Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (14): 2252-2258.doi: 10.3969/j.issn.2095-4344.3796

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Potential of Nel-like molecule 1 to treat osteoarthritis by promoting cartilage formation and             anti-inflammatory effects 

Tang Xiaokai, Li Weiming   

  1. First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
  • Received:2020-04-03 Revised:2020-04-14 Accepted:2020-05-13 Online:2021-05-18 Published:2020-12-31
  • Contact: Li Weiming, MD, Chief physician, First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
  • About author:Tang Xiaokai, Master candidate, First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
  • Supported by:
    China Postdoctoral Science Foundation, No. 2016M601449 (to LWM)

Abstract: BACKGROUND: Osteoarthritis is a complex total joint disease. The main affected joint is the knee joint, followed by the hand and hip joints. Treatments for osteoarthritis mainly focus on the relief of pain symptoms. Unfortunately, no drugs can stop the progression of the disease until now. Recently, an osteogenic protein with the characteristics of promoting cartilage formation, anti-inflammatory, anti-fat, and vascularization. Nel-like molecule 1 (Nell-1) has attracted researchers’ attentions. Because of its dual functional properties of promoting cartilage production and anti-inflammation, Nell-1 is expected to become a drug for improving the condition of osteoarthritis.
OBJECTIVE: To review the pathogenesis of osteoarthritis, ability of Nell-1 to promote chondrogenesis and its molecular cascade signals, anti-inflammatory effects of Nell-1 and its molecular mechanism, Nell-1’s deficiencies in the treatment of osteoarthritis and the latest clinical application of Nell-1, thereby providing new ideas for the treatment of osteoarthritis.
METHODS: CNKI and PubMed were retrieved for articles tightly related to Nell-1 and osteoarthritis with an impact factor > 3 using the keywords of “Nell-1 AND Osteoarthritis,” and “Osteoarthritis” in Chinese and English, respectively. The time range for literature retrieval was from January 1995 to March 2020. Finally, 88 articles were included for review.
RESULTS AND CONCLUSION: With the aging of population and increasing of obesity, osteoarthritis is more common than it was a few decades ago, thus leading to a heavier family and socioeconomic burden. Traditional analgesic methods cannot be used as curative treatments because they cannot reduce inflammation and cartilage damage. It is helpful for a clinical orthopedist to develop a more effective treatment protocol by fully understanding the pathogenesis, disease progression and outcome of osteoarthritis, and initiating multidisciplinary discussions involving biological technology, pharmacology, and molecular biology related to genetic engineering and tissue construction. The ultimate goal of an effective treatment protocol is to relieve the suffering of osteoarthritis patients and to reduce the financial burden of individuals and the society. Although the emerging role of Nell-1 in the pathogenesis of osteoarthritis is still in its infancy, there are still some limitations, including a lack of the best route of administration, incomplete understanding of relevant molecular mechanisms, and no optimal animal models. However, Nell-1 has a great potential in the treatment of osteoarthritis as a result of its dual effects of anti-inflammation and promoting cartilage production. Future research should reveal detailed potential mechanisms, and optimize the dosage, regimen, and method of Nell-1 administration, with an attempt to translate Nell-1’s therapeutic potential for osteoarthritis into clinical practice.

Key words: bone, arthritis, cartilage, regeneration, anti-inflammation, factor, review

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