Knee Osteoarthritis Therapy Targeting NLRP3 Inflammasome: Progress From Mechanism to Application

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OBJECTIVE: This paper briefly reviews the structure, function, and activation mechanism of the NLRP3 inflammasome and its molecular role in the pathogenesis of knee osteoarthritis (KOA), and explores the potential value of traditional Chinese medicine (TCM) in treating KOA by modulating NLRP3 inflammasome activity. The review covers evidence from mechanistic studies, in vitro experiments, in vivo models, and currently available clinical-related findings. METHODS: To investigate the role of the NLRP3 inflammasome in KOA, a comprehensive literature search was conducted across multiple databases, including PubMed, MEDLINE, Web of Science, Scopus, and various Chinese biomedical repositories (CNKI, CBM, VIP, COJ). Emphasis was placed on studies published in the past 5 years concerning TCM-based interventions targeting NLRP3 in KOA models, facilitating comparative analysis and synthesis of recent evidence. RESULTS: NLRP3 inflammasome has been implicated in multiple pathological processes of KOA, including cartilage degradation, inflammation of the synovium, programmed cell death (pyroptosis), and the activation of osteoclasts. Interventions using TCM-such as herbal monomers, multi-compound formulas, external preparations, and acupuncture-can mitigate these pathological events by modulating NLRP3 activity. CONCLUSION: The NLRP3 inflammasome is a critical mediator in KOA pathophysiology, influencing inflammation, cartilage deterioration, pyroptosis, and bone metabolism. Strategies derived from TCM that target this inflammasome may offer promising avenues for developing precise and effective treatments for KOA.