運動器の要：軟骨疾患の病態と治療

Analysis of Musculoskeletal Systems and Their Diseases. Pathophysiology of articular cartilage and its new therapeutic targets.

　軟骨疾患が進行した変形性関節症（OA）は多様な原因によって発生する疾患群である。現在までのところOA治療にエビデンスの高い薬物療法は開発されていない。近年，OAと生活習慣病との関連やOA病態での軟骨以外の関節組織の関与が多くの疫学研究や基礎研究で明らかになっている。これらのトピックを紹介して新しいOA治療ターゲットを展望する。また臨床において長らく使用されているヒアルロン酸の関節内注入の臨床評価の問題点を検証し，今後のOA薬物療法の評価方法について考察する。

　Osteoarthritis（OA）is a group of heterogenetic disorders occurring due to a variety of causes, resulting in cartilage degeneration and finally in cartilage loss. No conservative drug therapy with high-quality evidence in terms of OA treatment has been developed as of yet. In recent years, the relation between OA and lifestyle related diseases along with the involvement of joint tissues other than the cartilage is becoming clarified through many epidemiological studies and basic researches. These topics are introduced in order to put new OA therapeutic targets into perspective. Moreover, problems in the evaluation for intraarticular injection of hyaluronic acid, which is a drug therapy used in medical practice for long term, are investigated and a discussion is carried out on the evaluation method of future drug therapies for OA.