosis [35], rheumatoid arthritis [36], osteoarthritis [105], and Alzheimer’s disease [38].”
BackgroundThe role of metabolism in chondrocyte dysfunction and the progression of osteoarthritis
Zheng, L., Zhang, Z., Sheng, P., & Mobasheri, A. (2020) · Ageing Research Reviews · doi:10.1016/j.arr.2020.101249 · Cited by 767
Oxidative Stress and Inflammation in Osteoarthritis Pathogenesis: Role of Polyphenols
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The PI3K/AKT/mTOR signaling pathway in osteoarthritis: a narrative review
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Proteases involved in cartilage matrix degradation in osteoarthritis
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“It is increasingly accepted that inflammation also plays a role in the development of OA [4, 104].”
BackgroundCytokines and Chemokines Involved in Osteoarthritis Pathogenesis
Molnar, V., Matišić, V., Kodvanj, I., Bjelica, R., Jeleč, Ž., Hudetz, D., Rod, E., Čukelj, F., Vrdoljak, T., Vidović, D., et al. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22179208 · Cited by 664
“Furthermore, IL-1β-mediated NF-κB activation stimulates the production of various chemokines including IL-8, monocyte chemoattractant protein-1 (MCP-1 or CCL2), CCL5, also known as RANTES (regulated on activation, normal T cell expressed and secreted) and macrophage inflammatory protein-1a (MIP-1a), which, by attracti…”
BackgroundNF-κB Signaling Pathways in Osteoarthritic Cartilage Destruction
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“At the same time these mediators stimulate intercellular IL-6 production perpetuating osteoclast activity (148, 151).”
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“Their effect has been shown to reduce the progression of cartilage loss in OA models [77].”
BackgroundInfluentialIntra-articular treatment options for knee osteoarthritis
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The NF-κB signalling pathway in osteoarthritis.
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“They play a role in the disruption of cartilage homeostasis, and MMP mediated cartilage degradation [4,31] modulating the chondrocyte metabolism by increasing MMP expression and inhibiting the production”
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Mitophagy in degenerative joint diseases
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Cartilage-specific deletion of mTOR upregulates autophagy and protects mice from osteoarthritis
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Self-citationImmunopathogenesis of osteoarthritis
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Chronic low-grade inflammation and age-related sarcopenia
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The Anti-inflammatory and Matrix Restorative Mechanisms of Platelet-Rich Plasma in Osteoarthritis
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“In fact, TNF-a is a recognized mediator of acute inflammation and an activator of MMPs in many tissues including those of the articular environment.(23,42,45) Additionally, TNF-a is implicated in initiating neuropathic pain pathways in animal models and human disease states.”
BackgroundInfluentialSynovial cell cross-talk with cartilage plays a major role in the pathogenesis of osteoarthritis
Chou, C.-H., Jain, V., Gibson, J., Attarian, D. E., Haraden, C. A., Yohn, C. B., Laberge, R.-M., Gregory, S., & Kraus, V. B. (2020) · Scientific Reports · doi:10.1038/s41598-020-67730-y · Cited by 398
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“2a, IL-1β treatment significantly downregulated COL2A1 and ACAN and upregulated MMP13 and ADAMTS5 mRNA expressions (all P < 0.01); however, exosome pretreatment (40 μg) significantly attenuated IL-1β-induced changes in the expression of these genes (all P < 0.05).”
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“In an effort to balance anabolism and catabolism in an affected joint, several biological treatments such as intraarticular PRP injections have been proposed.5,9,15,16,24 This strategy stems from biochemical research on anabolic growth factors, such as transforming growth factor b (TGF-b), insulin-like growth factor 1…”
BackgroundInflammaging and Osteoarthritis
Motta, F., Barone, E., Sica, A., & Selmi, C. F. (2022) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-022-08941-1 · Cited by 439
Emerging pharmaceutical therapies for osteoarthritis
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Inflammatory mechanisms in tendinopathy – towards translation
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“Clinically, patients with OA have a variable degree of synovitis, as demonstrated by high levels of interleukin-1 (IL-1 ), tumor necrosis factor (TNF ), and complement factors (1,2).”
BackgroundMammalian Transient Receptor Potential TRPA1 Channels: From Structure to Disease
Talavera, K., Startek, J. B., Alvarez‐Collazo, J., Boonen, B., Alpizar, Y. A., Sánchez, A., Naert, R., & Nilius, B. (2019) · Physiological Reviews · doi:10.1152/physrev.00005.2019 · Cited by 407
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“It has frequently been reported that the quantities of inflammatory cytokines such as IL-1, IL-6, IL-15 and TNFα are elevated in the serum of patients with OA [30,31].”
BackgroundRegulation of the Catabolic Cascade in Osteoarthritis by the Zinc-ZIP8-MTF1 Axis
Kim, J., Jeon, J., Shin, M., Won, Y., Lee, M., Kwak, J.-S., Lee, G., Rhee, J., Ryu, J., Chun, C. H., et al. (2014) · Cell · doi:10.1016/j.cell.2014.01.007 · Cited by 369
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“Similarly, the expression of the specific receptors of IL-1b, called IL-1 receptor type I (IL-1RI), has been found to be increased in human chondrocytes and synovial fibroblasts affected by OA (47).”
BackgroundInfluentialSohn, D., Sokolove, J., Sharpe, O., Erhart, J., Chandra, P. E., Lahey, L., Lindstrom, T., Hwang, I., Boyer, K., Andriacchi, T., et al. (2012) · Arthritis Research & Therapy · doi:10.1186/ar3555 · Cited by 338
“We therefore assessed whether a subset of the identified plasma proteins could induce macrophages to produce TNF, a key cytokine that is thought to drive the inflammatory cascade in OA [27].”
BackgroundResultInfluentialRedox and NF-κB signaling in osteoarthritis
Lepetsos, P., Papavassiliou, K. A., & Papavassiliou, A. G. (2018) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2018.09.025 · Cited by 412
The CH25H–CYP7B1–RORα axis of cholesterol metabolism regulates osteoarthritis
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Senescent cells and osteoarthritis: a painful connection
Jeon, O. H., David, N. E., Campisi, J., & Elisseeff, J. H. (2018) · Journal of Clinical Investigation · doi:10.1172/jci95147 · Cited by 359
“Instead the phenotype is skewed toward matrix destruction and inflammatory cytokine production, primarily through collagen-degrading MMP-13 and aggrecan-degrading ADAMTS-5 (11, 12).”
OSTEOARTHRITIS JOINT PAIN: THE CYTOKINE CONNECTION
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“Cytokines that have been implicated in OA pathogenesis include tumor necrosis factor (TNF)-a, interleukin (IL)-1, IL-6, other common c-chain cytokines such as IL-2, IL-7, IL-15, and IL21, and chemokines (reviewed in [6,10]).”
The Role of Autophagy and Mitophagy in Bone Metabolic Disorders
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“As an important inflammation factor, IL-1β can induce experimental OA in chondrocytes [129].”
BackgroundReciprocal inhibition of YAP/TAZ and NF-κB regulates osteoarthritic cartilage degradation
Deng, Y.-J., Lu, J., Li, W., Wu, A.-L., Zhang, X., Tong, W.-X., Ho, K., Qin, L., Song, H., & Mak, K. K. (2018) · Nature Communications · doi:10.1038/s41467-018-07022-2 · Cited by 305
Early osteoarthritis of the knee
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“Catabolic activities are increased [24, 28], leading to biochemical changes in the composition of the extracellular matrix Table 2 Focal early OA”
BackgroundPost-traumatic osteoarthritis: from mouse models to clinical trials
Little, C., & Hunter, D. (2013) · Nature Reviews Rheumatology · doi:10.1038/nrrheum.2013.72 · Cited by 291
Notch Signaling and the Skeleton
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The Role of Innate Immunity in Osteoarthritis: When Our First Line of Defense Goes On the Offensive
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Biological aspects of early osteoarthritis
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Osteoarthritis, inflammation and obesity
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“Inflammatory mediators such as cytokines, lipid derivatives, reactive oxygen species or advanced-glycation end products can be produced and activate cells from joint tissues (mainly synovium, cartilage and subchondral bone), thus leading to the release of matrix metalloproteinases (MMPs) into the joint cavity and even…”
BackgroundChen, G., Jiang, N.-H., Zheng, J.-P., Hu, H., Yang, H.-B., Lin, A.-Z., Hu, B.-F., & Liu, H. (2023) · International Journal of Biological Macromolecules · doi:10.1016/j.ijbiomac.2023.124386 · Cited by 259
Does lipopolysaccharide-mediated inflammation have a role in OA?
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Metabolic stress-induced joint inflammation and osteoarthritis
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“critically for important intellectual content; and (3) final approval of the version to be 395 submitted 396”
BackgroundSmall extracellular vesicles from human adipose‐derived stem cells attenuate cartilage degeneration
Woo, C. H., Kim, H. K., Jung, G. Y., Jung, Y. J., Lee, K. S., Yun, Y. E., Han, J., Lee, J., Kim, W. S., Choi, J. S., et al. (2020) · Journal of Extracellular Vesicles · doi:10.1080/20013078.2020.1735249 · Cited by 290
“Among the pro-inflammatory cytokines, IL-1β and tumour necrosis factor (TNF)-α seem to be most involved in the catabolic process of OA [44,45].”
BackgroundTargeting Cell Death: Pyroptosis, Ferroptosis, Apoptosis and Necroptosis in Osteoarthritis
Yang, J., Hu, S., Bian, Y., Yao, J., Wang, D., Liu, X., Guo, Z., Zhang, S., & Peng, L. (2022) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2021.789948 · Cited by 244
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“control to induce the osteoarthritic phenotype of chondrocytes [31,32].”
BackgroundTGFβ/BMP Signaling Pathway in Cartilage Homeostasis
Thielen, N. G. M., van der Kraan, P. M., & van Caam, A. (2019) · Cells · doi:10.3390/cells8090969 · Cited by 271
Targets, models and challenges in osteoarthritis research
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Inflammation and epigenetic regulation in osteoarthritis
Shen, J., Abu‐Amer, Y., O’Keefe, R. J., & McAlinden, A. (2016) · Connective Tissue Research · doi:10.1080/03008207.2016.1208655 · Cited by 232
“production of catabolic MMPs and aggrecanases including MMPs and ADAMTs, leading to articular cartilage degradation (80).”
Cytokines as biochemical markers for knee osteoarthritis.
Mabey, T., & Honsawek, S. (2015) · World Journal of Orthopaedics · doi:10.5312/wjo.v6.i1.95 · Cited by 230
The evaluation of oxidative stress in osteoarthritis
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“These processes are activated by pro-inflammatory mediators such as cytokines, lipid mediators and reactive oxygen species (ROS), which are produced also by chondrocytes, synoviocytes and osteoblasts [3,4].”
BackgroundFleischmann, R., Bliddal, H., Blanco, F., Schnitzer, T., Peterfy, C., Chen, S., Wang, L., Feng, S., Conaghan, P., Berenbaum, F., et al. (2019) · Arthritis & Rheumatology · doi:10.1002/art.40840 · Cited by 222
“The unexpected lack of effect of IL1 inhibition on synovitis may signify that, although the synovium is an important source of IL1 (43), IL1 by itself may not be required to sustain synovitis.”
BackgroundSelf-citationMetabolic triggered inflammation in osteoarthritis
Wang, X., Hunter, D. J., Xu, J., & Ding, C. (2014) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2014.10.002 · Cited by 319
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“In close correlation with the reduction of TNF-a, a decreased level of MMP-1 in cartilage tissue, responsible of proteoglycan degradation, was noticed in ASC-treated groups at 16 and 24 weeks [42,43].”
BackgroundMicroRNAs: exploring new horizons in osteoarthritis
Nugent, M. (2015) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2015.10.018 · Cited by 212
Lipid peroxidation in osteoarthritis: focusing on 4-hydroxynonenal, malondialdehyde, and ferroptosis
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“The ability of IL-1β to induce chondrocyte catabolism [121] has been well known for a long time, but it is only recently that IL-1β has been shown to disrupt chondrocyte iron homeostasis [117] and trigger chondrocyte ferroptosis [22, 122].”
BackgroundBajpayee, A., Wong, C. R., Bawendi, M., Frank, E., & Grodzinsky, A. (2013) · Biomaterials · doi:10.1016/j.biomaterials.2013.09.091 · Cited by 205
“, IL-1, IL-6, TNFα) which can diffuse into cartilage and rapidly initiate proteolysis and loss of cartilage matrix [8, 9].”
Occhetta, P., Mainardi, A., Votta, E., Vallmajó-Martín, Q., Ehrbar, M., Martín, I., Barbero, A., & Rasponi, M. (2019) · Nature Biomedical Engineering · doi:10.1038/s41551-019-0406-3 · Cited by 236
Pathophysiological Perspective of Osteoarthritis
Yunus, M. H. M., Nordin, A., & Kamal, H. (2020) · Medicina · doi:10.3390/medicina56110614 · Cited by 196
“• induce chondrocyte apoptosis; reduced the survival of cells and inhibited mitochondrial respiratory chain function and ATP synthesis [34,38,46,49].”
BackgroundMoussa, M., Lajeunesse, D., Hilal, G., Atat, O. E., Haykal, G., Serhal, R., Chalhoub, A., Khalil, C., & Alaaeddine, N. (2017) · Experimental Cell Research · doi:10.1016/j.yexcr.2017.02.012 · Cited by 227
“IL-1β and TNF-α, two major pro-inflammatory cytokines, play the role of stimulators of the inflammatory and degradative cascades in OA [7].”
BackgroundSelf-citationContribution of Infrapatellar Fat Pad and Synovial Membrane to Knee Osteoarthritis Pain
Belluzzi, E., Stocco, E., Pozzuoli, A., Granzotto, M., Porzionato, A., Vettor, R., Caro, R. D., Ruggieri, P., Ramonda, R., Rossato, M., et al. (2019) · BioMed Research International · doi:10.1155/2019/6390182 · Cited by 195
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“Furthermore, the anti-TNF and IL-10 agents were applied in clinical osteoarthritis therapy [8, 48].”
BackgroundInfluentialAdipose tissue is a critical regulator of osteoarthritis
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“This implicates a role for the IL-1 and IL-6/IL-12 family of cytokines in protection and susceptibility to OA, which have been postulated as key therapeutic target networks for OA (36).”
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Metadata
- Authors
- Kapoor, M., Martel-Pelletier, J., Lajeunesse, D., Pelletier, J.-P., & Fahmi, H.
- Affiliations
- Hôpital Notre-Dame (CA)
- Venue
- Nature Reviews Rheumatology
- Published
- 2010-11-30
- Volume
- 7
- Issue
- 1
- Pages
- 33-42
- ISSN
- 1759-4790 (ISSN-L)
- 1759-4804
- OpenAlex
- W2038773696
- Cited by
- 2,778
- References
- 120
- Citations by year
- 2026: 207 · 2025: 232 · 2024: 252 · 2023: 271 · 2022: 249 · 2021: 252 · 2020: 234 · 2019: 199 · 2018: 175 · 2017: 141 · 2016: 145 · 2015: 128 · 2014: 106 · 2013: 83 · 2012: 73
- FWCI
- 7.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Rheumatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Proteoglycans and glycosaminoglycans research
- Keywords
- osteoarthritis, inflammatory cytokines, IL-1β, TNF-α, interleukin-6, cartilage degeneration, subchondral bone remodeling, synovitis, anti-cytokine therapy, IL-17, IL-18, IL-21, leukemia inhibitory factor, interleukin-8
- MeSH terms
- Cartilage, Articular, Humans, Osteoarthritis, Tumor Necrosis Factor-alpha, Interleukin-6, Disease Progression, Interleukin-1beta
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