Cytokines in osteoarthritis-current status on the pharmacological intervention

Cytokines and their broad spectrum of effects have been investigated since the 1980s. The already existing preliminary scientific results have been highly suggestive of the idea that cytokines play an essential role in the pathogenesis of OA. Nevertheless, the extent to which cytokines participate in the origin of OA, or are taken as a consequence of the OA process, remain unanswered questions. Unlike the case with rheumatoid arthritis, studies on the application of anti-cytokine medications with OA remain in their infancy. At the present time no clinical studies relating to OA have confirmed that anti-cytokine medications are antiphlogistically effective and/or prevent the origin of morphologically recognizable cartilage defects or at least decelerate the increasing destruction of joint cartilage. As with every other therapeutic approach the risk-benefit scenario is decisive for deciding on the current application of anti cytokine medications for rheumatoid arthritis as well as their potential future use against OA. Considering the long-term consequences of an anti-cytokine based therapy, our poor state of knowledge should be seen in a very critical light, since the discussed approach represents an immunesuppressive therapy that entails consequences with regard to defence against infections and tumour suppression. Also, little is currently known about the interplay between pro- and anti-inflammatory cytokines and growth factors in OA; the resulting specific and fundamental therapeutic possibilities for performing a structure-modifying basic therapy in OA are worthy of further study on the part of academic and industrial institutions.