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While regaling you with daring stories from her youth, it might be hard to believe your grandmother used to be a trapeze artist.
当奶奶讲起年轻时的大胆经历时，你可能很难相信她曾是一位飞人艺术家。
However, the bad backs, elbow pain, and creaky knees so common in older people is more than just "old age."
然而，老年人常见的背痛、肘痛和膝盖吱吱作响的毛病不仅仅只是“老年病”。
In fact, the source of this stiffness plagues many young people as well.
事实上，这种僵硬的根源也困扰着许多年轻人。
The culprit is arthritis: a condition that causes inflammation and pain in the joints of over 90 million people in the U.S. alone.
其罪魁祸首就是关节炎：仅在美国，超过九千万人遭受其导致的关节发炎和疼痛。
But are stiff, creaky joints really inevitable?
僵硬而老旧的关节毛病真的无法避免吗？
What makes arthritis so pervasive, and why haven't we found a cure for this widespread condition?
什么原因使关节炎如此普遍，为什么我们还没找到这种常见病的治愈方法呢？
The first hurdle is that arthritis is actually a spectrum of over 100 different arthritic conditions.
第一个难题是，关节炎其实是100多种不同关节病的总称。
All these conditions share symptoms of joint pain and inflammation, but the origin and severity of those symptoms vary widely.
它们都有关节疼痛和发炎的症状，但是这些症状的起源和严重程度差异很大。
Even the most common type, osteoarthritis, is trickier to prevent than one might think.
即使要避免最常见的骨关节炎，也比人们想象的难得多。
It's a general misconception that arthritis is confined to old age.
人们普遍误以为关节炎只是老年病。
The origins of osteoarthritis can often be traced to a patient's early life, from any seemingly ordinary joint injury.
骨关节炎的病根，通常可追溯到患者早些年看似普通的关节损伤。
Following impact, immune cells rush in to help clean and repair the damaged site
关节遭受冲击后，免疫细胞涌入以帮助清理和修复受损部位，
and begin pumping out enzymes, including matrix metalloproteinases and aggrecanases.
并释放包括基质金属蛋白酶和聚集蛋白聚糖酶在内的酶。
These enzymes clear out the damaged tissue and contribute to inflammation.
这些酶清除受损组织，并引起发炎症状。
But while this rapid swelling helps protect the joint during recovery,
但是，尽管这种迅速的肿胀有助于在恢复过程中保护关节，
inadequately healed tissue can cause these immune cells to overstay their welcome.
愈合不充分的组织可能会导致免疫细胞滞留。
The continuing flood of enzymes starts to degrade the cartilage, weakening the joint and leading to arthritis later on.
持续的酶代谢使软骨退化、削弱关节，并后来发展为关节炎。
Not all forms of arthritis can simply be traced to an old sports injury.
并非所有形式的关节炎都能简单追溯到旧运动损伤。
Take rheumatoid arthritis, which affects 1.3 million U.S. adults.
以类风湿关节炎为例，这种疾病影响到130万美国成年人。
This condition is actually an autoimmune disease in which autoantibodies target natively produced proteins, some of which are secreted by cartilage cells.
这种情况实际是自身免疫性疾病，自身抗体靶向正常产生的蛋白质，有些蛋白质是软骨细胞分泌的。
We still don't know what causes this behavior, but the result is that the body treats joint tissue like a foreign invader.
我们仍然不知道导致这种行为的原因，但结果是，人体错把关节组织当成外来入侵者一样对待。
Immune cells infiltrate the joint despite there being no tissue damage to repair.
免疫细胞涌入关节，尽管没有组织损伤需要修复。
This response leads to chronic inflammation, which destroys bone and cartilage.
这种反应导致慢性炎症，破坏骨骼和软骨。
Yet another condition, spondyloarthritis, has similarities to both of the conditions we've covered.
另一种疾病脊椎关节炎，与我们刚才提到的两种情况类似。
Patients experience continuous inflammation in the joints and at the sites where ligaments and tendons attach to bones, even without any initial injury.
即使初期没有任何伤害的情况下，患者的关节、韧带以及肌腱附着的骨骼部位也会持续发炎。
This leads to the flood of enzymes and degradation seen in osteoarthritis, but is driven by different inflammatory proteins called cytokines.
并且也会出现骨关节炎中产生大量酶和削弱关节的现象，但由不同的炎症蛋白引起，这种蛋白称为细胞因子。
As the enzymes eat away at cartilage, the body attempts to stabilize smaller joints by fusing them together.
随着酶不断吞噬软骨，人体试图将较小关节衔接起来以保持稳定。
This process sometimes leads to outgrowths called bone spurs, which also cause intense stiffness and joint pain.
这一过程有时会导致骨刺的生长，也会引起严重僵硬和关节痛。
With so many factors causing arthritis, our current treatments are tailored to tackle specific symptoms rather than underlying causes.
有许多导致关节炎的因素，我们目前的治疗方法只是专门针对特定症状，而非潜在的病因。
These range from promising MACI techniques, which harvest cells from small pieces of cartilage to grow replacement tissue.
这些包括有前景的MACI技术（自体软骨细胞移植技术），该技术可从软骨切片中提取细胞以培养移植组织。
To a technique called microfracture, where surgeons create small holes in the bone,
还有一种微骨折的技术，在这种技术中，外科医生会在骨骼上打小孔，
allowing bone marrow stem cells to leak out and form new cartilage.
从而使骨髓干细胞流出并生成新的软骨。
As a last resort, people with withered cartilage can even undergo full joint replacements.
作为最后的选择，软骨萎缩的人甚至可以进行全关节置换。
But outside these drastic measures, the underlying drivers of autoimmune arthritis still present a unique treatment challenge.
但除了这些激进的治疗措施外，自身免疫性关节炎的潜在病因仍然提出了独特的治疗挑战。
Scientists are making progress with therapies that block TNF-alpha, one of the primary proteins causing inflammation in rheumatoid arthritis.
科学家在阻断TNF-α疗法上正取得研究进展，TNF-α是导致类风湿关节炎发炎的主要蛋白质之一。
But even this approach only treats the symptoms of the condition, not the cause.
但是，即使这种方法也只能治疗症状，而非病因。
In the meantime, some of our best defenses against arthritis are lifestyle choices:
同时，对关节炎的最佳防治方法是生活方式的选择：
maintaining a healthy weight to take pressure off joints, low-impact exercises like yoga or cycling, and avoiding smoking.
保持健康的体重以减轻关节压力，选择低影响的运动如瑜伽或骑自行车，并避免吸烟。
These arthritis-fighting behaviors can help us lead longer lives as we continue to research cures and treatments for the huge diversity of arthritic conditions.
面对种类繁多的关节炎病，在我们继续研究治愈方法和治疗方案的同时，这些抗关节炎行为可以帮助我们延长寿命。
