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Involvement of Macrophages and Spinal Microglia in Osteoarthritis Pain

  • Chronic Pain (R Staud, Section Editor)
  • Published:
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Abstract

Purpose of Review

Chronic pain in osteoarthritis (OA) is characterized by pain sensitization, which involves both peripheral and central mechanisms. Studies suggest synovial macrophage and spinal microglia are implicated in pain sensitization in OA. We, therefore, reviewed the evidence of whether synovial macrophage and spinal microglia facilitated pain sensitization at diverse levels and how this event occurred in OA.

Recent Findings

Peripherally, joint inflammation is now believed to be a source of OA-related pain. Synovial macrophages accumulate in OA inflamed synovium and display a pro-inflammatory phenotype. Abundant macrophage-derived pro-inflammatory cytokines and other pain-causing substance facilitate hyperexcitation of primary sensory neuron in OA-related pain. Thus, activated synovial macrophage was considered a predictor for phenotyping of OA pain clinically. In response to affected joint-derived strong nociception, aberrant neuronal excitability is often associated with the hyperactivity of microglia in the spinal dorsal horn, thereby leading to central sensitization.

Summary

Hyperactivity of synovial macrophage and spinal microglia underlies the mechanisms of pain sensitization at the peripheral and central level in OA. This concept provides not only a clinically relevant strategy for identifying the phenotype of OA-related pain but also has the potential to develop individualized interventions for OA, particularly in those patients with hyperactivity of macrophage and microglia.

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Funding

This study was supported by Natural Science Foundation of China (No. 81703524).

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Authors and Affiliations

  1. Department of Anesthesiology, Pain Clinic, First Affiliated Hospital of USTC (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China

    Ting-ting Pan, Wei Gao & Di Wang

  2. Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia

    Feng Pan

  3. Institute of Clinical Pharmacology, Anhui Medical University, Hefei, 230032, China

    Shan-shan Hu

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  1. Ting-ting Pan
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  5. Di Wang
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TP and DW wrote this paper. FP, SH, and WG gave some critical comments and reviewed this paper. SH drew the figure.

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Correspondence to Di Wang.

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Pan, Tt., Pan, F., Gao, W. et al. Involvement of Macrophages and Spinal Microglia in Osteoarthritis Pain. Curr Rheumatol Rep 23, 29 (2021). https://doi.org/10.1007/s11926-021-00997-w

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