In
Western Europe, more than 57 million people suffer from OA. Long considered a
“wear and tear” condition of the elderly, it is now known that OA is a highly
complex disease of the entire joint affecting a large proportion of the
population under the age of 65.
Typically
developing over time as a chronic disease, OA involves all tissues of the
joint, including the bone, ligaments, cartilage, fat, and the tissues lining
the joint. While any joint of the body can be affected, it is most frequently
caused in the knee, hand, and hip. Major symptoms include:
- Chronic pain
- Stiffness
- Swelling
- Limited flexibility and mobility
Clinically, OA is characterised by loss of articular cartilage,
remodelling of the bone, and associated inflammation besides affecting all
other tissues constituting a joint.
There is no cure for OA, and current treatment options are often costly
and inefficient. Hence, there is a pressing need to understand the causes and
underlying mechanisms of this degenerative disease to develop new, more
effective, and personalised therapies to both alleviate pain and slow down
disease progression. Even more so, since the severity of the condition varies
significantly from patient to patient. While some only face minor limitations
in their well-being and daily life, others are affected by severe pain
resulting in the need for continuous care.
Current
OA therapy recommendations range from non-drug measures to creams and pills or
injections, depending on the severity of OA pain. Surgery can be seen as the
“last” treatment option in case all other regimens have failed, or in case the
damage to the joint is so severe that no other therapy is possible. However,
all of these measures can only slow the progression of degenerative arthritis.
Plus, taking medications oftentimes shows only limited success, and at the same
time can lead to gastric complications and other potential adverse side
effects.
Research currently sees a paradigm shift in the understanding of OA from
considering it a purely mechanical disease caused by cartilage wear to a highly
complex pathology involving biomechanics, inflammation, and the immune system.
Thus, OA is a multifactorial and multi-tissue disease in which risk factors
such as age, sex, obesity, and genes play an important part.
In the face of poor OA treatment response and outcomes, recent treatment
strategies have drawn attention to gene therapy. The latter represents a
promising therapeutic pathway as it specifically targets disease-causing genes,
thus enabling a more individualised and patient-centric treatment approach. One
of the strands of gene-based, nanotherapeutic strategies is centred around
so-called small interfering RNA (siRNA).
Along this line of understanding, SINPAIN – an international project that includes 9 countries and 12 centers of investigation - seeks to advance RNA-based therapies for the treatment of OA in the knee, focusing on the use of siRNA. This specific nucleic acid modality, once introduced directly to a particular tissue of a patient, can silence disease-causing genes.
For more information please contact Grupo HPA Saude on +351 282 420 400