Therapeutics of osteoarthritis and pharmacological mechanisms: A focus on RANK/RANKL signaling.

Osteoarthritis (OA) is a chronic degenerative disease afflicting millions globally. Despite the development of numerous pharmacological treatments for OA, a substantial unmet need for effective therapies persists. The RANK/RANKL signaling pathway has emerged as a promising therapeutic target for OA, owing to its pivotal role in regulating osteoclast differentiation and activity. In this comprehensive review, we aim to elucidate the relevant mechanisms of OA mediated by RANK/RANKL signaling, including bone remodeling, inflammation, cartilage degradation, osteophyte formation, and pain sensitization. Furthermore, we discuss and summarize the cutting-edge strategies targeting RANK/RANKL signaling for OA therapy, encompassing approaches such as gene-based interventions and biomaterials-aided pharmacotherapy. In addition, we highlight the prevailing challenges associated with pharmacological OA treatments and explore potential future directions, approached through a clinical-translational lens. • The RANK/RANKL pathway plays a pivotal role in osteoarthritis (OA) pathogenesis by regulating osteoclast differentiation. • Advanced gene-based strategies hold promise for precisely targeting and modulating RANK/RANKL signaling in OA. • Biomaterials-based approaches enable localized delivery of RANK/RANKL-targeting therapeutics to affected joints. [ABSTRACT FROM AUTHOR]