Emerging targets in osteoarthritis therapy

• Different OA etiologies present a challenge for developing a single targeted therapy.
• Common mechanisms occur in inflammatory, mechanical, and oxidative stress in OA.
• Microinflammation, loss of autophagy, and angiogenesis indicate new targets.

Osteoarthritis (OA) is a destructive joint disease in which the initiation may be attributed to direct injury and mechanical disruption of joint tissues, but the progressive changes are dependent on active cell-mediated processes that can be observed or inferred during the generally long time-course of the disease. Based on clinical observations and experimental studies, it is now recognized a that it is possible for individual patients to exhibit common sets of symptoms and structural abnormalities due to distinct pathophysiological pathways that act independently or in combination. Recent research that has focused on the underlying mechanisms involving biochemical cross talk among the cartilage, synovium, bone, and other joint tissues within a background of poorly characterized genetic factors will be addressed in this review.