Mecanismos de dor envolvidos na osteoartrite: uma revisão sistemática

Abstract

In view of the population aging process, there is an increase in chronic pathologies, including osteoarthritis (OA). This disease is characterized as a degenerative pathology of multifactorial etiology, causing pain and functional disability. Objective: To search in the literature which are the main mediators/biological markers related to pain in OA. Methodology: A systematic review of the literature was conducted using the Medline, Pubmed, Web of Science, Virtual Health Library and ScienceDirect databases from 2011 to 2021. Thirty-two articles containing clinical trials, animal trials or reviews addressing the relationship of OA pain and its respective markers/biological mediators involved in this process were selected. Results: Based on the analysis of the studies, it was clear the relationship of neurotrophins nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) and glial cell-derived neurotrophic factor (GDNF), as well as interleukins, mainly TNF-alpha and IL-6, throughout the pain process of the pathology, prospecting an increase in the level of neurotrophins and a direct involvement of interleukins in inflammatory cascades at the joint level (SNP), in the same way in the CNS, with the contribution of microglia and astrocytes in the maintenance of neuropathic pain. The identification of all these biological events during the course of the disease may facilitate better pain management. Conclusion: Numerous biological mediators and inflammatory markers are involved in the genesis of pain, offering new targets for the development of analgesic therapies and consequently new treatments for the disease, since this is the main clinical symptom of OA. Thus, understanding the biochemical and physiological mechanisms of how pathology occurs allows us to think about more effective therapeutic strategies.