“…Thus, these studies also provided compelling evidence that the pro- and anti-inflammatory cytokines, tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), IL-4, IL-6, IL-15, IL-10, IL-13, IL-15, IL-17, IL-18, IL-21, as well as chemokines, such as monocyte chemotactic protein-1 (MCP-1), fractalkine and IL-8, transcription factors, such as NF-κB and NFAT1, members of the bone morphogenetic protein family including the BMP, WNT, GREM1, FRZB and DKK1 genes, growth factors, such as transforming growth factor-β, vascular endothelial growth factor, and epidermal growth factor [20, 21], leukemia inhibitory factor [22, 23], hormonally-stimulated pain pathways, and OA susceptibility genes, such as GDF5 , all appear to be vital components germane to the OA process [24–38]. Thus, it is likely that further understanding of how a balance between the pro-inflammatory and anti-inflammatory cytokine repertoire is maintained will not only reveal the complexity inherent in regulating the destruction of synovial joints in OA, but will also be instructive for designing interventional strategies that would have been completely ignored 20 or more years ago.…”