Can metabolic profiling provide a new description of osteoarthritis and enable a personalised medicine approach?

Abstract

Osteoarthritis (OA) is a multifactorial disease contributing to significant disability and economic burden in Western populations. The aetiology of OA remains poorly understood, but is thought to involve genetic, mechanical and environmental factors. Currently, the diagnosis of OA relies predominantly on clinical assessment and plain radiographic changes long after the disease has been initiated. Recent advances suggest that there are changes in joint fluid metabolites that are associated with OA development. If this is the case, biochemical and metabolic biomarkers of OA could help determine prognosis, monitor disease progression and identify potential therapeutic targets. Moreover, for focussed management and personalised medicine, novel biomarkers could sub-stratify patients into OA phenotypes, differentiating metabolic OA from post-traumatic, age-related and genetic OA. To date, OA biomarkers have concentrated on cytokine action and protein signalling with some progress. However, these remain to be adopted into routine clinical practice. In this review, we outline the emerging metabolic links to OA pathogenesis and how an elucidation of the metabolic changes in this condition may provide future, more descriptive biomarkers to differentiate OA subtypes.

Changes in the Serum Metabolome in an Inflammatory Model of Osteoarthritis in Rats

“…Lipid molecules were found at T0 vs. T28 and T0 vs. T84. These possible biomarkers were related to the findings of several studies, where there is an alteration of lipid metabolism associated with OA due to its pro-inflammatory properties [22][23][24]39,40]. Kosinska et al detected alterations at the level of phospholipids and sphingolipids at different stages of the disease in synovial fluid [41][42][43].…”

“…For this reason, it has become an ideal method for the identification of OA biomarkers in a variety of biological samples. Different studies have reported several metabolites and metabolic pathways that can be altered in OA, such as amino acid metabolism, fatty acid and lipid metabolism, phospholipids, arginine, phosphatidylcholine, L-tryptophan, tyrosine, carnitine, and arachidonic acid [ 1 , 2 , 4 , 10 , 20 , 21 , 22 , 23 , 24 , 25 ]. In order to identify biomarkers, one must go to the metabolic pathways that affect amino acid metabolism.…”

Effects of quercetin on apoptosis and extracellular matrix degradation of chondrocytes induced by oxidative stress‐mediated pyroptosis

“…Its clinical manifestations are the slow development of joint pain, stiffness, joint swelling, limited activity, and joint deformity. [26] The pathogenesis of OA is complex.…”

Changes in the Serum Metabolome in an Inflammatory Model of Osteoarthritis in Rats

“…For this reason, it has become an ideal method for the identification of OA biomarkers in a variety of biological samples. Different studies have reported several metabolites and metabolic pathways that can be altered in OA, such as amino acid metabolism, fatty acid and lipids metabolism, phospholipids, arginine, phosphatidylcholine, L-tryptophan, tyrosine, carnitine, and arachidonic acid [1,2,4,9,[14][15][16][17][18][19].…”