Degradative enzyme systems in cartilage.

There appears to be a final common pathway in the pathogenesis of osteoarthritis, regardless of the initiating cause. This involves an increase in degradative enzymes that arise from the cartilage. Both proteoglycan- and collagen-degrading enzymes, active at a neutral pH, increase in proportion to the severity of the arthritis until a final end-stage state is reached. This increase in enzyme activity may be triggered by release of a synovial messenger protein similar to interleukin-1. It is suggested by studies in an animal model that inhibition of these enzymes could lead to treatment of osteoarthritis.