N6-methyladenosine (m6A) methylation, the most prevalent internal mRNA modification in eukaryotes, plays a crucial role in regulating various biological processes. Recent advancements reveal its significant involvement in osteoarthritis (OA) and intervertebral disc degeneration (IVDD). m6A modifications influence key cellular processes such as inflammation, stress responses, and matrix homeostasis, which are pivotal in OA and IVDD pathogenesis. In OA, m6A methylation affects inflammatory responses, macrophage polarization, and chondrocyte ferroptosis, while in IVDD, it regulates RNA methylation and matrix integrity. Additionally, m6A interacts with noncoding RNAs, impacting their stability and function, thus influencing disease outcomes. Emerging evidence suggests that targeting m6A pathways could provide novel therapeutic strategies for managing OA and IVDD. Further research into m6A’s role in these diseases may reveal new biomarkers and therapeutic targets, offering potential for more effective treatments and improved patient outcomes.
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