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      Mechanism of Traditional Chinese Medicine in Treating Knee Osteoarthritis

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          Abstract

          Knee osteoarthritis (KOA) is a degenerative disease, making a unique contribution to chronic pain, edema, and limited mobility of knee joint. Traditional Chinese Medicine (TCM) is a common complementary therapy for KOA and has been found effective. The aim of this review is to consolidate the current knowledge about the mechanism of four interventions of TCM: acupuncture, moxibustion, herbs, and massage in treating KOA, and how they alleviate symptoms such as pain, swelling, and dysfunction. Furthermore, this review highlights that four therapies have different mechanisms but all of them can manage KOA through inhibiting inflammation, which indicates that alternative therapies should be considered as a viable complementary treatment for pain management in clinical practice.

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          Most cited references 87

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          The Role of Inflammatory and Anti-Inflammatory Cytokines in the Pathogenesis of Osteoarthritis

          Osteoarthritis (OA) is the most common chronic disease of human joints. The basis of pathologic changes involves all the tissues forming the joint; already, at an early stage, it has the nature of inflammation with varying degrees of severity. An analysis of the complex relationships indicates that the processes taking place inside the joint are not merely a set that (seemingly) only includes catabolic effects. Apart from them, anti-inflammatory anabolic processes also occur continually. These phenomena are driven by various mediators, of which the key role is attributed to the interactions within the cytokine network. The most important group controlling the disease seems to be inflammatory cytokines, including IL-1 β , TNF α , IL-6, IL-15, IL-17, and IL-18. The second group with antagonistic effect is formed by cytokines known as anti-inflammatory cytokines such as IL-4, IL-10, and IL-13. The role of inflammatory and anti-inflammatory cytokines in the pathogenesis of OA with respect to inter- and intracellular signaling pathways is still under investigation. This paper summarizes the current state of knowledge. The cytokine network in OA is put in the context of cells involved in this degenerative joint disease. The possibilities for further implementation of new therapeutic strategies in OA are also pointed.
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            Epidemiology of osteoarthritis

             Ernest Vina,  C Kwoh (2018)
            The purpose of this review is to highlight recent studies of osteoarthritis epidemiology, including research on prevalence, disease impact, and potential risk factors.
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              The Role of Changes in Extracellular Matrix of Cartilage in the Presence of Inflammation on the Pathology of Osteoarthritis

              Osteoarthritis (OA) is a degenerative disease that affects various tissues surrounding joints such as articular cartilage, subchondral bone, synovial membrane, and ligaments. No therapy is currently available to completely prevent the initiation or progression of the disease partly due to poor understanding of the mechanisms of the disease pathology. Cartilage is the main tissue afflicted by OA, and chondrocytes, the sole cellular component in the tissue, actively participate in the degeneration process. Multiple factors affect the development and progression of OA including inflammation that is sustained during the progression of the disease and alteration in biomechanical conditions due to wear and tear or trauma in cartilage. During the progression of OA, extracellular matrix (ECM) of cartilage is actively remodeled by chondrocytes under inflammatory conditions. This alteration of ECM, in turn, changes the biomechanical environment of chondrocytes, which further drives the progression of the disease in the presence of inflammation. The changes in ECM composition and structure also prevent participation of mesenchymal stem cells in the repair process by inhibiting their chondrogenic differentiation. This review focuses on how inflammation-induced ECM remodeling disturbs cellular activities to prevent self-regeneration of cartilage in the pathology of OA.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                JPR
                jpainres
                Journal of Pain Research
                Dove
                1178-7090
                15 June 2020
                2020
                : 13
                : 1421-1429
                Affiliations
                [1 ]Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation , Beijing, People’s Republic of China
                [2 ]Graduate School, Beijing University of Chinese Medicine , Beijing 100029, People’s Republic of China
                [3 ]Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences , Beijing, People’s Republic of China
                [4 ]School of Health and Biomedical Sciences, RMIT University , Melbourne, Victoria, Australia
                [5 ]School of Biological Sciences, Nanyang Technological University , Singapore 637551
                [6 ]Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Biomedicum , Stockholm SE-17177, Sweden
                [7 ]Department of Neurology, Beth Israel Deaconess Medical Centre and Harvard Medical School , Boston, MA, USA
                [8 ]Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine , Beijing, People’s Republic of China
                Author notes
                Correspondence: Bin Li Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation , Beijing, People’s Republic of ChinaTel +86 18910781852 Email libin@bjzhongyi.com
                Article
                247827
                10.2147/JPR.S247827
                7304682
                © 2020 Wang et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Tables: 1, References: 97, Pages: 9
                Funding
                Funded by: China National Natural Science Foundation
                Funded by: China Postdoctoral Science Foundatio
                Funded by: Beijing Hospitals Authority Youth Programme
                Funded by: Beijing Municipal Science & Technology Commission
                Funded by: Beijing Traditional Chinese Medicine Science and Technology
                Funded by: Beijing Municipal Hospital Authority-Beijing Municipal Hospital Scientific research and training program
                Funded by: Beijing Traditional Chinese Medicine Administration-Standardized construction
                This study was funded by the National Key Research and Development Plan (2019YFC1709703), 2019 National Administration of Traditional Chinese-Project of building evidence based practice capacity for TCM-Project BEBPC-TCM (NO. 2019XZZX-ZJ002), Beijing Traditional Chinese Medicine Science and Technology Project (Grant No. JJ2018-53), China Association for Science and Technology Young Talent Lifting Project (2019-2021ZGZJXH-QNRC001), Capital Health Development Scientific Research Project Excellent Young Talents (Capital development 2020-4-2236), Beijing Dongcheng District Excellent Talent Development Funding (2019WJGW-10-05), China Postdoctoral Science Foundation Funded Project (2018M630261), Beijing Hospitals Authority Youth Programme (QML20181001), and Beijing Traditional Chinese Medicine Administration-Innovative and Inheritable “Fist” Construction Projects of Yanjing School.
                Categories
                Review

                Anesthesiology & Pain management

                knee osteoarthritis, acupuncture, moxibustion, herbs, massage

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