Osteoarthritis is a common degenerative joint disorder characterized by cartilage damage causing pain and movement impairment. Its progression involves inflammatory responses, metabolic abnormalities, and cell death pathways including autophagy. This review elucidates the regulatory mechanisms of autophagy in programmed cell death and its impact on osteoarthritis. Studies demonstrate that autophagy can regulate apoptosis, necroptosis and other death pathways through specific components, distinguishing ''autophagy-mediated cell death'' from the direct elimination mechanism of ''autophagy-dependent cell death''. In osteoarthritis, autophagy participates in cartilage degeneration and joint inflammation by modulating inflammatory factors and stress responses. Understanding the dual regulatory mechanisms of autophagy provides theoretical foundations for developing targeted therapeutic strategies. This article systematically compares pathway characteristics of different autophagy-related cell death types, proposing that precise regulation of autophagy-mediated death processes may emerge as a novel approach to protect cartilage and delay disease progression. These research advances offer crucial theoretical support for precision medicine in osteoarthritis management.

Keywords: Autophagy-mediated cell death (AMCD); Cartilage degradation; Inflammation; Osteoarthritis; Programmed cell death (PCD); Therapeutic targets.

© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

骨关节炎是一种常见的退行性关节疾病，其特点是软骨损伤导致疼痛和运动功能障碍。该疾病的进展涉及炎症反应、代谢异常以及包括自噬在内的细胞死亡途径。本文综述了自噬在程序性细胞死亡中的调控机制及其对骨关节炎的影响。研究表明，自噬可以通过特定的组分调节凋亡、坏死性凋亡等其他死亡途径，从而区分由“自噬介导的细胞死亡”和直接消除机制的“依赖自噬的细胞死亡”。在骨关节炎中，自噬通过调控炎症因子和应激反应参与软骨退变和关节炎症。理解自噬的双重调节机制为开发靶向治疗策略提供了理论基础。本文系统地比较了不同自噬相关细胞死亡类型的途径特征，提出精确调节由自噬介导的死亡过程可能成为保护软骨和延缓疾病进展的新方法。这些研究进展为精准医学在骨关节炎管理中的应用提供了重要的理论支持。

关键词： 自噬介导的细胞死亡（AMCD）；软骨降解；炎症；骨关节炎；程序性细胞死亡（PCD）；治疗靶点。

© 2025. 作者保留独家授权给Springer Science+Business Media, LLC，隶属Springer Nature的使用权。