The role of metabolomics in precision medicine of osteoarthritis: How far are we?

OBJECTIVES: A narrative review on recent published studies of metabolomics in osteoarthritis (OA) with the focus on how the metabolomic findings help stratify OA patients in precision medicine. DESIGN: A narrative review based on selected population-based metabolomics studies in OA. RESULTS: PubMed search resulted in a total 139 articles on metabolomics of OA. One hundred and seven articles were excluded because they were either reviews, in vitro studies, animal models. Thirty-two population-based metabolomic studies using either plasma/serum, synovial fluid, cartilage, or subchondral bone samples were reviewed. The most reported metabolic pathways to be involved in OA included energy metabolic pathways, arginine and proline metabolism, taurine and hypotaurine metabolism, and glycerophospholipid metabolism. CONCLUSIONS: While metabolomics of OA research is still in its infancy, the published data showed that metabolomics is a promising tool to help better understanding of pathogenesis of OA, classify OA patients into different endotypes, and develop precision medicine tools for OA management.