To summarize the current understanding of non-coding RNAs (ncRNAs) in the pathogenesis of osteoarthritis (OA) and discuss their potential as biomarkers and therapeutic targets in clinical applications.
Approach:
Overview of ncRNAs: The article reviews the roles of microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs) in OA, focusing on their mechanisms of action, involvement in key signaling pathways, and potential clinical applications.
Key Findings:
miR-140-5p is the most validated cartilage-protective miRNA, suppressing ADAMTS5-mediated extracellular matrix degradation.
Other miRNAs like miR-146a, miR-21, and miR-34a regulate inflammatory signaling and chondrocyte survival.
Many lncRNAs and circRNAs lack extensive validation in primary human OA tissues.
Circulating ncRNAs show promise as minimally invasive biomarkers for OA, but current studies face methodological limitations.
Interpretation:
ncRNAs are critical regulators in OA pathogenesis and hold potential as biomarkers and therapeutic targets.
Limitations:
Current biomarker studies are limited by methodological heterogeneity and small cohort sizes.
Many ncRNAs lack extensive validation in primary human OA tissues.
Challenges in delivery efficiency and long-term safety of ncRNA-based therapeutics remain.
Conclusion:
ncRNAs represent promising molecular regulators and potential therapeutic targets for OA.
In a UK cohort, patients with osteoarthritis who initiated centrally acting analgesics had a higher hazard of knee or hip replacement than those who initiated SSRIs, though residual confounding by pain severity remains a key limitation.
Two single-injection cross-linked hyaluronic acid formulations showed no statistically significant advantage over saline for pain or functional outcomes through 24 weeks.