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Chen H, Xiong R, Cheng J, Ye J, Qiu Y, Huang S, Li M, Liu Z, Pang J, Zhang X, Guo S, Li H, Zhu H. Effects and Mechanisms of Polyunsaturated Fatty Acids on Age-Related Musculoskeletal Diseases: Sarcopenia, Osteoporosis, and Osteoarthritis-A Narrative Review. Nutrients 2024; 16:3130. [PMID: 39339730 PMCID: PMC11434726 DOI: 10.3390/nu16183130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Revised: 09/13/2024] [Accepted: 09/15/2024] [Indexed: 09/30/2024] Open
Abstract
Background: The process of the globally aging population has been accelerating, leading to an increasing social burden. As people age, the musculoskeletal system will gradually go through a series of degenerative and loss of function and eventually develop age-related musculoskeletal diseases, like sarcopenia, osteoporosis, and osteoarthritis. On the other hand, several studies have shown that polyunsaturated fatty acids (PUFAs) possess various important physiological functions on the health of muscles, bones, and joints. Objective: This narrative review paper provides a summary of the literature about the effects and mechanisms of PUFAs on age-related musculoskeletal diseases for the prevention and management of these diseases. Methods: Web of Science, PubMed, Science Direct, and Scopus databases have been searched to select the relevant literature on epidemiological, cellular, and animal experiments and clinical evidence in recent decades with keywords "polyunsaturated fatty acids", "PUFAs", "omega-3", "omega-6", "musculoskeletal diseases", "sarcopenia", "osteoporosis", "osteoarthritis", and so on. Results: PUFAs could prevent and treat age-related musculoskeletal diseases (sarcopenia, osteoporosis, and osteoarthritis) by reducing oxidative stress and inflammation and controlling the growth, differentiation, apoptosis, and autophagy of cells. This review paper provides comprehensive evidence of PUFAs on age-related musculoskeletal diseases, which will be helpful for exploitation into functional foods and drugs for their prevention and treatment. Conclusions: PUFAs could play an important role in the prevention and treatment of sarcopenia, osteoporosis, and osteoarthritis.
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Affiliation(s)
- Haoqi Chen
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ruogu Xiong
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jin Cheng
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jialu Ye
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yingzhen Qiu
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Siyu Huang
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Mengchu Li
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhaoyan Liu
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jinzhu Pang
- Mengniu Institute of Nutrition Science, Global R&D Innovation Center, Inner Mongolia Mengniu Dairy (Group) Co., Ltd., Hohhot 011050, China
| | - Xuguang Zhang
- Mengniu Institute of Nutrition Science, Global R&D Innovation Center, Inner Mongolia Mengniu Dairy (Group) Co., Ltd., Hohhot 011050, China
- Sun Yat-sen University-Mengniu Joint Research Center of Nutrition and Health for Middle-Aged and Elderly, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Shanshan Guo
- Mengniu Institute of Nutrition Science, Global R&D Innovation Center, Inner Mongolia Mengniu Dairy (Group) Co., Ltd., Hohhot 011050, China
| | - Huabin Li
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Huilian Zhu
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
- Sun Yat-sen University-Mengniu Joint Research Center of Nutrition and Health for Middle-Aged and Elderly, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
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2
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Zhang R, Lei YJ, Wen SY, Pang J, Cao YL, Zhang M, Zhan HS, Lin X, Chen B. Effect of Shi-Style Steaming and Bathing Decoction in Patients with Knee Osteoarthritis: Study Protocol for a Randomized Placebo-Controlled Trial. J Pain Res 2024; 17:2851-2860. [PMID: 39253736 PMCID: PMC11382682 DOI: 10.2147/jpr.s466741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 08/27/2024] [Indexed: 09/11/2024] Open
Abstract
Purpose To prove more accurately that Chinese herbal bath therapy may be a safe, effective, simple alternative treatment modality for knee OA, we designed a randomized, double-blind, placebo-controlled trial to explore the effectiveness of SSBD for the relief of pain, daily activities, and quality of life in patients with knee OA. Patients and Methods A single-center, 52-week, randomized controlled trial of SSBD versus placebo is being performed. A total of 200 patients with symptomatic knee OA will be randomly allocated to the SSBD treatment or placebo intervention group for 4 weeks. The two groups of patients are allowed to steam and bathe their knees once every other day, using one packet of SSBD each time, for 30 minutes, 3 times a week, for a total of 4 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale at 4 weeks is the primary outcome measure, and the secondary outcomes include WOMAC stiffness and function scores, the Lysholm knee scale score, quality of life, the Brief Pain Inventory score, the Patient's Global Impressions of Improvement Scale score and the Clinical Global Impressions of Severity scale score. The safety of the herbal medications will also be evaluated. Conclusion We will discuss whether SSBD has greater advantages in terms of efficacy, safety, and patient overall perception than does placebo control in middle-aged and elderly patients with knee OA. The findings may provide new and valuable information about the efficacy and safety of Chinese herbal bath therapy in the treatment of knee osteoarthritis.
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Affiliation(s)
- Ran Zhang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Ya-Jie Lei
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Sheng-Yue Wen
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Jian Pang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Yue-Long Cao
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Min Zhang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Hong-Sheng Zhan
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Xun Lin
- Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Bo Chen
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Institute of Orthopedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China
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3
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Cavazos-Escobar E, Lozano MR, Rizzo AV, Al Snih S. Metabolic syndrome and arthritis among Mexican American older adults: findings from a 23-year follow-up. Eur Geriatr Med 2024; 15:1111-1118. [PMID: 38368571 PMCID: PMC11330538 DOI: 10.1007/s41999-024-00940-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/10/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE To examine the sex differences in the relationship of metabolic syndrome (MetS) criteria with arthritis and symptomatic arthritis among Mexican American older adults aged ≥ 65 without self-reported arthritis at baseline over 23-years of follow-up. METHODS Participants (N = 1447) were from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1993/94-2016). Measures included MetS criteria, arthritis defined as self-reported physician-diagnosed arthritis, socio-demographics, morbidities, depressive symptoms, pain on weight-bearing, cognitive and physical function, handgrip strength, mobility, and activities of daily living (ADLs) limitations. Symptomatic arthritis was defined as self-reported arthritis and having ≥ 1 of the following: pain, mobility limitation, or limited ADLs. RESULTS At baseline, the mean age was 72.6 years and 730 (50.5%) of our participants were females. Female participants with 2 and 3 MetS criteria had greater odds of arthritis [odds ratio (OR) = 1.77, 95% Confidence Interval (Cl) = 1.28-2.45 and OR = 2.68, 95% CI = 1.69-4.27, respectively) and symptomatic arthritis (OR = 1.74, 95% Cl = 1.24-2.44 and OR = 3.27, 95% CI = 2.04-5.26, respectively) after controlling for covariates. Male participants with 2 and 3 MetS criteria had greater odds of arthritis (OR = 1.65, 95% Cl = 1.14-2.39 and OR = 2.52, 95% CI = 1.51-4.19, respectively) and symptomatic arthritis (OR = 1.93, 95% Cl = 1.30-2.86 and OR = 2.98, 95% CI = 1.62-5.47, respectively) after controlling for covariates. Both females and males with pain on weight-bearing had greater odds of arthritis than those without pain. CONCLUSIONS At 23-years of follow-up, Mexican American older adults with MetS have an increased risk of arthritis and symptomatic arthritis. Early MetS screening and management may reduce arthritis in this population at high risk of disability.
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Affiliation(s)
- Emilio Cavazos-Escobar
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Mauricio Ramos Lozano
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Alan Villarreal Rizzo
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Soham Al Snih
- Department of Population Health and Health Disparities/School of Public and Population Health, The University of Texas Medical Branch, Galveston, TX, 77555-0177, USA.
- Division of Geriatric and Palliative Medicine/Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, 77555, USA.
- Sealy Center of Aging, The University of Texas Medical Branch, Galveston, TX, 77555, USA.
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Oo WM. Prospects of Disease-Modifying Osteoarthritis Drugs. Rheum Dis Clin North Am 2024; 50:483-518. [PMID: 38942581 DOI: 10.1016/j.rdc.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Osteoarthritis (OA) causes a massive disease burden with a global prevalence of nearly 23% in 2020 and an unmet need for adequate treatment, given a lack of disease-modifying drugs (DMOADs). The author reviews the prospects of active DMOAD candidates in the phase 2/3 clinical trials of drug development pipeline based on key OA pathogenetic mechanisms directed to inflammation-driven, bone-driven, and cartilage-driven endotypes. The challenges and possible research opportunities are stated in terms of the formulation of a research question known as the PICO approach: (1) population, (2) interventions, (3) comparison or placebo, and (4) outcomes.
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Affiliation(s)
- Win Min Oo
- Department of Physical Medicine and Rehabilitation, Mandalay General Hospital, University of Medicine, Mandalay, Mandalay, Myanmar; Rheumatology Department, Royal North Shore Hospital, Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, Sydney, Australia.
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Felson DT, Misra D, LaValley M, Clancy M, Rabasa G, Lichtenstein A, Matthan N, Torner J, Lewis CE, Nevitt MC. Essential Fatty Acids and Osteoarthritis. Arthritis Care Res (Hoboken) 2024; 76:796-801. [PMID: 38225177 PMCID: PMC11132918 DOI: 10.1002/acr.25302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 01/17/2024]
Abstract
OBJECTIVE Inflammation worsens joint destruction in osteoarthritis (OA) and aggravates pain. Although n-3 fatty acids reduce inflammation, different n-3 fatty acids have different effects on inflammation and clinical outcomes, with eicosapentaenoic acid (EPA) having the strongest effect. We examined whether specific essential fatty acid levels affected the development of OA. METHODS We studied participants from the Multicenter Osteoarthritis Study (MOST) at risk of developing knee OA. As part of MOST, participants were asked repeatedly about knee pain, and knee radiographs and magnetic resonance images (MRIs) were obtained. Using baseline fasting samples, we analyzed serum fatty acids with standard assays. After excluding participants with baseline OA, we defined two sets of cases based on their status through 60 months' follow-up: those developing incident radiographic OA and those developing incident symptomatic OA (knee pain and radiographic OA). Controls did not develop these outcomes. Additionally, we examined worsening of MRI cartilage damage and synovitis and worsening knee pain and evaluated the number of hand joints affected by nodules. In regression models, we tested the association of each OA outcome with levels of specific n-3 and n-6 fatty acids, adjusting for age, sex, body mass index, education, physical activity, race, baseline pain, smoking, statin use, and depressive symptoms. RESULTS We studied 363 cases with incident symptomatic knee OA and 295 with incident radiographic knee OA. The mean age was 62 years (59% women). We found no associations of specific n-3 fatty acid levels, including EPA, or of n-6 fatty acid levels with incident OA (eg, for incident symptomatic knee OA, the odds ratio per SD increase in EPA was 1.0 [95% confidence interval 0.87-1.17]). Results for other OA outcomes also failed to suggest a protective effect of specific n-3 fatty acids with OA outcomes. CONCLUSION We found no association of serum levels of EPA or of other specific n-3 fatty acids or n-6 fatty acids with risk of incident knee OA or other OA outcomes.
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Affiliation(s)
| | - Devyani Misra
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Shawl M, Geetha T, Burnett D, Babu JR. Omega-3 Supplementation and Its Effects on Osteoarthritis. Nutrients 2024; 16:1650. [PMID: 38892583 PMCID: PMC11174396 DOI: 10.3390/nu16111650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/16/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Osteoarthritis (OA) is a degenerative joint disease characterized by the destruction of the articular cartilage, resulting in a pro-inflammatory response. The progression of OA is multifactorial and is influenced by the underlying cause of inflammation, which includes but is not limited to trauma, metabolism, biology, comorbidities, and biomechanics. Although articular cartilage is the main tissue affected in osteoarthritis, the chronic inflammatory environment negatively influences the surrounding synovium, ligaments, and subchondral bone, further limiting their functional abilities and enhancing symptoms of OA. Treatment for osteoarthritis remains inconsistent due to the inability to determine the underlying mechanism of disease onset, severity of symptoms, and complicating comorbidities. In recent years, diet and nutritional supplements have gained interest regarding slowing the disease process, prevention, and treatment of OA. This is due to their anti-inflammatory properties, which result in a positive influence on pain, joint mobility, and cartilage formation. More specifically, omega-3 polyunsaturated fatty acids (PUFA) have demonstrated an influential role in the progression of OA, resulting in the reduction of cartilage destruction, inhibition of pro-inflammatory cytokine cascades, and production of oxylipins that promote anti-inflammatory pathways. The present review is focused on the assessment of evidence explaining the inflammatory processes of osteoarthritis and the influence of omega-3 supplementation to modulate the progression of osteoarthritis.
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Affiliation(s)
- Megan Shawl
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
| | - Thangiah Geetha
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
- Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, AL 36849, USA
| | - Donna Burnett
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
| | - Jeganathan Ramesh Babu
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
- Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, AL 36849, USA
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7
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Liu Y, Song F, Liu M, Huang X, Xue S, Zhang X, Hao H, Zhang J. Association between omega-3 polyunsaturated fatty acids and osteoarthritis: results from the NHANES 2003-2016 and Mendelian randomization study. Lipids Health Dis 2024; 23:147. [PMID: 38760818 PMCID: PMC11100232 DOI: 10.1186/s12944-024-02139-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/08/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Omega-3 polyunsaturated fatty acids (omega-3 PUFAs) exhibit potential as therapeutics for a variety of diseases. This observational and Mendelian randomization (MR) study aims to explore the relationship between omega-3 PUFAs and osteoarthritis (OA). METHODS Excluding individuals under 20 years old and those with missing data on relevant variables in the National Health and Nutrition Examination Survey (NHANES) spanning from 2003 to 2016, a total of 22 834 participants were included in this cross-sectional study. Weighted multivariable-adjusted logistic regression was used to estimate the association between omega-3 PUFAs and OA in adults. Moreover, restricted cubic splines were utilized to examine the dose-response relationship between omega-3 PUFAs and OA. To further investigate the potential causal relationship between omega-3 PUFAs and OA risk, a two-sample MR study was conducted. Furthermore, the robustness of the findings was assessed using various methods. RESULTS Omega-3 PUFAs intake were inversely associated with OA in adults aged 40 ∼ 59 after multivariable adjustment [Formula: see text], with a nonlinear relationship observed between omega-3 PUFAs intake and OA [Formula: see text]. The IVW results showed there was no evidence to suggest a causal relationship between omega-3 PUFAs and OA risk [Formula: see text]. CONCLUSIONS Omega-3 PUFAs were inversely associated with OA in adults aged 40 ∼ 59. However, MR studies did not confirm a causal relationship between the two.
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Affiliation(s)
- Yuxuan Liu
- School of Management, Shanxi Medical University, Jinzhong, China
| | - Feichao Song
- School of Management, Shanxi Medical University, Jinzhong, China
| | - Muchun Liu
- Academy of Medical Sciences, Shanxi Medical University, Taiyuan, China
| | - Xi Huang
- Academy of Medical Sciences, Shanxi Medical University, Taiyuan, China
| | - Shuyan Xue
- Third Clinical College, Shanxi University of Traditional Chinese Medicine, Jinzhong, China
| | - Xuanyu Zhang
- School of Management, Shanxi Medical University, Jinzhong, China
| | - Huiqin Hao
- School of Basic Medicine, Shanxi University of Traditional Chinese Medicine, Jinzhong, China
| | - Junfeng Zhang
- School of Management, Shanxi Medical University, Jinzhong, China.
- School of Basic Medicine, Shanxi University of Traditional Chinese Medicine, Jinzhong, China.
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Liew JW, Turkiewicz A, Roemer FW, Frobell RB, Felson D, Englund M. Diagnostic Accuracy of Candidate Magnetic Resonance Imaging Knee Osteoarthritis Definitions Versus Radiograph in an Acute Anterior Cruciate Ligament Injury Cohort. Arthritis Care Res (Hoboken) 2024; 76:409-414. [PMID: 37781746 PMCID: PMC10922537 DOI: 10.1002/acr.25248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE We tested the diagnostic accuracy of previously proposed magnetic resonance imaging (MRI) osteoarthritis (OA) definitions in a cohort after acute anterior cruciate ligament (ACL) injury. METHODS We studied participants with posteroanterior and lateral knee radiographs and MRI 5 years after ACL injury, scored using the Anterior Cruciate Ligament Osteoarthritis Score. Radiographic OA (ROA) was defined using Osteoarthritis Research Society International scoring of osteophytes and joint space narrowing considering medial/lateral tibiofemoral and patellofemoral compartments. We tested three candidate MRI OA definitions that performed well in an older adult cohort. "Multicenter Osteoarthritis Study (MOST) simple" required cartilage score ≥2 (range 0-6) and osteophyte score ≥2 (0-7); "MOST optional" included cartilage score ≥2, osteophyte score ≥2, and either bone marrow lesions (BMLs) ≥1 (0-3) or synovitis ≥2 (0-3). The third, a Delphi panel definition, included nonzero scores for cartilage, osteophyte, BMLs, meniscus, and other structures. We calculated sensitivity and specificity with 95% confidence intervals (95% CIs) for each MRI definition versus ROA. RESULTS We included 113 participants (mean age 26 years, 26% female). At 5 years, 29 participants (26%) had ROA. "MOST simple" had a sensitivity of 52% (95% CI 33%-71%), and specificity of 76% (95% CI 66%-85%). Sensitivity and specificities for "MOST optional" were 28% (95% CI 29%-67%) and 83% (95% CI 74%-91%), respectively. The Delphi panel definition had a sensitivity of 48% (95% CI 29%-67%) and specificity of 77% (95% CI 67%-86%). CONCLUSION Simple MRI-based OA definitions requiring at least cartilage damage and an osteophyte have low sensitivity and high specificity in young persons after knee injury.
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Affiliation(s)
- Jean W. Liew
- Section of Rheumatology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Aleksandra Turkiewicz
- Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
| | - Frank W. Roemer
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander Universität Erlangen Nürnberg (FAU), Erlangen, Germany & Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Richard B. Frobell
- Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
| | - David Felson
- Section of Rheumatology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Martin Englund
- Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
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Tekeli SÖ, Köse Ö, Yapar D, Tekeli FY, Asoğlu MM, Kartal EM. Relationship between serum vitamin D levels and the prevalence of knee osteoarthritis: A retrospective study on 3424 subjects. Technol Health Care 2024; 32:3649-3658. [PMID: 38306069 DOI: 10.3233/thc-230802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND The extent of the association between vitamin D deficiency and knee osteoarthritis remains inadequately understood. OBJECTIVE This study aimed to elucidate the relationship between vitamin D levels and knee osteoarthritis through a cross-sectional analysis. METHODS This retrospective study involved an analysis of knee radiographs and serum 25-hydroxyvitamin D3 (25-(OH) vitamin D3) levels in a cohort of 3424 individuals (2901 women and 523 men). Knee osteoarthritis severity was evaluated using the Kellgren-Lawrence radiological scoring system. RESULTS Of the participants, 49.2% (n= 1,683) were diagnosed with knee osteoarthritis. Among these patients, the levels of adjusted 25-(OH) vitamin D3 were significantly lower (p< 0.001). Regression analysis revealed a significant association between vitamin D deficiency and knee osteoarthritis, with an adjusted odds ratio (OR) of 1.7 (95% CI: 1.5-2.0; p< 0.001). Notably, a stronger association was observed between vitamin D deficiency and knee osteoarthritis in women under 65 compared to those aged 65 and above. CONCLUSIONS The findings of this study indicate a higher prevalence of vitamin D deficiency in patients with knee osteoarthritis. Maintaining adequate serum 25-(OH) vitamin D3 levels may prevent knee osteoarthritis, especially in women below 65.
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Affiliation(s)
- Seçkin Özgür Tekeli
- Department of Biochemistry, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Özkan Köse
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
- Department of Anatomy, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Dilek Yapar
- Department of Public Health, Ministry of Health, Antalya, Turkey
| | - Feyza Yağmur Tekeli
- Department of Biochemistry, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Mehmet Melih Asoğlu
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Emre Mücahit Kartal
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
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Patnaik R, Riaz S, Sivani BM, Faisal S, Naidoo N, Rizzo M, Banerjee Y. Evaluating the potential of Vitamin D and curcumin to alleviate inflammation and mitigate the progression of osteoarthritis through their effects on human chondrocytes: A proof-of-concept investigation. PLoS One 2023; 18:e0290739. [PMID: 38157375 PMCID: PMC10756552 DOI: 10.1371/journal.pone.0290739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/14/2023] [Indexed: 01/03/2024] Open
Abstract
Osteoarthritis (OA) is a chronic degenerative joint disorder primarily affecting the elderly, characterized by a prominent inflammatory component. The long-term side effects associated with current therapeutic approaches necessitate the development of safer and more efficacious alternatives. Nutraceuticals, such as Vitamin D and curcumin, present promising therapeutic potentials due to their safety, efficacy, and cost-effectiveness. In this study, we utilized a proinflammatory human chondrocyte model of OA to assess the anti-inflammatory properties of Vitamin D and curcumin, with a particular focus on the Protease-Activated Receptor-2 (PAR-2) mediated inflammatory pathway. Employing a robust siRNA approach, we effectively modulated the expression of PAR-2 to understand its role in the inflammatory process. Our results reveal that both Vitamin D and curcumin attenuate the expression of PAR-2, leading to a reduction in the downstream proinflammatory cytokines, such as Tumor Necrosis Factor-alpha (TNF-α), Interleukin 6 (IL-6), and Interleukin 8 (IL-8), implicated in the OA pathogenesis. Concurrently, these compounds suppressed the expression of Receptor Activator of Nuclear Factor kappa-Β Ligand (RANKL) and its receptor RANK, which are associated with PAR-2 mediated TNF-α stimulation. Additionally, Vitamin D and curcumin downregulated the expression of Interferon gamma (IFN-γ), known to elevate RANKL levels, underscoring their potential therapeutic implications in OA. This study, for the first time, provides evidence of the mitigating effect of Vitamin D and curcumin on PAR-2 mediated inflammation, employing an siRNA approach in OA. Thus, our findings pave the way for future research and the development of novel, safer, and more effective therapeutic strategies for managing OA.
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Affiliation(s)
- Rajashree Patnaik
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine, and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Sumbal Riaz
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine, and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Bala Mohan Sivani
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine, and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Shemima Faisal
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine, and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Nerissa Naidoo
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine, and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine, and Medical Specialties (Promise), University of Palermo, Palermo, Italy
| | - Yajnavalka Banerjee
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine, and Health Sciences (MBRU), Dubai, United Arab Emirates
- Centre for Medical Education, University of Dundee, Dundee, United Kingdom
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11
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Wei G, Lu K, Umar M, Zhu Z, Lu WW, Speakman JR, Chen Y, Tong L, Chen D. Risk of metabolic abnormalities in osteoarthritis: a new perspective to understand its pathological mechanisms. Bone Res 2023; 11:63. [PMID: 38052778 PMCID: PMC10698167 DOI: 10.1038/s41413-023-00301-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/11/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023] Open
Abstract
Although aging has traditionally been viewed as the most important risk factor for osteoarthritis (OA), an increasing amount of epidemiological evidence has highlighted the association between metabolic abnormalities and OA, particularly in younger individuals. Metabolic abnormalities, such as obesity and type II diabetes, are strongly linked to OA, and they affect both weight-bearing and non-weight-bearing joints, thus suggesting that the pathogenesis of OA is more complicated than the mechanical stress induced by overweight. This review aims to explore the recent advances in research on the relationship between metabolic abnormalities and OA risk, including the impact of abnormal glucose and lipid metabolism, the potential pathogenesis and targeted therapeutic strategies.
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Affiliation(s)
- Guizheng Wei
- Department of Bone and Joint Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
- Research Center for Computer-aided Drug Discovery, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Faculty of Pharmaceutical Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Ke Lu
- Research Center for Computer-aided Drug Discovery, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Faculty of Pharmaceutical Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Muhammad Umar
- Research Center for Computer-aided Drug Discovery, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Faculty of Pharmaceutical Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Zhenglin Zhu
- Department of Orthopedic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - William W Lu
- Faculty of Pharmaceutical Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - John R Speakman
- Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Yan Chen
- Department of Bone and Joint Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.
| | - Liping Tong
- Research Center for Computer-aided Drug Discovery, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
| | - Di Chen
- Research Center for Computer-aided Drug Discovery, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Faculty of Pharmaceutical Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
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12
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Zhao SS, Mason A, Gjekmarkaj E, Yanaoka H, Burgess S. Associations between vitamin D and autoimmune diseases: Mendelian randomization analysis. Semin Arthritis Rheum 2023; 62:152238. [PMID: 37437450 PMCID: PMC7614794 DOI: 10.1016/j.semarthrit.2023.152238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/14/2023] [Accepted: 06/25/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVE The VITAL trial of vitamin D supplementation suggested a possible protective effect for autoimmune diseases but uncertainties remain. We investigated potential causal effects of vitamin D on composite and individual autoimmune diseases using Mendelian randomization. METHODS We used data from 332,984 participants of the UK Biobank of whom 23,089 had at least one autoimmune disease defined using ICD code and/or self-report. Diseases were further considered in mechanistic subgroups driven by "autoimmunity" (n = 12,774) or "autoinflammation" (n = 11,164), then individually. We selected variants within gene regions implicated in vitamin D biology to generate a weighted genetic score. We performed population-wide analysis using the ratio method, then examined non-linear effects across five quantiles based on 25-hydroxycholecalciferol levels. RESULTS Genetically-predicted vitamin D was associated with lower risk of diseases in the autoinflammation group (OR 0.95 per 10 ng/ml increase in 25-hydroxycholecalciferol; 95%CI 0.91-0.99; p = 0.03) but not the autoimmunity group (OR 0.99; 95%CI 0.95-1.03; p = 0.64) or combined. When considering individual diseases, genetically-predicted vitamin D was associated with lower risk of psoriasis (OR 0.91; 95%CI 0.85-0.97; p = 0.005), the most common disease in the autoinflammation group, and suggestively with systemic lupus erythematosus (OR 0.84; 95%CI 0.69-1.02; p = 0.08); results were replicated using data from independent studies. We found no evidence for a plausible non-linear relationship between vitamin D and any outcome. CONCLUSIONS We found genetic evidence to support a causal link between 25-hydroxycholecalciferol concentrations and psoriasis and systemic lupus erythematosus. These results have implications for potential disease prevention strategies, and the interpretation and design of vitamin D supplementation trials.
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Affiliation(s)
- Sizheng Steven Zhao
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Science, School of Biological Sciences, Faculty of Biological Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Amy Mason
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Heart and Lung Research Institute, University of Cambridge, Cambridge, UK; Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Eva Gjekmarkaj
- Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Haruyuki Yanaoka
- Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo, Japan
| | - Stephen Burgess
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Heart and Lung Research Institute, University of Cambridge, Cambridge, UK; Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK.
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13
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Dai Y, Chen Y, Gu R, Zhang C, Jiang R. Causal association of polyunsaturated fatty acids with chronic pain: a two-sample Mendelian randomization study. Front Nutr 2023; 10:1265928. [PMID: 37743908 PMCID: PMC10512421 DOI: 10.3389/fnut.2023.1265928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/25/2023] [Indexed: 09/26/2023] Open
Abstract
Background Observational studies have indicated an association between polyunsaturated fatty acids (PUFAs) and chronic pain, but the potential causal link remains controversial. Here, we aimed to investigate whether a causal relationship exists between the concentration of circulating PUFAs and chronic pain as well as the direction of this association. Methods We collected statistical data from relevant genome-wide association studies to explore the causal link between four PUFAs, along with the ratio of omega-6 fatty acids (FAs) to omega-3 FAs (omega-6:3 ratio), and chronic pain in eight specific body parts. We used the inverse-variance weighting (IVW) method for two-sample Mendelian randomization (MR) analysis and conducted supplementary analyses using four other methods (MR-Egger, weighted median, weighted mode, and simple mode). To verify the robustness of the MR study, we performed multiple sensitivity analyses. Results The results revealed a negative correlation between omega-3 FAs [IVW, OR 95% CI: 0.952 (0.914, 0.991), p = 0.017] and docosahexaenoic acid (DHA) [IVW, OR 95% CI: 0.935 (0.893, 0.978), p = 0.003] with abnormal and pelvic pain. Furthermore, a positive correlation was observed between the omega-6:3 ratio [IVW, OR 95% CI: 1.057 (1.014, 1.101), p = 0.009] with abdominal and pelvic pain. Additionally, we found a negative correlation between omega-3 FAs [IVW, OR 95% CI: 0.947 (0.902, 0.994), p = 0.028] and lower back pain or sciatica. However, no causal relationship was found between the concentration of circulating PUFAs and pain in other body parts, including the face, throat and chest, joints, limbs, lower back, and gynecological parts. The robustness of these MR results was verified through multi-validity and retention method analyses. Conclusion Our analysis suggests that higher circulating concentrations of omega-3 FAs and DHA and a lower omega-6:3 ratio are associated with a reduced risk of abdominal and pelvic pain. Additionally, a higher concentration of circulating omega-3 FAs is linked to a reduced risk of lower back pain and/or sciatica. These findings have major implications for the targeted prevention and treatment of chronic pain using PUFAs.
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Affiliation(s)
- Yuxuan Dai
- Department of Plastic Surgery, The Third Bethune Hospital of Jilin University, Changchun, China
| | - Yu Chen
- Department of Surgical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Rui Gu
- Department of Orthopedics, The Third Bethune Hospital of Jilin University, Changchun, China
| | - Chao Zhang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Rui Jiang
- Department of Orthopedics, The Third Bethune Hospital of Jilin University, Changchun, China
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14
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Zhou R, Zhang L, Sun Y, Yan J, Jiang H. Causal Associations between Dietary Habits and Chronic Pain: A Two-Sample Mendelian Randomization Study. Nutrients 2023; 15:3709. [PMID: 37686741 PMCID: PMC10490345 DOI: 10.3390/nu15173709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
Chronic pain is a prevalent and debilitating condition with significant impacts on individuals and society. While the role of diet in chronic pain is well-known, the relationship between special dietary choices and chronic pain remains unclear. This study investigates the causal associations between 20 dietary habits and chronic pain using a Mendelian randomization (MR) approach. Publicly available genome-wide association study data from the UK Biobank dataset were utilized for secondary analysis, and genetic instrumental variables strongly correlated with 20 different dietary habits were selected. Multisite chronic pain (MCP) scores were used as the primary outcome, with site-specific chronic pain (SSCP) including back pain, headache, knee pain, neck pain, and hip pain as secondary outcomes. The inverse-variance-weighted (IVW) method was the primary method used in the MR. The weighted median (WM) and Mendelian randomization pleiotropy residual sum and outlier test (MR-PRESSO) methods were used as sensitivity analyses. This study identified causal associations between specific dietary habits and chronic pain. A high intake of cheese, cereal, dried fruits, and fresh fruits was associated with lower MCP scores. Conversely, high alcohol, salt, pork, and poultry intakes were associated with higher MCP scores. Similar associations between special dietary habits and some types of SSCP, such as back and neck pain, were also observed. The findings were consistent across different statistical methods, and sensitivity analyses confirmed the reliability of the results. In conclusion, our study provides evidence of a causal relationship between various dietary habits and different types of chronic pain based on secondary analysis of the UK Biobank dataset. Adhering to an anti-inflammatory diet, including increased consumption of fruits and cereal while reducing salt and pork intake, may potentially alleviate chronic pain symptoms.
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Affiliation(s)
| | | | | | - Jia Yan
- Department of Anesthesiology, The Ninth People’s Hospital of Shanghai, Jiao Tong University School of Medicine, Shanghai 200011, China; (R.Z.); (L.Z.); (Y.S.)
| | - Hong Jiang
- Department of Anesthesiology, The Ninth People’s Hospital of Shanghai, Jiao Tong University School of Medicine, Shanghai 200011, China; (R.Z.); (L.Z.); (Y.S.)
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15
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Yang Q, Zhao Y, Li N, Wu JL, Huang X, Zhang M, Bian X, Zhu YZ. Identification of polyunsaturated fatty acids as potential biomarkers of osteoarthritis after sodium hyaluronate and mesenchymal stem cell treatment through metabolomics. Front Pharmacol 2023; 14:1224239. [PMID: 37649888 PMCID: PMC10462907 DOI: 10.3389/fphar.2023.1224239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/02/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction: Osteoarthritis (OA) is a prevalent joint disorder worldwide. Sodium hyaluronate (SH) and mesenchymal stem cells (MSCs) are promising therapeutic strategies for OA. Previous studies showed they could improve knee function and clinical symptoms of OA. However, the mechanism of the therapeutic effects on the improvement of OA has not been clearly explained. Methods: In our study, we used a technique called 5-(diisopropylamino)amylamine derivatization liquid chromatography coupled with mass spectrometry to find the metabolites in OA synovial fluid under different treatments. Results and Discussion: After looking into the metabolomics, we discovered that SH and MSC treatment led to the downregulation of ω-6 polyunsaturated fatty acids (PUFAs) and the upregulation of ω-3 PUFAs. Significantly, the contents of 5(S)-HETE, PGA2, PGB2, and PGJ2 were lower in the MSC group than in the SH group after quantification using 5-(diisopropylamino)amylamine derivatization-UHPLC-QQQ-MS. This is the first report on the relationship of 11(S)-HETE, PGA2, PGB2, PGF2β, 11β-PGF2α, and DK-PGE2 with OA. Moreover, the correlation analysis of metabolites and inflammation factors showed the positive association of ω-6 PUFAs with pro-inflammation cytokines, and of ω-3 PUFAs with anti-inflammation cytokines. Our results indicated the therapeutic effect of SH and MSCs in patients with OA. In addition, this reliable metabolic approach could uncover novel biomarkers to treat OA.
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Affiliation(s)
- Qinyan Yang
- School of Pharmacy, Macau University of Science and Technology, Taipa, Macao SAR, China
- State Key Laboratory for Quality Research of Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
- Liver Transplant Center and HBP Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yiran Zhao
- State Key Laboratory for Quality Research of Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
| | - Na Li
- State Key Laboratory for Quality Research of Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
| | - Jian-Lin Wu
- State Key Laboratory for Quality Research of Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
| | - Xiaolun Huang
- School of Pharmacy, Macau University of Science and Technology, Taipa, Macao SAR, China
- State Key Laboratory for Quality Research of Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
- Liver Transplant Center and HBP Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Mei Zhang
- School of Pharmacy, Macau University of Science and Technology, Taipa, Macao SAR, China
- State Key Laboratory for Quality Research of Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
| | - Xiqing Bian
- School of Pharmacy, Macau University of Science and Technology, Taipa, Macao SAR, China
- State Key Laboratory for Quality Research of Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
| | - Yi-Zhun Zhu
- School of Pharmacy, Macau University of Science and Technology, Taipa, Macao SAR, China
- State Key Laboratory for Quality Research of Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
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16
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Wang R, Wang ZM, Xiang SC, Jin ZK, Zhang JJ, Zeng JC, Tong PJ, Lv SJ. Relationship between 25-hydroxy vitamin D and knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne) 2023; 10:1200592. [PMID: 37601800 PMCID: PMC10433223 DOI: 10.3389/fmed.2023.1200592] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023] Open
Abstract
Objective In order to examine the relationship between 25-hydroxyl vitamin D and knee osteoarthritis (KOA), a meta-analysis of 8 randomized controlled trials (RCTs) publications was hereby performed. Methods For the purpose of finding pertinent research, the databases of PubMed, Embase and the Cochrane Library were searched. Factors including tibial cartilage volume, joint space width (JSW), synovial fluid volume, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were correspondingly evaluated, and the results were expressed using SMD and 95% confidence intervals (CI). Results The present meta-analysis evaluated the effects of vitamin D supplementation in patients with knee osteoarthritis, with 3,077 patients included. The results showed that vitamin D administration had a statistically significant impact on the amount of synovial fluid, Visual Analog Scale (VAS) and tibial cartilage. The pain and function scales of the WOMAC scale presented a statistically significant difference, and there was no discernible difference between the vitamin D and placebo groups in the stiffness scale. Additionally, bone marrow lesions and alterations in the diameter of the joint space were not influenced by the administration of vitamin D, and according to a subgroup study, a daily vitamin D supplement containing more than 2,000 IU significantly slowed the development of synovial tissue. Conclusion Vitamin D supplementation did benefit those suffering from knee discomfort and knee dysfunction. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022332033, identifier: CRD42022332033.
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Affiliation(s)
- Rui Wang
- Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Orthopedic Surgery, Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Zheng-ming Wang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Si-cheng Xiang
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhao-kai Jin
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jing-jing Zhang
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ji-cheng Zeng
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Pei-jian Tong
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Shuai-jie Lv
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
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17
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Liew JW, Rabasa G, LaValley M, Collins J, Stefanik J, Roemer FW, Guermazi A, Lewis CE, Nevitt M, Torner J, Felson D. Development of a Magnetic Resonance Imaging-Based Definition of Knee Osteoarthritis: Data From the Multicenter Osteoarthritis Study. Arthritis Rheumatol 2023; 75:1132-1138. [PMID: 36693143 PMCID: PMC10361157 DOI: 10.1002/art.42454] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/15/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Although magnetic resonance imaging (MRI) is the imaging modality of choice for research, there is no widely accepted MRI definition of knee osteoarthritis (OA). We undertook this study to test the performance of different MRI definitions of OA. METHODS We studied Multicenter Osteoarthritis Study participants with knee symptoms using posteroanterior and lateral knee radiographs and MRIs. Radiographic OA was defined as Kellgren/Lawrence grade ≥2 in the tibiofemoral (TF) and/or patellofemoral (PF) joint. Symptomatic OA was defined using a validated questionnaire. MRI findings of cartilage damage, osteophytes, bone marrow lesions (BMLs), and synovitis were scored using the Whole-Organ MRI Score system. We compared definitions using combinations of MRI features to the validation criteria of prevalent radiographic OA and symptomatic OA. All combinations included cartilage damage score ≥2 (0-6 scale) and osteophyte score ≥2 (0-6 scale); addition of BMLs and synovitis score was also tested. We also evaluated a Delphi panel definition that defined OA differently for the PF and TF joints. For each definition, we calculated sensitivity, specificity, and the area under the curve (AUC). RESULTS We included 1,185 knees from 1,185 participants (mean age 66 years, 62% female, 89% White). Among the 1,185 knees, 482 knees had radiographic OA, and 524 knees had symptomatic OA. The MRI definitions with a cartilage score ≥2 and osteophyte score ≥2 and definitions which added BMLs or synovitis score ≥1 had the highest sensitivities (95.2% and 94.5%, respectively) for prevalent radiographic OA (AUCs 0.67 and 0.69, respectively), and also had the highest sensitivities for symptomatic OA. The Delphi panel definition had similar performance but was more complex to apply. CONCLUSION An MRI OA definition requiring cartilage damage and a small osteophyte with or without BMLs or synovitis had the best performance and was simplest for identifying radiographic OA and symptomatic OA.
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Affiliation(s)
- Jean W. Liew
- Section of Rheumatology, Boston University School of Medicine, Massachusetts
| | - Gabriela Rabasa
- Section of Rheumatology, Boston University School of Medicine, Massachusetts
| | | | - Jamie Collins
- Department of Orthopedic Surgery, Orthopedic and Arthritis Center for Outcomes Research, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts
| | | | - Frank W. Roemer
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander Universität Erlangen Nürnberg (FAU), Erlangen, Germany, and Department of Radiology, Boston University School of Medicine, Massachusetts
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, and Department of Radiology, VA Boston Healthcare System, Massachusetts
| | | | | | | | - David Felson
- Section of Rheumatology, Boston University School of Medicine, Massachusetts
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18
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Bassuk SS, Manson JE. Marine omega-3 fatty acid supplementation and prevention of cardiovascular disease: update on the randomized trial evidence. Cardiovasc Res 2023; 119:1297-1309. [PMID: 36378553 PMCID: PMC10262192 DOI: 10.1093/cvr/cvac172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
To date, the VITamin D and OmegA-3 TriaL (VITAL) is the only large-scale randomized trial of marine omega-3 fatty acid (n-3 FA) supplementation for cardiovascular disease (CVD) prevention in a general population unselected for elevated cardiovascular risk. We review the findings of VITAL, as well as results from recent secondary prevention trials and updated meta-analyses of n-3 FA trials in the primary and secondary prevention of CVD. In VITAL, a nationwide sample of 25 871 US adults aged 50 and older, including 5106 African Americans, were randomized in a 2 × 2 factorial design to n-3 FAs (1 g/day; 1.2:1 ratio of eicosapentaenoic to docosahexaenoic acid) and vitamin D3 (2000 IU/day) for a median of 5.3 years. Compared with an olive oil placebo, the n-3 FA intervention did not significantly reduce the primary endpoint of major CVD events [composite of myocardial infarction (MI), stroke, and CVD mortality; hazard ratio (HR) = 0.92 (95% confidence interval 0.80-1.06)] but did significantly reduce total MI [HR = 0.72 (0.59-0.90)], percutaneous coronary intervention [HR = 0.78 (0.63-0.95)], fatal MI [HR = 0.50 (0.26-0.97)], and recurrent (but not first) hospitalization for heart failure [HR = 0.86 (0.74-0.998)]. The intervention neither decreased nor increased risk of atrial fibrillation. African Americans derived the greatest treatment benefit for MI and for recurrent hospitalization for heart failure (P interaction < 0.05 for both outcomes). Meta-analyses that include VITAL and high-risk or secondary prevention n-3 FA trials show coronary, but generally not stroke, risk reduction. More research is needed to determine which individuals may be most likely to derive net benefit. (VITAL clinicaltrials.gov identifier: NCT01169259).
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Affiliation(s)
- Shari S Bassuk
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 900 Commonwealth Avenue, 3rd Floor, Boston, Massachusetts 02215, USA
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 900 Commonwealth Avenue, 3rd Floor, Boston, Massachusetts 02215, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
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19
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Deng W, Yi Z, Yin E, Lu R, You H, Yuan X. Effect of omega-3 polyunsaturated fatty acids supplementation for patients with osteoarthritis: a meta-analysis. J Orthop Surg Res 2023; 18:381. [PMID: 37226250 DOI: 10.1186/s13018-023-03855-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/13/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Omega-3 polyunsaturated fatty acids (n-3 PUFAs) confers anti-inflammatory efficacy, which has been suggested to be effective for patients with osteoarthritis (OA). However, previous studies evaluating the influence of n-3 PUFAs supplementation in patients with OA showed inconsistent results. We performed a systematic review and meta-analysis to comprehensively evaluate the influence of n-3 PUFAs on symptom and joint function of patients with OA. METHODS Relevant randomized controlled trials (RCTs) were obtained by searching PubMed, Embase, and Cochrane Library databases. A random-effects model was employed to combine the results. RESULTS Nine RCTs with 2070 patients with OA contributed to the meta-analysis. Pooled results showed that n-3 PUFAs supplementation could significantly relieve the arthritis pain as compared to placebo (standardized mean difference [SMD]: - 0.29, 95% confidence interval [CI] - 0.47 to - 0.11, p = 0.002, I2 = 60%). Besides, supplementation with n-3 PUFAs was also associated with improved joint function (SMD: - 0.21, 95% CI - 0.34 to - 0.07, p = 0.002, I2 = 27%). Subgroup analysis showed consistent results of studies with arthritis pain and joint function evaluated by the Western Ontario-McMaster University Osteoarthritis Index and other scales (p for subgroup difference = 0.33 and 0.34, respectively). No severe treatment-related adverse events (AEs) were observed in the included patients, and the incidence of overall AEs was similar between groups (odds ratio: 0.97, 95% CI 0.64-1.45, p = 0.86, I2 = 0%). CONCLUSIONS Supplementation of n-3 PUFAs is effective to relieve pain and improve joint function in patients with OA.
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Affiliation(s)
- Wen Deng
- Medical Affairs Office, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhiqian Yi
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Enzhi Yin
- Department of Traumatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Avenue 1095, Wuhan, 430030, China
| | - Rui Lu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hongbo You
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xuefeng Yuan
- Department of Traumatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Avenue 1095, Wuhan, 430030, China.
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Overstreet DS, Strath LJ, Hasan FN, Sorge RE, Penn T, Rumble DD, Aroke EN, WIggins AM, Dembowski JG, Bajaj EK, Quinn TL, Long DL, Goodin BR. Racial Differences in 25-Hydroxy Vitamin D and Self-Reported Pain Severity in a Sample of Individuals Living with Non-Specific Chronic Low Back Pain. J Pain Res 2022; 15:3859-3867. [PMID: 36514480 PMCID: PMC9741831 DOI: 10.2147/jpr.s386565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Considerable evidence suggests that there are significant ethnic/racial differences in the experience of pain among individuals suffering from chronic musculoskeletal conditions. Additionally, low levels of vitamin D have been associated with pain severity. Further, vitamin D deficiency is more prevalent in Non-Hispanic Black (NHB) individuals compared to Non-Hispanic Whites (NHW). Objective The aim of this study was to investigate the associations among race, pain severity, and serum levels of vitamin D in a sample of patients with chronic low back pain (cLBP). Methods All study participants (n = 155) self-identified their race/ethnicity as either NHB or NHW. Blood samples were collected to assess circulating levels of serum 25- hydroxy vitamin D. Vitamin D levels were categorized as optimal (≥20 ng/mL), insufficient (12-19 ng/mL) or deficient (<12 ng/mL). Participants then self-reported their pain severity using the Brief Pain Inventory - Short Form. Results Results showed that a greater proportion of NHB versus NHW participants were categorized as Vitamin D deficient (χ 2 (2, N = 155) = 16.79, p < 0.001). An analysis of covariance (ANCOVA) revealed that NHBs reported significantly greater pain severity relative to NHWs (F(1150) = 6.45) p = 0.012. Further, self-reported pain severity significantly differed according to Vitamin D clinical categories (F(2150) = 4.19, p = 0.013). Participants with deficient vitamin D reported significantly greater pain severity in comparison to participants with optimal vitamin D (F(1101) = 7.28, p = 0.008). Conclusion The findings suggest that Vitamin D deficiency may be linked to greater pain severity in a sample of individuals with cLBP, especially for those who identify as NHB.
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Affiliation(s)
- Demario S Overstreet
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Larissa J Strath
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Fariha N Hasan
- School of Public Health, Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert E Sorge
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Terence Penn
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Deanna D Rumble
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Edwin N Aroke
- School of Nursing, Nurse Anesthesia Program, Department of Acute, Chronic, & Continuing Care, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Asia M WIggins
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jonas G Dembowski
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eeshaan K Bajaj
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tammie L Quinn
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - D Leann Long
- School of Public Health, Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Burel R Goodin
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
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21
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Chevalley T, Brandi ML, Cashman KD, Cavalier E, Harvey NC, Maggi S, Cooper C, Al-Daghri N, Bock O, Bruyère O, Rosa MM, Cortet B, Cruz-Jentoft AJ, Cherubini A, Dawson-Hughes B, Fielding R, Fuggle N, Halbout P, Kanis JA, Kaufman JM, Lamy O, Laslop A, Yerro MCP, Radermecker R, Thiyagarajan JA, Thomas T, Veronese N, de Wit M, Reginster JY, Rizzoli R. Role of vitamin D supplementation in the management of musculoskeletal diseases: update from an European Society of Clinical and Economical Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) working group. Aging Clin Exp Res 2022; 34:2603-2623. [PMID: 36287325 PMCID: PMC9607746 DOI: 10.1007/s40520-022-02279-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/10/2022] [Indexed: 01/04/2023]
Abstract
Vitamin D is a key component for optimal growth and for calcium-phosphate homeostasis. Skin photosynthesis is the main source of vitamin D. Limited sun exposure and insufficient dietary vitamin D supply justify vitamin D supplementation in certain age groups. In older adults, recommended doses for vitamin D supplementation vary between 200 and 2000 IU/day, to achieve a goal of circulating 25-hydroxyvitamin D (calcifediol) of at least 50 nmol/L. The target level depends on the population being supplemented, the assessed system, and the outcome. Several recent large randomized trials with oral vitamin D regimens varying between 2000 and 100,000 IU/month and mostly conducted in vitamin D-replete and healthy individuals have failed to detect any efficacy of these approaches for the prevention of fracture and falls. Considering the well-recognized major musculoskeletal disorders associated with severe vitamin D deficiency and taking into account a possible biphasic effects of vitamin D on fracture and fall risks, an European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) working group convened, carefully reviewed, and analyzed the meta-analyses of randomized controlled trials on the effects of vitamin D on fracture risk, falls or osteoarthritis, and came to the conclusion that 1000 IU daily should be recommended in patients at increased risk of vitamin D deficiency. The group also addressed the identification of patients possibly benefitting from a vitamin D loading dose to achieve early 25-hydroxyvitamin D therapeutic level or from calcifediol administration.
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Affiliation(s)
- Thierry Chevalley
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - Maria Luisa Brandi
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liege, Liege, Belgium
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- UKNIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Nasser Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science King Saud University, Riyadh, 11451, Saudi Arabia
| | - Oliver Bock
- Department of Osteoporosis, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- International Osteoporosis Foundation, Nyon, Switzerland
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liege, Belgium
| | - Mario Miguel Rosa
- Centro de Estudos Egas Moniz Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Bernard Cortet
- Department of Rheumatology, University of Lille, CHU Lille, MABlab ULR 4490, Lille, France
| | | | - Antonio Cherubini
- Dipartimento dei percorsi geriatrici della fragilità, Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamentodella continuità di cura e riabilitativi, IRCCS INRCA, Ancona, Italy
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Roger Fielding
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Nicholas Fuggle
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - John A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Jean-Marc Kaufman
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Olivier Lamy
- Bone Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Andrea Laslop
- Scientific Office, Federal Office for Safety in Health Care, Austrian Medicines and Medical Devices Agency, Vienna, Austria
| | | | - Régis Radermecker
- Department of Clinical Pharmacology Diabetes, Nutrition and Metabolic Disorders, CHU Liege, Liège, Belgium
| | | | - Thierry Thomas
- Department of Rheumatology, North Hospital, CHU Saint-Etienne and INSERM U1059, University of Lyon-University Jean Monnet, Saint-Etienne, France
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Marten de Wit
- Department of Medical Humanities, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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22
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Chang X, Kang Y, Yang Y, Chen Y, Shen Y, Jiang C, Shen Y. Pyroptosis: A Novel Intervention Target in the Progression of Osteoarthritis. J Inflamm Res 2022; 15:3859-3871. [PMID: 35845090 PMCID: PMC9285853 DOI: 10.2147/jir.s368501] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/04/2022] [Indexed: 11/23/2022] Open
Abstract
Osteoarthritis (OA) is one of the most common chronic joint diseases and is gradually becoming the main cause of disability and joint pain in the elderly worldwide. Pyroptosis is a regulated programmed cell death triggered by inflammasomes. It leads to cell swelling, lysis, and bioactive molecule secretion. Studies found that the damaged chondrocytes in OA joints had morphological characteristics of pyroptosis, and the cytokines associated with pyroptosis in synovial fluid increased, indicating that pyroptosis may have certain impacts on the pathological progression of OA. This review briefly summarizes the molecular mechanisms of pyroptosis and the epidemiology and pathogenesis of OA. Furthermore, we discussed the role of pyroptosis in articular cartilage and synovium during OA and reviewed the progress of pyroptosis-related molecules in the targeted therapy of OA joints, hoping to provide feasible directions for the diversified treatment of OA.
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Affiliation(s)
- Xingyu Chang
- The First Clinical Medical College, Lanzhou University, Lanzhou, People's Republic of China
| | - Yuchen Kang
- The Second Clinical Medical College, Lanzhou University, Lanzhou, People's Republic of China
| | - Yuxuan Yang
- The First Clinical Medical College, Lanzhou University, Lanzhou, People's Republic of China
| | - Yajie Chen
- The First Clinical Medical College, Lanzhou University, Lanzhou, People's Republic of China
| | - Yanyu Shen
- The First Clinical Medical College, Lanzhou University, Lanzhou, People's Republic of China
| | - Chenjun Jiang
- The First Clinical Medical College, Lanzhou University, Lanzhou, People's Republic of China
| | - Yi Shen
- Department of Orthopaedics, The Second Xiangya Hospital of Central South University, Changsha, People's Republic of China
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23
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Oo WM, Hunter DJ. Repurposed and investigational disease-modifying drugs in osteoarthritis (DMOADs). Ther Adv Musculoskelet Dis 2022; 14:1759720X221090297. [PMID: 35619876 PMCID: PMC9128067 DOI: 10.1177/1759720x221090297] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/10/2022] [Indexed: 12/12/2022] Open
Abstract
In spite of a major public health burden with increasing prevalence, current osteoarthritis (OA) management is largely palliative with an unmet need for effective treatment. Both industry and academic researchers have invested a vast amount of time and financial expense to discover the first diseasing-modifying osteoarthritis drugs (DMOADs), with no regulatory success so far. In this narrative review, we discuss repurposed drugs as well as investigational agents which have progressed into phase II and III clinical trials based on three principal endotypes: bone-driven, synovitis-driven and cartilage-driven. Then, we will briefly describe the recent failures and lessons learned, promising findings from predefined post hoc analyses and insights gained, novel methodologies to enhance future success and steps underway to overcome regulatory hurdles.
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Affiliation(s)
- Win Min Oo
- Rheumatology Department, Royal North Shore Hospital, and Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Physical Medicine and Rehabilitation, Mandalay General Hospital, University of Medicine, Mandalay, Mandalay, Myanmar
| | - David J. Hunter
- Rheumatology Department, Royal North Shore Hospital, and Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
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24
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25
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Dagnino APA, Campos MM. Chronic Pain in the Elderly: Mechanisms and Perspectives. Front Hum Neurosci 2022; 16:736688. [PMID: 35308613 PMCID: PMC8928105 DOI: 10.3389/fnhum.2022.736688] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/27/2022] [Indexed: 12/12/2022] Open
Abstract
Chronic pain affects a large part of the population causing functional disability, being often associated with coexisting psychological disorders, such as depression and anxiety, besides cognitive deficits, and sleep disturbance. The world elderly population has been growing over the last decades and the negative consequences of chronic pain for these individuals represent a current clinical challenge. The main painful complaints in the elderly are related to neurodegenerative and musculoskeletal conditions, peripheral vascular diseases, arthritis, and osteoarthritis, contributing toward poorly life quality, social isolation, impaired physical activity, and dependence to carry out daily activities. Organ dysfunction and other existing diseases can significantly affect the perception and responses to chronic pain in this group. It has been proposed that elderly people have an altered pain experience, with changes in pain processing mechanisms, which might be associated with the degeneration of circuits that modulate the descending inhibitory pathways of pain. Aging has also been linked to an increase in the pain threshold, a decline of painful sensations, and a decrease in pain tolerance. Still, elderly patients with chronic pain show an increased risk for dementia and cognitive impairment. The present review article is aimed to provide the state-of-art of pre-clinical and clinical research about chronic pain in elderly, emphasizing the altered mechanisms, comorbidities, challenges, and potential therapeutic alternatives.
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Affiliation(s)
- Ana P. A. Dagnino
- Programa de Pós-graduação em Medicina e Ciências da Saúde, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria M. Campos
- Programa de Pós-graduação em Medicina e Ciências da Saúde, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- *Correspondence: Maria M. Campos, ,
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26
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Park S. Polygenetic Variants Related to Osteoarthritis Risk and Their Interactions with Energy, Protein, Fat, and Alcohol Intake in Adults in a Large Cohort. Diagnostics (Basel) 2022; 12:340. [PMID: 35204431 PMCID: PMC8871305 DOI: 10.3390/diagnostics12020340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 12/04/2022] Open
Abstract
Osteoarthritis (OA) is increasing globally, especially among elderly Asian women, and its increase may be due to the interaction between genetic factors and lifestyle. This study tested the hypothesis that polygenetic variants associated with OA risk interacted with lifestyle in adults over 40 years in the Ansan-Ansung cohort. Genetic variants were chosen through a genome-wide association study with OA participants (case; n = 580) and controls without arthritis (n = 4850). Genetic variants with interactions were selected by a generalized multifactor dimensionality reduction. The best model's polygenic risk scores (PRS) were calculated by summing the number of risk alleles in the selected genetic variants. The best five single nucleotide polymorphism (SNP) model included AIG1_rs6570550, COX10_rs62054459, DLG2_rs148643344, SOX5_rs73283615, and PLXNA4_rs1472529430, while IL12A_ rs1491318751 was added to the five-SNP model to produce a six-SNP model. Only COX10_rs62054459 in subcutaneous and visceral adipose tissue was associated with COX10 protein expression. The participants, having high-PRS from the five-SNP and six-SNP models, were at a higher OA risk than those with low-PRS by 3.88 and 4.42 times, respectively. The PRS was not associated with metabolic syndrome or with the insulin resistance index (HOMA-IR). Energy, protein, fat, alcohol, and a Western-style diet intake interacted with the PRS to influence OA risk (p = 0.005, 0.042, and 0.021, respectively). In the high energy and alcohol intake and low protein, fat, Western-style diet intake, the participants with a high-PRS had a higher incidence of OA than those with low-PRS. In conclusion, the adults with a high-PRS were at a higher OA risk. Particularly, adults with high PRS should have a lower energy intake, higher WSD containing higher protein and fat intake, and moderate alcohol intake to alleviate OA risk. These results can be applied to personalized nutrition plans to decrease OA risk.
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Affiliation(s)
- Sunmin Park
- Food and Nutrition, Obesity/Diabetes Center, Hoseo University, 165 Sechul-Ri, BaeBang-Yup, Asan-Si 31499, Korea
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27
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Wijayabahu AT, Mickle AM, Mai V, Garvan C, Glover TL, Cook RL, Zhao J, Baum MK, Fillingim RB, Sibille KT. Associations between Vitamin D, Omega 6:Omega 3 Ratio, and Biomarkers of Aging in Individuals Living with and without Chronic Pain. Nutrients 2022; 14:266. [PMID: 35057447 PMCID: PMC8779718 DOI: 10.3390/nu14020266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 02/01/2023] Open
Abstract
Elevated inflammatory cytokines and chronic pain are associated with shorter leukocyte telomere length (LTL), a measure of cellular aging. Micronutrients, such as 25-hydroxyvitamin D (vitamin D) and omega 3, have anti-inflammatory properties. Little is known regarding the relationships between vitamin D, omega 6:3 ratio, LTL, inflammation, and chronic pain. We investigate associations between vitamin D, omega 6:3 ratio, LTL, and C-reactive protein (CRP) in people living with/without chronic pain overall and stratified by chronic pain status. A cross-sectional analysis of 402 individuals (63% women, 79.5% with chronic pain) was completed. Demographic and health information was collected. Chronic pain was assessed as pain experienced for at least three months. LTL was measured in genomic DNA isolated from blood leukocytes, and micronutrients and CRP were measured in serum samples. Data were analyzed with general linear regression. Although an association between the continuous micronutrients and LTL was not observed, a positive association between omega 6:3 ratio and CRP was detected. In individuals with chronic pain, based on clinical categories, significant associations between vitamin D, omega 6:3 ratio, and CRP were observed. Findings highlight the complex relationships between anti-inflammatory micronutrients, inflammation, cellular aging, and chronic pain.
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Affiliation(s)
- Akemi T. Wijayabahu
- Department of Epidemiology, College of Public Health and Health Professions, and College of Medicine, University of Florida, Gainesville, FL 32610, USA; (A.T.W.); (V.M.); (R.L.C.); (J.Z.)
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Angela M. Mickle
- Department of Physical Medicine & Rehabilitation and Aging & Geriatric Research, University of Florida, Gainesville, FL 32610, USA;
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32610, USA;
| | - Volker Mai
- Department of Epidemiology, College of Public Health and Health Professions, and College of Medicine, University of Florida, Gainesville, FL 32610, USA; (A.T.W.); (V.M.); (R.L.C.); (J.Z.)
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Cynthia Garvan
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA;
| | - Toni L. Glover
- School of Nursing, Oakland University, Rochester, MI 48309, USA;
| | - Robert L. Cook
- Department of Epidemiology, College of Public Health and Health Professions, and College of Medicine, University of Florida, Gainesville, FL 32610, USA; (A.T.W.); (V.M.); (R.L.C.); (J.Z.)
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Jinying Zhao
- Department of Epidemiology, College of Public Health and Health Professions, and College of Medicine, University of Florida, Gainesville, FL 32610, USA; (A.T.W.); (V.M.); (R.L.C.); (J.Z.)
| | - Marianna K. Baum
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33174, USA;
| | - Roger B. Fillingim
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32610, USA;
| | - Kimberly T. Sibille
- Department of Physical Medicine & Rehabilitation and Aging & Geriatric Research, University of Florida, Gainesville, FL 32610, USA;
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32610, USA;
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA;
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28
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Chronische Knieschmerzen: Vitamin D und Omega-3-Fettsäuren ohne Effekt. AKTUEL RHEUMATOL 2021. [DOI: 10.1055/a-1416-9650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Arthrosebedingte Schmerzen im Knie sind häufig in der erwachsenen Bevölkerung. Im Rahmen der VITAL-Studie bestand die einmalige Gelegenheit, die Rolle von Vitamin D und Fischöl auf Knieschmerzen zu untersuchen. Ob Vitamin D und eine Supplementation mit Omega-3-Fettsäuren (n-3-FA) einen langfristigen, günstigen Effekt erzielen, untersuchten Ärzt*innen des Brigham und Womenʼs Krankenhauses der Harvard Medical School in Boston, USA.
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29
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Tecer D, Cinar M, Yilmaz S. The Importance of Establishing a Suitable Study Population in Osteoarthritis Studies: Comment on the Article by MacFarlane et al. Arthritis Rheumatol 2021; 73:900-901. [PMID: 33421341 DOI: 10.1002/art.41646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 12/09/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Duygu Tecer
- University of Health Sciences, and Gulhane Education and Research Hospital, Ankara, Turkey
| | - Muhammet Cinar
- University of Health Sciences, and Gulhane Education and Research Hospital, Ankara, Turkey
| | - Sedat Yilmaz
- University of Health Sciences, and Gulhane Education and Research Hospital, Ankara, Turkey
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30
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Bassuk SS, Chandler PD, Buring JE, Manson JE. The VITamin D and OmegA-3 TriaL (VITAL): Do Results Differ by Sex or Race/Ethnicity? Am J Lifestyle Med 2020; 15:372-391. [PMID: 34366734 DOI: 10.1177/1559827620972035] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/13/2020] [Accepted: 10/19/2020] [Indexed: 12/31/2022] Open
Abstract
Whether vitamin D or marine omega-3 (n-3) fatty acid supplementation reduces risk of cancer or cardiovascular disease (CVD) in general populations at usual risk for these outcomes is relatively unexplored in randomized trials. The primary goal of the VITamin D and OmegA-3 TriaL (VITAL), a nationwide, randomized, placebo-controlled, 2 × 2 factorial trial of vitamin D3 (2000 IU/day) and marine n-3 fatty acids (1 g/day) in the primary prevention of cancer and CVD among 25 871 US men aged ≥50 years and women aged ≥55 years, was to fill these knowledge gaps. Studying the influence of sex and race/ethnicity on treatment-related outcomes was a prespecified goal; such analyses help ensure that important effects are not missed and contribute to the foundation for developing targeted recommendations for supplement use. To enable investigation of potential sex- and race-specific treatment effects, trial investigators enrolled an even balance of men (n = 12 786) and women (n = 13 085) and oversampled African Americans (n = 5106). Significant or suggestive variation in intervention effects according to sex, race/ethnicity, and other participant characteristics was observed for some, though not all, outcomes. Additional research is needed to determine which individuals may be most likely to derive a net benefit from vitamin D or n-3 fatty acid supplementation. (VITAL clinicaltrials.gov identifier: NCT01169259).
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Affiliation(s)
- Shari S Bassuk
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (SSB, PDC, JEB, JEM).,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (JEB, JEM)
| | - Paulette D Chandler
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (SSB, PDC, JEB, JEM).,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (JEB, JEM)
| | - Julie E Buring
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (SSB, PDC, JEB, JEM).,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (JEB, JEM)
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (SSB, PDC, JEB, JEM).,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (JEB, JEM)
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