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12-09-2018 | Osteoarthritis | Review | Article

Modern-day environmental factors in the pathogenesis of osteoarthritis

Journal: Nature Reviews Rheumatology

Authors: Francis Berenbaum, Ian J. Wallace, Daniel E. Lieberman, David T. Felson

Publisher: Nature Publishing Group UK

Abstract

The prevalence of osteoarthritis (OA) is rising for reasons that are not fully understood. In this Opinion article, we review the possibility that OA is an evolutionary mismatch disease, which is a disease more common today than in the past because genes inherited from previous generations are inadequately or imperfectly adapted to modern environmental conditions. We focus on four major environmental factors in OA pathogenesis that have become ubiquitous within the past half-century: obesity, metabolic syndrome, dietary changes and physical inactivity. Because a cure for OA does not yet exist, prevention strategies that target these modifiable environmental factors are needed to curb further increases in OA prevalence.

Adaptation

A phenotypic trait favoured by natural selection because it improves an organism’s ability to survive and reproduce.

Developed nations

Wealthy countries with post-industrial economies and advanced technological infrastructure.

Hunter–gatherers

People who subsist on foraged wild plants and hunted wild animals, in contrast to agriculturalists who subsist mainly on domesticated plants and animals.

Knee adduction moments

Dynamic rotational forces (torques) that act on the knee in the coronal plane, applying a compressive force to the medial side of the knee.

Kellgren−Lawrence score

A common method of classifying the severity of knee osteoarthritis using radiography.

Mechaflammation

Focal inflammation owing to a local mechanical insult.

Metaflammation

Chronic, low-grade, metabolic and systemic inflammation.

Varus malalignment

A deformity of the knee in which the distal leg is angled medially in relation to the axis of the thigh, resulting in a bowlegged appearance.

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Medicine Matters Rheumatology

Abstract