The 2010 World Congress on Osteoarthritis: Start of a New Decade was held in Brussels, Belgium on September 23-26 and was chaired by Yves Henrotin and Amanda Fosang. More than 1000 of the world's leading scientists, clinicians and others interested in OA convened for this annual event featuring the latest research and clinical updates.
This year's program covered issues related to joint issues and OA, including the mechanisms of cartilage degradation, non-pharmacological and pharmacological modalities, obesity, angiogenesis, animal models, mechanobiology, imaging, biomarkers, epidemiology, genetics, spine OA, dietary and surgery. A pre- Congress workshop was organized on the evolving evidence and changes in the OARSI recommendations for the management of hip and knee OA. Felix Eckstein, Paracelsus Private Medical University, Salzburg, Austria received the Clinical Research Award for his work on the integration of imaging methods for understanding the morphology, function and disease of musculoskeletal issues related to OA. The Basic Science Award was presented to Martin Lotz, Scripps Research Institute, LaJolla, California for his work on chondrocyte differentiation, apoptosis and OA. His studies on human joint aging in vitro and on animal models led to the identification of cell death as an important event in the pathogenesis of aging-related and post traumatic OA. Paul Dieppe received the OARSI Lifetime Achievement Award for recognition of his outstanding career. His team at the University of Bristol, UK became world leaders in OA research in the areas of clinical aspects of OA and its response to therapy. Dr. Dieppe recently moved to the Peninsula Medical School, UK as Chair of Clinical Education Research. In addition, OARSI recognized 14 young investigators for their contributions to the field.
Osteoarthritis is a global joint disease affecting not only the cartilage, but also tendons, peri-articular muscles, capsules, ligaments and sub-chondral bone. Important advances have occurred in the understanding of the role played by these tissues in the onset and progression of the disease. One important feature of OA is the endochondral ossification of articular cartilage. The Congress session on "Aging and Cell Signaling" was dedicated to this pathological aspect. Using an experimental mouse OA model by surgically producing instability in the knee joint, Hiroshi Kawaguchi, (University of Tokyo) demonstrated the expression of Type X collagen which is an essential step for skeletal growth and healing. The link between obesity and OA was the central topic of a plenary session introduced by the lecture of Stephen Messier (Wake Forest University). Recently, epidemiological studies have shown an association between obesity and hand OA, suggesting that systemic factors could also play a role in the genesis of OA damage.
A major barrier for developing disease modifying drugs in OA is the absence of parameters allowing a rapid demonstration of drug efficiency on structural changes. At this time the gold standard remains the measurement of joint space narrowing on standard x-ray, a technique that lacks sensitivity and reproducibility and requires serial assessments over 1-3 years. Radiographic evidence is seen only after significant cartilage degradation has already taken place. The early stages of OA may be asymptomatic for many years. Therefore there is a need for reliable biomarkers that can facilitate early diagnosis and monitor the efficiency of therapeutic modalities. The two major methods of investigation are biochemical markers and MRI. Two concurrent sessions were focused on these new technologies. A consensus based suggestion for an MRI definition of early or pre-OA was presented by Frank Roemer (Boston University School of Medicine). New imaging technologies have emerged for assessing joint function and was presented by Scott Tashman (University of Pittsburgh).
New soluble biomarkers, including proteins, protein fragments and metabolites identified by proteomics and also miRNAs were discussed as potential biomarkers. Francisco Blanco's team (Coruna, Spain) presented the proteomic profile of OA serum.
OARSI is working on a 3 year biomarkers initiative and will be requesting funding from the Foundation for NIH to continue the studies.
During other sessions in the Congress, various studies were presented related to molecular treatment of OA, tissue engineering and repair and physical therapy and rehabilitation. Rosemary extract and related flavonoid carnosol stimulated accregan production invitro (Marie-Noelle Horcajada, Switzerland) , resveratrol and curcumin demonstrated anticatabolic and anti-inflammatory properties (Ali Mobasheri, UK, massive weight loss improved the algo-functional status of patients with knee OA and induced changes in levels of joint biomarkers (Pascal Richette, France.) Devyani Misra (Boston University) found that Vitamin K deficiency was associated with an increased risk of incident knee OA. Other studies were presented indicating that exercise programs improved symptoms in patients with knee OA.
During this new decade the challenge will be to find therapeutic modalities that are capable of positively and significantly modifying the natural course of the disease. These include developing biomarkers which will help reduce the time of drug development, developing tools for pre-radiological diagnostic of OA, promoting prevention, producing new guidelines for the management of OA that will integrate not only the scientific evidence and clinical expertise, but also the economical and societal impact of the disease. OARSI understands the challenges ahead and is a leader in finding the prevention and cure and developing effective treatments for OA.
Slides from invited speakers will be available soon in the member's only section of the website.