A groundbreaking study in mice has unveiled a critical link between menopause and the increased risk of osteoarthritis. The research identified a significant drop in 17beta-estradiol and progesterone following menopause, leading to accelerated cartilage aging and degeneration. While these findings highlight menopause as a risk factor for osteoarthritis, the absence of similar evidence in humans underscores the need for further investigation.
The study, which focused on hormonal changes post-menopause, revealed that the decline of key sex hormones—17beta-estradiol and progesterone—heightens cartilage vulnerability as women age. This hormonal imbalance contributes to the disassembly of the extracellular matrix, a crucial component in maintaining healthy cartilage. Despite promising insights, experts stress the necessity for comprehensive human trials to determine the real-world impact.
“The question arises of whether we should consider use of hormone replacement therapy, either to prevent osteoarthritis or try to treat it if it occurs in postmenopausal populations. This would be outside of its existing licenses. We lack evidence in humans to support this currently and fully powered human randomised clinical trials in populations at risk of or with osteoarthritis are needed to better understand whether [hormone replacement therapy] or similar agents would be efficacious.” – Fiona Watt, MBBS, BMedSci, PhD
Fiona Watt, a consultant rheumatologist, noted that hormone replacement therapy (HRT) could potentially mitigate markers of senescence and enhance chondrogenic markers, suggesting a possibility for cartilage regeneration. This study lays the groundwork for developing strategies aimed at slowing or preventing osteoarthritis onset, thereby improving life quality for millions.
“The study suggests that hormone replacement reduced markers of senescence and promoted chondrogenic markers suggesting potential for regeneration. I think this is entirely conceivable but not yet proven in humans and these results should increase research activity in the fields of endocrinology, women’s health and [osteoarthritis] to understand these relationships better in translational human studies.” – Fiona Watt, MBBS, BMedSci, PhD
Dr. Kecia Gaither, an expert in obstetrics and gynecology, emphasized that while murine models offer valuable insights, they do not fully replicate human physiology. Therefore, more research is needed to ascertain HRT's effectiveness in humans.
“Murine models of research, while enlightening, don’t fully replicate the human body. [The findings] thought-provoking as to potential therapeutics, but certainly more research need be done.” – Kecia Gaither, MD, MPH, MS, MBA, FACOG
The research team aims to bridge the gap between laboratory discoveries and practical solutions for those living with osteoarthritis. The study suggests hormone replacement therapy might hold promise as a preventive or slowing therapy for osteoarthritis in postmenopausal women.
“These findings provide valuable insights into the underlying mechanisms of osteoarthritis and offer a foundation for bridging the gap between lab-based discoveries and real-world solutions for individuals living with this condition.” – Ambrosio
Leave a Reply