Ion channels in osteoarthritis: emerging roles and potential targets.

Osteoarthritis (OA) is a highly prevalent joint disease that causes substantial disability, yet effective approaches to disease prevention or to the delay of OA progression are lacking. Emerging evidence has pinpointed ion channels as pivotal mediators in OA pathogenesis and as promising targets for disease-modifying treatments. Preclinical studies have assessed the potential of a variety of ion channel modulators to modify disease pathways involved in cartilage degeneration, synovial inflammation, bone hyperplasia and pain, and to provide symptomatic relief in models of OA. Some of these modulators are currently being evaluated in clinical trials. This review explores the structures and functions of ion channels, including transient receptor potential channels, Piezo channels, voltage-gated sodium channels, voltage-dependent calcium channels, potassium channels, acid-sensing ion channels, chloride channels and the ATP-dependent P2XR channels in the osteoarthritic joint. The discussion spans channel-targeting drug discovery and potential clinical applications, emphasizing opportunities for further research, and underscoring the growing clinical impact of ion channel biology in OA. Ion channels have key functions in chondrocytes, bone cells, immune cells and neurons. Liu and colleagues discuss how these functions might contribute to cartilage degeneration, bone formation inflammation and pain in osteoarthritis, and highlight the therapeutic potential of ion channel modulators. Key points: Ion channels have key functions in the joints and emerge as important contributors to pathogenic processes in osteoarthritis (OA). Dysregulation of mechanical and biochemical stimuli activates ion channels such as TRPV4 and Piezo channels, leading to Ca2+ and Na+ influx, which contributes to cartilage destruction, inflammation and pain in OA. Some ion channels typically associated with peripheral neurons are also expressed in chondrocytes and immune cells, and have a crucial role in the pathophysiology of OA. Exploration of ion channel expression, interactions, and properties in joints, along with development of specific channel agonists and antagonists, has helped to accelerate research on their potential roles in OA. Several ion channel modulators have been recently tested in animal models and patients with OA, with encouraging results. Targeting of ion channels holds promise for the development of new and more effective OA treatment strategies. [ABSTRACT FROM AUTHOR]