Osteoarthritis Is a Low-Grade Inflammatory Disease: Obesity’s Involvement and Herbal Treatment

Abstract

Osteoarthritis (OA) is considered a major cause of disability around the globe. This handicapping disease causes important cartilage and bone alteration that is associated with serious pains and loss of joint function. Despite its frequent association with obesity, the aetiology of OA is not fully understood. In this review, the different aspects of OA and its correlation with obesity were analysed. Through examining different mechanisms by which obesity may trigger and/or exacerbate OA, we point out some relevant signalling pathways that may evolve as candidates for pharmacological drug development. As such, we also suggest a review of different herbal medicines (HMs) and their main compounds, which specifically interfere with the identified pathways. We have shown that obesity's involvement in OA is not only limited to the mechanical weight exerted on the joints (mechanical hypothesis), but also induces an inflammatory state by different mechanisms, including increased leptin expression, compromised gut mucosa, and/or gut microbiota disruption. The main signalling pathways involved in OA inflammation, which are associated with obesity, are protein tyrosine phosphatase 1B (PTP1B) and TLR4 or DAP12. Moreover, we also underline the contamination of plant extracts with LPS as an important factor to consider when studying HM's effects on articular cells. By summarizing recent publications, this review aims at highlighting newly established aspects of obesity involvement in OA other than the mechanical one.

Structural Characteristics and Functional Analysis of Gut Microbiome in Patients with Osteoarthritis

“…And the imbalance of gastrointestinal micro ora may be one of the main causes of obesity-related, lowlevel in ammation [28]. In our study, we also found that the enrichment of lipid metabolism, glycan biosynthesis and metabolism related genes in the OA group was signi cantly lower than that in HC group.…”

“…With the development of epidemiology and basic research, studies have reported that the low-level in ammatory and metabolic disorders may play important roles in the progression of osteoarthritis [27]. And the imbalance of gastrointestinal micro ora may be one of the main causes of obesity-related, lowlevel in ammation [28]. In our study, we also found that the enrichment of lipid metabolism, glycan biosynthesis and metabolism related genes in the OA group was signi cantly lower than that in HC group.…”

“…All participants were from the Orthopedic Department of the First A liated Hospital of Zhengzhou University. At the same time, the body mass index (BMI) of the two groups was calculated, the BMI of OA group was (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28), and that of healthy control group was (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). The diagnostic criteria of knee osteoarthritis are detailed in the table (Table 1 ).…”

Exploring the Crosstalk between Hydrostatic Pressure and Adipokines: An In Vitro Study on Human Osteoarthritic Chondrocytes

“…Obesity also increases the risk in developing OA in non-weight-bearing joints, ascribing a prominent role of metabolic factors in the OA pathogenesis [ 2 , 15 , 16 ]. Interestingly, obesity induces a low-grade chronic inflammatory state mainly through the production of inflammatory mediators, such as adipokines, cytokines, chemokines, and complement factors by white adipose tissue [ 17 ].…”

Effect of femoral posterior condyle offset on knee joint function after total knee replacement: a network meta-analysis and a sequential retrospective cohort study

“…Osteoarthritis (OA) is a kind of joint degenerative disease and often results in serious pains and loss of joint function, mainly afflicting the middle-aged and elderly population [ 1 , 2 ]. The disease has a complex and multifactorial epidemiology with genetic, biological, and biomechanical components [ 3 ].…”