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2012, Número 1

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Investigación en Discapacidad 2012; 1 (1)


El desarrollo del esqueleto y la osteoartritis

Garciadiego CD

Idioma: Español
Referencias bibliográficas: 91
Paginas: 7-17
Archivo PDF: 189.74 Kb.


RESUMEN

El cartílago articular, a diferencia del cartílago de la placa de crecimiento, es un tejido especializado para no calcificarse. Sin embargo, la mineralización del cartílago articular es un proceso común en las complicaciones de la osteoartritis (OA) y el envejecimiento. Algunos trabajos han demostrado cierta similitud de los mecanismos del desarrollo de la placa de crecimiento y la degeneración del cartílago articular. Éstos incluyen la proliferación de los condrocitos, la hipertrofia, mineralización de la matriz extracelular (MEC) y la apoptosis. El desarrollo de la placa de crecimiento está regulado por la señalización de algunos factores de crecimiento y por las interacciones de los condrocitos con las moléculas de la matriz extracelular. La proteína relacionada a la hormona paratiroidea (PthrP) e Indian Hedgehog (Ihh) son los mediadores centrales del desarrollo del hueso endocondral; la PthrP es abundante en el líquido sinovial de los pacientes con OA, pero la expresión de Ihh disminuye en el cartílago con OA. Además, PthrP se conoce por inducir la proliferación de los condrocitos, mientras que el factor de crecimiento de fibroblastos 18 (Fgf-18) la regula negativamente y su aplicación intrasinovial en las ratas con OA resulta en la generación de cartílago. La señalización Wnt también juega un papel importante en la diferenciación del condrocito de la placa de crecimiento. Wnt-5a promueve la prehipertrofia del condrocito, pero al mismo tiempo inhibe la hipertrofia del cartílago; por el contrario, Wnt-4 induce la hipertrofia del condrocito y desde las etapas tempranas de la OA incrementa su expresión en el cartílago articular. Por otro lado, el desbalance del recambio de la matriz del cartílago durante la OA resulta en un mayor depósito de colágena tipo I y X, características del cartílago hipertrófico, mientras que disminuye la expresión de la colágena tipo II y IX. Es decir, aunque el condrocito es la unidad celular del cartílago articular y el de la placa de crecimiento que comparten varías características, presentan una diferencia importante; la tasa de la hipertrofia del condrocito es mayor en el cartílago articular con OA que en el cartílago articular sano y recapitula la señalización del cartílago de la placa de crecimiento. Pero, ¿cuál es la señal que hace la diferencia? Nosotros pensamos que la respuesta está en el origen embrionario de estos dos tipos de cartílago, justo en la formación de las articulaciones durante la esqueletogénesis.


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