Document Detail

Angiogenesis in osteoarthritis and spondylosis: successful repair with undesirable outcomes.
MedLine Citation:
PMID:  15314503     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Osteoarthritis and spondylosis are frequently described as "wear-and-tear" arthritis, apparently contradicting modern management, which focuses on continuing and progressive exercise. Laboratory findings, including the growth of new blood vessels, encourage comparisons with repair processes. This review aims to place recent evidence in the context of previous work emphasizing the dynamic nature of tissues in these conditions. RECENT FINDINGS: Synovitis has now become recognized as a common and important feature of osteoarthritis, and vascular growth is enhanced in osteoarthritic synovia when infiltrating macrophages generate angiogenic factors. As the molecular balance between angiogenic and antiangiogenic factors is disturbed, new blood vessels are permitted to grow into normally avascular structures, such as the articular cartilage and intervertebral disc. Angiogenesis is a key factor in new bone formation in osteophytes and at the osteochondral junction, thereby contributing to radiologic disease progression. Innervation of new blood vessels may contribute importantly to chronic pain. SUMMARY: Reconceptualizing osteoarthritis and spondylosis as reparative processes provides a pathologic model consistent with current advice to exercise, when exercise facilitates repair. Repair does not, however, lead to normal tissue, and understanding the mechanisms by which changes in joint innervation may occur as a consequence of angiogenesis should lead to novel therapies that alleviate the common symptoms of these highly prevalent conditions.
David A Walsh
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in rheumatology     Volume:  16     ISSN:  1040-8711     ISO Abbreviation:  Curr Opin Rheumatol     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-17     Completed Date:  2004-11-30     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9000851     Medline TA:  Curr Opin Rheumatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  609-15     Citation Subset:  IM    
Copyright Information:
Copyright 2004 Lippincott Williams & Wilkins
Academic Rheumatology, University of Nottingham, UK.
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MeSH Terms
Cartilage, Articular / blood supply
Intervertebral Disk / blood supply
Joints / innervation
Low Back Pain / etiology,  pathology,  physiopathology
Neovascularization, Pathologic*
Osteoarthritis / pathology*,  physiopathology
Osteogenesis / physiology
Recovery of Function
Spinal Osteophytosis / pathology*,  physiopathology

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