Scientists investigating the genes involved in osteoarthritis have identified new links with inflammation and pain sensitisation.
Osteoarthritis involves pain that is thought to arise from structures in the arthritic joint, contributing to the pain and reduced function. Recently there has been an interest in the importance of bone marrow lesions in relation to pain in osteoarthritis.
A team from St George’s, University of London, UK, examined the ways bone marrow lesions are linked to angiogenesis, fibrosis, new cartilage formation and increased bone turnover.
They carried out whole transcriptomic analysis of bone marrow lesions. This highlighted "upregulated expression of genes involved in neurogenesis, pain sensitisation, cell signalling as well as cartilage remodelling pathways".
In Annals of Rheumatic Diseases on Monday (17 July), the authors report that they recruited 84 participants with osteoarthritis, 72 of whom had advanced disease, and 14 healthy comparable people.
They found that in bone marrow lesions, "bone marrow volume was starkly reduced being replaced by dense fibrous connective tissue, new blood vessels, hyaline cartilage and fibrocartilage".
Microarray found a significant difference in expression of 218 genes in bone marrow lesions of patients, versus healthy participants.
"Bone marrow lesions demonstrated areas of high metabolic activity expressing pain sensitisation, neuronal, extracellular matrix and proinflammatory signalling genes that may explain their strong association with pain," they conclude.
Lead author Dr Nidhi Sofat said: "Our study has found that a number of new genes not previously linked to arthritis are found in bone marrow lesions and may be driving the pain and stiffness that patients suffer from. This may help us to develop ways of understanding the disease and combat it in the future.
"The cause of pain in osteoarthritis is not fully understood so any clues we come across is a step nearer to developing new improved treatments."
Kuttapitiya, A. et al. Microarray analysis of bone marrow lesions in osteoarthritis demonstrates upregulation of genes implicated in osteochondral turnover, neurogenesis and inflammation. Annals of Rheumatic Diseases 17 July 2017; doi: 10.1136/annrheumdis-2017-211396 [abstract]
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