Prevention and treatment of knee osteoarthritis by natural products: Potential mechanisms based on articular cartilage targets

Knee osteoarthritis (KOA) is a common chronic degenerative disease characterized by an imbalance between the destruction and construction of articular cartilage, which is a key factor in the pathogenesis of KOA. Due to the lack of effective treatments for KOA, there is an urgent need to gain a deeper understanding of its pathological mechanisms, develop specific biomarkers for early diagnosis and prognostic assessment, and identify safer and more effective therapeutic agents. In recent years, natural products have garnered significant attention due to their low toxicity, cost-effectiveness, and unique biological activities, demonstrating a substantial impact in the treatment of KOA. Natural products can inhibit the progression of KOA through various mechanisms, including promoting cartilage synthesis, alleviating inflammation, reducing oxidative stress, inhibiting chondrocyte apoptosis, and regulating autophagy, thereby laying the foundation for clinical applications. This review summarizes biomarkers applicable for early diagnosis and phenotypic assessment of KOA, with a focus on reviewing the pharmacological basis and molecular mechanisms of natural products such as flavonoids, alkaloids, saponins, terpenes, and traditional Chinese medicine formulas in the treatment of KOA, aiming to provide promising solutions for the management of KOA