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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: If good things come from above, do bad things come from below? | Findlay Arthritis Research Therapy 2010 12 119 http arthritis-research.eom content 12 3 119 EDITORIAL L_ If good things come from above do bad things come from below David M Findlay See related research by Tanamas etal. http arthritis-research.eom content 12 2 R58 Abstract Factors in the synovial fluid that maintain healthy articular cartilage such as hyaluronic acid and l ubricin come from above. Is it possible that factors which lead to the destruction of cartilage come from below in the subchondral bone The recent acquisition of tools to probe early events in osteoarthritis is shedding new light on possible contributions from this compartment on the initiation and progression of the disease. Tanamas and co-workers now provide evidence that bone marrow lesions in the subchondral bone are predictive both of loss of cartilage and of formation of subchondral cysts. These data provoke questions about the nature and role of bone marrow lesions. Finding the factors that initiate or the mechanisms that lead to progression of osteoarthritis OA has proven frustrating and largely unproductive. Identification of risk factors for the condition - such as prior trauma to the joint elevated body weight and female sex - may have helped with management of OA but has done little to progress understanding of the underlying factors that drive it. OA research has been more difficult than research for some other diseases of the skeleton for several important reasons. Early OA at the level of symptoms can be episodic making it difficult to identify the disease and to follow it longitudinally. Since the main early symptom is pain clinical trials of new therapies have been problematic. Animal experiments have been bedevilled by a lack of models that accurately replicate the human disease. And perhaps as argued by a minority of workers in the field disease initiators have been sought in the wrong place that is cartilage versus bone. Correspondence david.findlay@adelaide.edu.au .
