Tackling osteoarthritis by understanding its inner workings

Understanding osteoarthritis: how the condition develops and affects joints

To tackle a disease such as osteoarthritis, it is important to understand first its inner workings. Osteoarthritis affects around 10 million people in the UK, yet existing therapies only partially reduce symptoms and no cure exists. Through team science, this Centre is leading research to unpick this disease, the Centre is bringing new medicines closer to those affected. With £4.5 million of investment from Arthritis UK, their research is helping to unlock the origins of osteoarthritis, identify novel ‘markers’ which indicate disease risk, and develop new therapies for people with osteoarthritis. 

Read about their successes to date in our Impact Report here: Arthritis UK Centre for Osteoarthritis Pathogenesis Impact Report

What is osteoarthritis?

An active, biologically driven disease that affects the joints and their normal joint repair systems. Research from this Centre has also shown that osteoarthritis is one variable disease with a common core biology, rather than multiple conditions. They are helping to dispel other myths about the disease such as:

1. Myth: Exercise wears down joints and worsens osteoarthritis. Centre research supports the fact that keeping active helps maintain cartilage health as we get older.
2. Myth: Cartilage can’t repair itself and this explains why it breaks down as we age. Centre research has discovered that cartilage can repair itself throughout our lives. It even happens in people with advanced osteoarthritis.

Practical management strategies for hand osteoarthritis

Centre researchers have prepared 10 top tips for clinicians to help them support people with hand osteoarthritis. These are:

1. Make a clear diagnosis of hand osteoarthritis
2. Give positive, accurate messages about what to expect from osteoarthritis
3. Explain that osteoarthritis is mechanically driven by an active cellular process
4. Consider if there is another concurrent condition (and treat it)
5. Advise hand exercises to all people with hand osteoarthritis
6. Identify ways to mechanically offload the hand joints
7. Consider analgesics when there is pain uncontrolled by other means
8. Think about the life course and sex-specific factors
9. Treat a flare of osteoarthritis like a soft tissue injury
10. Avoid suggesting a ‘single solution’

Finding new potential targets

Centre researchers have found several promising new targets that restore cartilage health while also easing symptoms. Two potential targeting molecules that have progressed furthest along the development pipeline are:

• Retinoic acid, a derivative of vitamin A that suppresses injury-induced inflammation in cartilage.  
• Agrin, a molecule that activates resident stem cells within the joint and promotes the formation of new cartilage by switching on repair pathways that are normally lost during osteoarthritis. From this discovery, a powerful new technology is being developed and a spin-out company called ReFleks has been formed.