MASNO TKIVO I KOST

Jozo Jelčić

Obesity is one of leading public health issues. Along with genetic predisposition it is the main risk factor for osteoarthritis and it also has an influence on rheumatoid arthritis. Fatty tissue acts on arthritic joints through a biomechanical and humoral mechanisms. The humoral mechanism is complex and the role of adipokines in the pathogenesis of arthritis is still not entirely clear. It is assumed that no adipokine can cause joint damage on its own, but only a dysfunction in a relationship between leptine and other adipokines can cause inflammatory-destructive processes. It remains unclear whether the involvement of adipokines is primary or secondary in the process of joint inflammation. The relative influence of visceral fatty tissue adipokines as compared to that of locally synthesised adipokines from various joint structures is unclear. Adipokines have a predominantly pro-inflammatory action and destroy the cartilage, although they can also have a protective action. A better knowledge of the role adipokines play not only allows for a better knowledge of pathophysiological processes in osteoarthritis and rheumatoid arthritis, but it also opens possibilities for development of new therapies.

Debljina je jedan od vodećih javnozdravstvenih problema. Ona je, uz genetsku predispoziciju, glavni čimbenik rizika za osteoartritis, a utječe i na reumatoidni artritis. Masno tkivo na zglobove u artritisu djeluje biomehaničkim i humoralnim mehanizmom. Humoralni mehanizam je kompleksan, a uloga adipokina u patogenezi artritisa još uvijek nije potpuno jasna. Pretpostavlja se da nijedan adipokin samostalno nije dovoljan da uzrokuje oštećenje zgloba, nego tek poremećaj odnosa leptina i drugih adipokina uzrokuje upalno-destruktivne procese. Nije jasno radi li se o primarnoj ili sekundarnoj uključenosti adipokina u procese upale u zglobu i koliki je utjecaj adipokina iz visceralnog masnog tkiva, a koliki lokalno sintetiziranih adipokina iz različitih struktura zgloba. Adipokini dominantno djeluju proupalno i oštećujuće na hrskavicu, mada mogu imati i protektivno djelovanje. Bolje poznavanje uloge adipokina u patogenezi artritisa ne samo da omogućuje bolje poznavanje patofizioloških procesa u osteoartitisu i reumatoidnom artitisu, nego otvara mogućnosti za razvoj novih lijekova.