# The role of reactive oxygen species-mitophagy regulation in the treatment of osteoarthritis by active Chinese herbal medicine monomers: a review

## TL;DR

This review explores how Chinese herbal medicine monomers may treat osteoarthritis by regulating reactive oxygen species and mitophagy.

## Contribution

The paper systematically reviews the role of mitophagy regulation by herbal monomers in osteoarthritis treatment, highlighting novel therapeutic perspectives.

## Key findings

- Chinese herbal medicine monomers show multi-target therapeutic potential for osteoarthritis.
- Mitophagy regulation is crucial for maintaining chondrocyte health and may slow OA progression.
- Oxidative stress and mitophagy are key axes in OA pathogenesis, offering new treatment targets.

## Abstract

The primary pathological features of osteoarthritis (OA) involve articular cartilage degradation and structural damage, coupled with osteophyte formation and inflammatory responses. As aging populations expand, the prevalence of knee osteoarthritis has risen substantially, severely compromising patients’ quality of life. Current therapeutic strategies for knee osteoarthritis remain limited in clinical efficacy, creating an urgent need for novel treatments that are both effective and safe. Chinese herbal medicine monomers have demonstrated significant potential in OA management, offering multi-pathway therapeutic effects, multi-target modulation, and favorable safety profiles. However, its underlying mechanisms require further elucidation. Mitophagy, a selective mitochondrial quality control mechanism that eliminates reactive oxygen species-damaged organelles, plays a crucial role in maintaining chondrocyte homeostasis and function. Emerging evidence highlights the regulatory significance of mitophagy in OA progression, presenting novel therapeutic perspectives. This review comprehensively analyzes the molecular mechanisms and physiological roles of the oxidative stress-mitophagy axis in knee osteoarthritis pathogenesis, while summarizing recent advances in herbal monomer-mediated regulation of this pathway. Future research directions are proposed to facilitate the systematic exploration and clinical translation of Chinese herbal medicine in OA therapeutics.