In chronic degenerative and autoimmune diseases such as Osteoarthritis (OA) and rheumatoid arthritis, neuroinflammation is an emerging therapeutic target. Mast cells (MCs) play an important role in joint homeostasis, and their activation causes the release of a large number of proteins. mediators that stoke the fires of neuroinflammation Synovial MCs, in particular, release substances that hasten the breakdown of the extracellular matrix, resulting in morphological joint changes and cartilage damage, as well as inducing synovial fibroblast proliferation, angiogenesis, as well as the sprouting of sensory nerve fibres that mediate chronic pain Palmitoylethanolamide (PEA) is a well-known MCs modulator, but its levels are significantly lower in osteoarthritic joints reduced. Adelmidrol is a synthetic azelaic acid derivate from the AL Amides family PEA booster.

Osteoarthritis (OA), which affects nearly 16% of the population, is a leading cause of musculoskeletal chronic pain characterized by cartilage degeneration and stiffness. A mechanism-based approach to OA should include at least three targets: peripheral inflammatory mechanisms, central pain hypersensitivity mechanisms, and joint destruction prevention. Mast Cells (MCs) have recently received a lot of attention as a potential target for modulating peripheral and central nervous system inflammation. Neuro inflammation targets joints in chronic degenerative and autoimmune diseases such as OA and rheumatoid arthritis, and MC activation has been identified as a prominent feature of synovial tissue in OA patients. The purpose of this review is to present preclinical and clinical evidence for a new intra-articular formulation containing Adelmidrol for neuro inflammation targeting in OA diseases.