Exploring kartogenin: advances in therapeutics and signaling mechanisms for musculoskeletal regeneration

Kartogenin (KGN) is a small synthetic heterocyclic molecule with chondrogenic and chondroprotective effects. Since its discovery, there has been a focus on regenerating cartilage damage and treating Osteoarthritis) OA(. In the treatment of OA, it's important to target both cartilage and subchondral bone. KGN appears to reduce cartilage degradation and changes in subchondral trabecular bone. It can also reduce inflammation and pain behavior in vitro and in vivo. Additionally, KGN promotes chondrocyte differentiation and proliferation. It has been applied in many regenerative research fields including aesthetic procedures, limb skeletal growth, wound healing, tendon and bone regeneration and disc regeneration. KGN is similar to the natural ligands involved in cell signaling and differentiation. The master regulator of cartilage genes, Sex‑determining region‑box 9 protein (SOX9), is upregulated by KGN, making it an ideal drug to promote cartilage repair. Advantages of KGN include demonstrated low toxicity across various cell types and no apparent adverse effects in animals. It is highly stable, easily stored at room temperature, and can be synthesized inexpensively and efficiently. Analogues of KGN have entered clinical trials.