Ion channels involved in inflammation and pain in osteoarthritis and related musculoskeletal disorders

Osteoarthritis (OA) is a currently incurable, chronic, progressive, and debilitating musculoskeletal (MSK) condition. One of its hallmark symptoms is chronic nociceptive and neuropathic pain, which significantly reduces the quality of life of patients with OA. Although research into the pathomechanisms of OA pain is ongoing and several pain pathways are well understood, the true source of OA pain remains unclear. Ion channels and transporters are key mediators of nociceptive pain. In this narrative review article, we summarize the state-of-the-art in relation to the distribution and function of ion channels in all major synovial joint tissues in the context of pain generation. We provide an update on the ion channels likely involved in mediating peripheral and central nociceptive pathways in the nervous system in OA pain, including voltage-gated sodium and potassium channels, members of the transient receptor potential (TRP) channel family, and purinergic receptor complexes. We focus on ion channels and transporters that have the potential to be candidate drug targets for pain management in patients with OA. We propose that ion channels expressed by the cells of constituent tissues of OA-afflicted synovial joints including cartilage, bone, synovium, ligament, and muscle, should be more thoroughly investigated and targeted in the context of OA pain. Based on key findings from recent basic research articles as well as clinical trials, we propose novel directions for the development of future analgesic therapies to improve the quality of life of patients with OA.