Abstract
Knee osteoarthritis (KOA) is a complex joint disease characterized by progressive cartilage degeneration with programmed cell death of chondrocytes. Programmed cell death (PCD) of chondrocytes plays a central role in the development of knee osteoarthritis, and epigenetics provides new explanations for this complex biological process. By regulating DNA methylation, histone modification and non-coding RNA, epigenetic mechanisms can significantly affect chondrocyte survival and apoptosis without altering the gene sequence. Recent studies have found that TCM can intervene in the epigenetic regulatory network by targeting epigenetic enzymes with active ingredients, non-coding RNA-mediated co-regulation, and epigenetic-metabolic reprogramming. In this paper, we review the latest studies on epigenetics in chondrocyte programmed cell death, focusing on the mechanisms of DNA methylation, histone modification, and non-coding RNAs, such as miRNAs and lncRNAs, and also discuss the interventional roles of TCM in this process, providing therapeutic references to delve into the pathogenesis of KOA.