Polysaccharide nanosystems for osteoarthritis therapy: Mechanisms, combinations, and future directions

Osteoarthritis (OA) represents a chronic degenerative joint ailment characterized by the gradual breakdown of cartilage, inflicting substantial physical and economic burdens, especially among the elderly. Given the incomplete understanding of OA's pathogenesis, there is an increasing need to develop targeted therapeutic strategies and preventive measures. Conventional pharmaceutical interventions, such as non-steroidal anti-inflammatory drugs, steroids, and opioids, though effective, are often accompanied by notable adverse effects, thus emphasizing the urgency in seeking safer and more efficient therapeutic alternatives. The rapid evolution of nanotechnology has opened the door to various nanosystems for drug delivery, offering a promising avenue to mitigate these side effects. Of particular interest, recent research has shed light on the significant potential of polysaccharide-based nanosystems in the context of OA therapy, demonstrating their capability to counter inflammation, oxidative stress, regulate chondrocyte metabolism and proliferation, and protect cartilage. Therefore, in this review, we provide an in-depth examination of the role of polysaccharide nanosystems in OA, focusing on summarizing these findings based on different mechanisms of action. Furthermore, this review explores the application of combined polysaccharide nanosystems in OA, aiming to establish a foundation for the utilization of novel drug delivery nanoplatforms in OA treatment, ultimately expanding therapeutic options for this debilitating condition.