Progress in siRNA therapy and delivery platforms for osteoarthritis

Osteoarthritis (OA) is driven by a cycle of cartilage decay, synovial inflammation, and bone remodeling. This progression is fueled by the self-perpetuating synergy between matrix-degrading enzymes and pro-inflammatory cytokines, posing a formidable barrier to effective therapy. Small interfering RNAs (siRNAs) offer a transformative precision medicine paradigm, harnessing the RNA interference (RNAi) machinery to silence pathogenic drivers. However, their clinical application hinges on navigating the complex intra-articular microenvironment. This review synthesizes current progress in siRNA delivery architectures, spanning viral vectors, lipidic nanoplatforms, polymeric assemblies, and hybrid biomimetic systems. The spatiotemporal retention and intracellular bioavailability of siRNAs have been augmented by key engineering breakthroughs, including ligand-mediated active targeting, precise surface topography tuning, and integrated stimulus-responsive functionalities. This review, by exploring future directions like multi-target silencing and the use of large animal models relevant to clinical practice, highlights how siRNA-based treatments are moving beyond experimental ideas to applications as real anti-OA drugs.