Osteoarthritis is counted among the osteoarticular diseases. It induces the degradation of cartilage which causes inflammation of the synovial membrane that surrounds it. Pain, loss of mobility, and sometimes inflammatory flare-ups are the price to pay for this pathology. But, beyond the management of pain, it seems that there are no basic treatments. A few perspectives are nevertheless under study.
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[EN VIDÉO] Osteoarthritis in the sights of targeted therapies The development of targeted therapies, supported by nanomedicine, could one fine day change the lives of ten million French people suffering from osteoarthritis. This joint disease remains incurable for the moment.
Usually located at the level of joints hand, knee, hip or spine, L’arthritis causes a loss of thickness of the cartilage. It cracks and eventually disappears. The mechanisms are poorly understood, but age is a risk factor major since 65% of over 65s are affected.
What are the current options for treating osteoarthritis?
The treatments are symptomatic. They aim to relieve without actually curing the pathology. NSAIDs, paracetamol and sometimes local injections of corticosteroids are the alternatives to pain when these drugs are tolerated by the patient.
Food supplements such as chondroitin sulfate which may be combined with glucosamine stimulating the production of cartilage exist, but these treatments are no longer covered by Health Insurance in view of their modest effect.
Other potential candidates such as monoclonal antibodies against NGF (nerve growth factor) seem to be effective against pain. The NGF, growth factor nervous, is a protein signaling pain produced by injured tissue. It reaches a high concentration in the joints witharthritis. Unfortunately, deleterious effects on the joint have been reported. According to FDA (Food and Drug Administration, US Pharmaceuticals Agency), which recently failed to provide marketing authorization, this treatment does not present an added value compared to the usual analgesics.
Infiltrations based onhyaluronic acid which consist in injecting a viscous product close to the composition of synovial fluid have controversial effectiveness. However, they reduce pain and allow prevention of worsening osteoarthritis.
In the end, it would seem that at present, there is no disease-modifying treatment capable of eradicating the disease.
New therapies for osteoarthritis in development
Because inflammation appears to be involved in the processes of cartilage breakdown, several molecules anti-inflammatory drugs are under evaluation. The same goes for new therapies intended to stimulate the production of cartilage by the chondrocytes (cells that produce cartilage).
Based on cell therapy, from stem cells greasy (adipocytes) are injected into the diseased joint to regenerate the cartilage. These cells have a great capacity for differentiation and immunomodulation. The European Adipoa project, led by the Montpellier University Hospital Center, is setting up clinical tests in this direction. The first published results are encouraging since joint administration of these stem cells attenuates thearthritis in an experimental rabbit model by promoting cartilage repair. In humans, the first phases of this study show that the treatment generates an anti-inflammatory response.
At present, therefore, there is still no effective treatment for osteoarthritis. Only prevention makes it possible to fight against this pathology by avoiding as much as possible the risk factors (overweight, metabolic disorders, sedentary lifestyle). In short, the activity physical still the best medicine.
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