Lipid metabolic reprogramming in osteoarthritis: cartilage-centered mechanisms, whole-joint interactions, and therapeutic challenges
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By
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Kai Xu
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Junchen Li
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Genghong Wang
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Jing Lin
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Ji Li
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June 29, 2026
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Clinical Scorecard: Reprogramming of Lipid Metabolism in Osteoarthritis: Mechanisms Involving Cartilage, Joint Interactions, and Therapeutic Obstacles
At a Glance
| Category | Detail |
|---|
| Condition | Osteoarthritis (OA) |
| Key Mechanisms | Lipid metabolic dysregulation, including cholesterol dysregulation and fatty-acid lipotoxicity. |
| Target Population | Individuals with osteoarthritis, particularly those with metabolic dysfunction. |
| Care Setting | Clinical and experimental settings focusing on joint health and metabolic interactions. |
Key Highlights
- OA is characterized by cartilage damage, synovitis, and subchondral bone remodeling.
- Lipid metabolism disturbances contribute to OA susceptibility and disease progression.
- Key pathways include the CH25H-CYP7B1-RORα axis and mitochondrial oxidative injury.
- Lipid overload and chronic inflammation can amplify proinflammatory responses.
- Current evidence supports metabolic stratification in OA.
Guideline-Based Recommendations
Diagnosis
- Consider lipidomic profiling to assess OA severity and metabolic status.
Management
- Explore lipid-targeted strategies such as statins and nutritional interventions.
Monitoring & Follow-up
- Monitor circulating lipid alterations in relation to tissue-specific mechanisms.
Risks
- Be aware of the potential for lipid peroxidation and ferroptotic cell death in OA.
Patient & Prescribing Data
Patients with osteoarthritis, particularly those with obesity and metabolic syndrome.
Lipid-targeted interventions may be beneficial for specific patient subsets.
Clinical Best Practices
- Integrate metabolic assessments into OA management plans.
- Evaluate the role of adipose tissue in joint health and disease progression.
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