The Multifaceted Role of p53 in Musculoskeletal Diseases: A Comprehensive Review

p53 critically influences the development and progression of musculoskeletal diseases (osteoporosis, osteoarthritis, rheumatoid arthritis, low back pain, gout, and scoliosis) through diverse mechanisms: Disrupting bone formation/resorption balance (via the p53-Nedd4-Runx2 axis in osteoporosis). Promoting chondrocyte apoptosis (via the miR-34a-SIRT1-p53 pathway in osteoarthritis). Modulating inflammatory mediators (TNF-α, IL-6 in rheumatoid arthritis). Regulating oxidative stress responses (p53-SLC2A9 axis in gout). p53 exhibits dual roles (pro-apoptotic vs. anti-inflammatory), necessitating precise targeting strategies. Promising therapeutic interventions include p53-focused gene editing (CRISPR/Cas9), small-molecule inhibitors (PFT-α), and natural products (naringin). However, further clinical validation is essential. Future research requires multidisciplinary approaches to deepen understanding of p53 mechanisms and advance clinical applications in musculoskeletal disorders.