A new perspective on the mechanism exploration and treatment of osteoarthritis

Osteoarthritis (OA) has long been defined as the progressive and irreversible loss of articular cartilage, a tissue known for its poor intrinsic regenerative capacity. The currently popular treatment strategies are palliative care or joint prosthesis replacement in end-stage diseases. However, the discovery of the resident population of cartilage progenitor cells (CPCs) within adult articular cartilage fundamentally challenges the long-held view that adult articular cartilage has limited intrinsic repair capacity. These cells possess clonogenicity, multipotency, and chondrogenic differentiation ability, and are potential repositories for tissue maintenance and repair. This view holds that the failure of OA cartilage is not merely a failure of matrix integrity, but more importantly, it is a failure of the endogenous progenitor cell system. In addition, mechanical stimulation and metabolic factors are both crucial for cartilage regeneration and repair as well as the determination of the fate of progenitor cells. With the rise of nucleic acid therapy, we can envision that gene therapy and stem/progenitor cell therapy will shift their therapeutic goals from slowing down degeneration to promoting true regeneration.