Inflammation in osteoarthritis: Our view on its presence and involvement in disease development over the years

Abstract

Inflammation, both locally in the joint and systemic, is nowadays considered among the mechanisms involved in osteoarthritis (OA). However, this concept has not always been generally accepted. In fact, for long OA has been described as a relatively simple degeneration of articular cartilage as the result of wear and tear only. In this narrative review, we present what our understanding of OA was at the time of the inaugural release of Osteoarthritis and Cartilage about 30 years ago and discuss a set of pivotal papers that changed our view on the role of inflammation in OA development. Furthermore, we briefly discuss the current view on the involvement of inflammation in OA. Next, we use the example of transforming growth factor-β signaling to show how inflammation might influence processes in the joint in a manner that is beyond the simple interaction of ligand and receptor leading to the release of inflammatory and catabolic mediators. Finally, we discuss our view on what should be done in the future to bring the field forward.

Keywords: Inflammation; Osteoarthritis; Pain; Pathology; Synovitis.