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Kuang S, Liu L, Hu Z, Luo M, Fu X, Lin C, He Q. A review focusing on the benefits of plant-derived polysaccharides for osteoarthritis. Int J Biol Macromol 2023; 228:582-593. [PMID: 36563826 DOI: 10.1016/j.ijbiomac.2022.12.153] [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: 07/18/2022] [Revised: 12/07/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
Osteoarthritis (OA) is a chronic joint disease characterized by progressive cartilage degeneration, which imposes a heavy physical and financial burden on the middle-aged and elderly population. As the pathogenesis of OA has not been fully elucidated, it is of great importance to develop targeted therapeutic or preventive medications. Traditional therapeutic drugs, such as non-steroidal anti-inflammatory drugs, steroids and opioids, have significant side effects, making the exploration for safe and effective alternative therapeutic drugs urgent. In recent years, many studies have reported the role of plant-derived polysaccharides in anti-inflammation, anti-oxidation, regulation of chondrocyte metabolism and proliferation, and cartilage protection, and have demonstrated their great potential in the treatment of OA. Therefore, by focusing on studies related to the intervention of plant-derived polysaccharides in OA, including in vivo and in vitro experiments, this review aimed to classify and summarize the existing research findings according to different mechanisms of action. In addition, reports on plant-derived polysaccharides as nanoparticles were also explored. Then, candidate monomers and theoretical bases were provided for the further development and application of novel drugs in the treatment of OA.
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Affiliation(s)
- Shida Kuang
- College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China; Andrology Laboratory, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China; Hunan University of Medicine, Huaihua, Hunan 418000, China
| | - Lumei Liu
- College of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China; Hunan University of Medicine, Huaihua, Hunan 418000, China
| | - Zongren Hu
- Andrology Laboratory, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China; Hunan University of Medicine, Huaihua, Hunan 418000, China
| | - Min Luo
- Andrology Laboratory, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China; Department of Rehabilitation Medicine and Health Care, Hunan University of Medicine, Huaihua 418000, Hunan, China; Hunan University of Medicine, Huaihua, Hunan 418000, China
| | - Xinying Fu
- College of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China; Andrology Laboratory, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China; Hunan University of Medicine, Huaihua, Hunan 418000, China
| | - Chengxiong Lin
- Hunan University of Medicine, Huaihua, Hunan 418000, China
| | - Qinghu He
- Andrology Laboratory, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China; Hunan University of Medicine, Huaihua, Hunan 418000, China.
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Lima IC, Castro RR, Adjafre BL, Sousa SHAF, de Paula DS, Alves APNN, Silva PGB, Assreuy AMS, Mota MRL. Galactomannan of Delonix regia seeds modulates cytokine expression and oxidative stress eliciting anti-inflammatory and healing effects in mice cutaneous wound. Int J Biol Macromol 2022; 203:342-349. [PMID: 35093436 DOI: 10.1016/j.ijbiomac.2022.01.144] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/14/2022] [Accepted: 01/23/2022] [Indexed: 11/05/2022]
Abstract
The galactomannans property of forming viscous solutions, along with the traditional use of Delonix regia as anti-inflammatory, antinociceptive and wound healing, justify the investigation of the healing mechanism of Delonix regia galactomannan (GM-DR) in a model of excisional cutaneous wound. GM-DR (% 0.01-1) was topically applied to the wounds of female Swiss mice during 14 days. The wound healing effect of GM-DR was evaluated by the following parameters: wound closure and clinical signs (hyperemia, edema and exudate by macroscopy, nociception by analgesimetry), oxidative stress markers (malondialdehyde - MDA, reduced glutathione - GSH) by ELISA, histopathological (HE and Picrosirius red), and histomorphometric (collagenesis, blood vessels, polymorphonuclear, mononuclear, fusiform cells) and immunohistochemistry (inflammatory and growth factor mediators) by tissue microarrayer. GM-DR reduced wound area (7-14th day) and hypernociception (6 h - 5th day), leukocyte infiltration (2 -7th days), expression and levels of IL-1β (2th day), IL-6 (2th day), MDA (44% - 2th day), and increased fusiform cells, granulation tissue, collagen deposition, GSH (25 - 50%, 2-5th day), expression of the transforming growth factor beta (TGF-β) (7-10th day) and smooth muscle alpha actin (α-SMA) (7-14th day). In conclusion, GM-DR accelerates the mice healing process acting both in the inflammatory and proliferative phases.
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Affiliation(s)
- Iásly C Lima
- Superior Institute of Biomedical Sciences, State University of Ceará, Av. Dr. Silas Munguba 1700, 60740-000 Fortaleza, CE, Brazil
| | - Rondinelle R Castro
- Faculty of Philosophy Dom Aureliano Matos, State University of Ceará, Av. Dom Aureliano Matos, 2000, Limoeiro do Norte, CE 62930-000, Brazil
| | - Beatriz L Adjafre
- Superior Institute of Biomedical Sciences, State University of Ceará, Av. Dr. Silas Munguba 1700, 60740-000 Fortaleza, CE, Brazil
| | - Skarlatt H A F Sousa
- Superior Institute of Biomedical Sciences, State University of Ceará, Av. Dr. Silas Munguba 1700, 60740-000 Fortaleza, CE, Brazil
| | - Dayrine S de Paula
- Department of Dental Clinic, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, State University of Ceará, Street Alexandre Baraúna 949, 60430-160 Fortaleza, CE, Brazil
| | - Ana Paula N N Alves
- Department of Dental Clinic, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, State University of Ceará, Street Alexandre Baraúna 949, 60430-160 Fortaleza, CE, Brazil
| | - Paulo G B Silva
- Department of Dental Clinic, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, State University of Ceará, Street Alexandre Baraúna 949, 60430-160 Fortaleza, CE, Brazil; Christus University Center (Unichristus), Street João Adolfo Gurgel 133, 60190-180 Fortaleza, CE, Brazil
| | - Ana M S Assreuy
- Superior Institute of Biomedical Sciences, State University of Ceará, Av. Dr. Silas Munguba 1700, 60740-000 Fortaleza, CE, Brazil.
| | - Mario R L Mota
- Department of Dental Clinic, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, State University of Ceará, Street Alexandre Baraúna 949, 60430-160 Fortaleza, CE, Brazil
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da Silva Nascimento FG, de Souza Ferreira Bringel PH, Maia FWS, Lima CPC, Alves RC, Feitosa JPA, Mota MRL, Assreuy AMS, Castro RR. Galactomannan of Delonix regia seeds reduces nociception and morphological damage in the rat model of osteoarthritis induced by sodium monoiodoacetate. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2021; 394:491-501. [PMID: 33057779 DOI: 10.1007/s00210-020-01996-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/08/2020] [Indexed: 01/06/2023]
Abstract
This study investigated the effects of the protein-free galactomannan obtained from Delonix regia seeds (GM-DR) in an experimental osteoarthritis (OA) model. GM-DR was obtained from water-homogenized endosperms by collection of the supernatant and precipitation with ethanol. The remaining proteins in the galactomannan were removed by alkaline hydrolysis. Weight average molar mass (Mw) of the galactomannan was estimated in 5.8 × 105 g mol-1, presenting mannose:galactose ratio of 2.39:1. Rats received sodium monoiodoacetate (OA groups, 1 mg/25 μL) or saline (sham group) in the right tibio-tarsal joint. GM-DR (30-300 μg) was administered by intra-articular route at days 14 and 21 after OA induction. Hypernociception was evaluated daily by the measurement of the mechanical threshold required to cause joint flexion and paw withdrawal reflex. The 56-day animal groups were euthanized for joint histopahological analysis using the OARSI score system. Lower doses of GM-DR (30 and 100 μg) promoted antinociception from day 15 until the endpoint at day 56. Joint damage was reduced by GM-DR administration (100 μg) in OA-subjected animals, compared to the vehicle-treated OA group (5.9 ± 1.8 vs 19.0 ± 1.8, respectively, p < 0.05). Conclusion: Both antinociception and damage reduction suggest that Delonix regia galactomannan is a promising approach for osteoarthritis therapy.
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Affiliation(s)
| | | | - Francisco Wildson Silva Maia
- Superior Institute of Biomedical Sciences, State University of Ceará, Av. Dr. Silas Munguba, 1700, Fortaleza, CE, 60714-903, Brazil
| | - Carlos Pinheiro Chagas Lima
- Department of Organic and Inorganic Chemistry, Federal University of Ceará, Av. Mister Hull, s/n, Fortaleza, CE, 60451-970, Brazil
| | - Rômulo Couto Alves
- Catarinian Federal Institute of Education, Science and Technology, R. Vigário Frei João, 550, Luzerna, SC, 89609-000, Brazil
| | - Judith Pessoa Andrade Feitosa
- Department of Organic and Inorganic Chemistry, Federal University of Ceará, Av. Mister Hull, s/n, Fortaleza, CE, 60451-970, Brazil
| | - Mário Rogério Lima Mota
- Department of Dental Clinic, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Street Alexandre Baraúna, 949, Fortaleza, CE, 60430-160, Brazil
| | - Ana Maria Sampaio Assreuy
- Superior Institute of Biomedical Sciences, State University of Ceará, Av. Dr. Silas Munguba, 1700, Fortaleza, CE, 60714-903, Brazil
| | - Rondinelle Ribeiro Castro
- Superior Institute of Biomedical Sciences, State University of Ceará, Av. Dr. Silas Munguba, 1700, Fortaleza, CE, 60714-903, Brazil.
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de Melo Nunes R, Cunha PLR, Pinto ACMD, Girão VCC, de Andrade Feitosa JP, Rocha FAC. Hylan G-F20 and galactomannan joint flares are associated to acute synovitis and release of inflammatory cytokines. Adv Rheumatol 2020; 60:26. [PMID: 32393335 DOI: 10.1186/s42358-020-00127-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 04/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Injection of Hylan G-F20 (HY) into joints may provoke local flares, which mechanisms may involve reaction to protein contaminants. We have previously developed a protein-free saline-soluble galactomannan derived from guar gum (GM) that displays both analgesia and chondroprotection in experimental osteoarthritis (OA). We now demonstrate that both GM and Hylan G-F20 (HY) promote mild synovitis with cytokine release after intra-articular injection. METHODS Mice received 100 μg/25 μL GM or HY or saline into the knees. Joint pain was evaluated using von Frey test; cell influx, interleukin (IL)-1, IL-6, and CXCL-1 (pg/mL) levels were assessed in joint lavage at 6 h. Synovia were excised for histopathology. RESULTS Neither GM nor HY after being given into mice knee joints induced pain albeit promoting mild cell influx into joint washings as well as mild synovitis at histology, with no damage to the underlying cartilage. HY but not GM promoted IL-1 release into mice joints. Both compounds induced IL-6 and CXCL-1 release. CONCLUSION Intra-articular injection of HY or GM promote acute transient synovitis whilst not provoking detectable significant joint damage. Local administration of these polysaccharides induces acute intra-articular release of inflammatory cytokines, which may account for joint flares following viscosupplementation.
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Affiliation(s)
- Rodolfo de Melo Nunes
- Departamento de Medicina Interna da Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | | | | | | | | | - Francisco Airton Castro Rocha
- Departamento de Medicina Interna da Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
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Machado RC, Capela S, Rocha FAC. Polysaccharides As Viscosupplementation Agents: Structural Molecular Characteristics but Not Rheology Appear Crucial to the Therapeutic Response. Front Med (Lausanne) 2017; 4:82. [PMID: 28674692 PMCID: PMC5475360 DOI: 10.3389/fmed.2017.00082] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/06/2017] [Indexed: 12/20/2022] Open
Abstract
Introduction Most clinical studies and basic research document viscosupplementation (VS) in terms of effectiveness and safety, but only a few highlight its molecular mechanisms of action. Besides, there is generally focus on hyaluronic acid (HA) as being the most relevant polysaccharide to reach the clinical endpoints, attributing its effect mainly to its unique viscoelastic properties, related to a high-molecular weight and gel formulation. Usually, studies do not approach the possible biological pathways where HA may interfere, and there is a lack of reports on other biocompatible polysaccharides that could be of use in VS. Aim We briefly review the main proposed mechanisms of action of intra-articular hyaluronic acid (IA-HA) treatment and discuss its effectiveness focusing on the role of rheological and intrinsic structural molecular properties of polysaccharides in providing a therapeutic effect. Methods We conducted a literature search using PubMed database to find articles dealing with the mechanisms of action of IA-HA treatment and/or emphasizing how the structural properties of the polysaccharide used influenced the clinical outcomes. Discussion/conclusion HA is involved in numerous biochemical interactions that may explain the clinical benefits of VS, most of them resulting from HA–cluster of differentiation 44 receptor interaction. There are other important aspects apart from the molecular size or the colloidal state of the IA-HA involved in VS efficiency that still need to be consolidated. Indeed, it seems that clinical response may be dependent on the intrinsic properties of the polysaccharide, regardless of being HA, rather than to rheology, posing some controversy to previous beliefs.
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Affiliation(s)
- Rita C Machado
- Rheumatology and Metabolic Bone Diseases Department, Hospital de Santa Maria, CHLN, Lisbon Academic Medical Centre, Lisbon, Portugal.,Rheumatology Research Unit, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
| | - Susana Capela
- Rheumatology and Metabolic Bone Diseases Department, Hospital de Santa Maria, CHLN, Lisbon Academic Medical Centre, Lisbon, Portugal.,Rheumatology Research Unit, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
| | - Francisco A C Rocha
- Faculty of Medicine, Department of Internal Medicine, Federal University of Ceará, Fortaleza, Brazil
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Ferrari LF, Araldi D, Bogen O, Levine JD. Extracellular matrix hyaluronan signals via its CD44 receptor in the increased responsiveness to mechanical stimulation. Neuroscience 2016; 324:390-8. [PMID: 26996509 DOI: 10.1016/j.neuroscience.2016.03.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 02/18/2016] [Accepted: 03/14/2016] [Indexed: 01/08/2023]
Abstract
We propose that the extracellular matrix (ECM) signals CD44, a hyaluronan receptor, to increase the responsiveness to mechanical stimulation in the rat hind paw. We report that intradermal injection of hyaluronidase induces mechanical hyperalgesia, that is inhibited by co-administration of a CD44 receptor antagonist, A5G27. The intradermal injection of low (LMWH) but not high (HMWH) molecular weight hyaluronan also induces mechanical hyperalgesia, an effect that was attenuated by pretreatment with HMWH or A5G27. Pretreatment with HMWH also attenuated the hyperalgesia induced by hyaluronidase. Similarly, intradermal injection of A6, a CD44 receptor agonist, produced hyperalgesia that was inhibited by HMWH and A5G27. Inhibitors of protein kinase A (PKA) and Src, but not protein kinase C (PKC), significantly attenuated the hyperalgesia induced by both A6 and LMWH. Finally, to determine if CD44 receptor signaling is involved in a preclinical model of inflammatory pain, we evaluated the effect of A5G27 and HMWH on the mechanical hyperalgesia associated with the inflammation induced by carrageenan. Both A5G27 and HMWH attenuated carrageenan-induced mechanical hyperalgesia. Thus, while LMWH acts at its cognate receptor, CD44, to induce mechanical hyperalgesia, HMWH acts at the same receptor as an antagonist. That the local administration of HMWH or A5G27 inhibits carrageenan-induced hyperalgesia supports the suggestion that carrageenan produces changes in the ECM that contributes to inflammatory pain. These studies define a clinically relevant role for signaling by the hyaluronan receptor, CD44, in increased responsiveness to mechanical stimulation.
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Affiliation(s)
- L F Ferrari
- Departments of Medicine and Oral Surgery, and Division of Neuroscience, University of California at San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - D Araldi
- Departments of Medicine and Oral Surgery, and Division of Neuroscience, University of California at San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - O Bogen
- Departments of Medicine and Oral Surgery, and Division of Neuroscience, University of California at San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - J D Levine
- Departments of Medicine and Oral Surgery, and Division of Neuroscience, University of California at San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143, USA.
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Yang H, Wu Y, Gan C, Yue T, Yuan Y. Characterization and antioxidant activity of a novel polysaccharide from Pholidota chinensis Lindl. Carbohydr Polym 2016; 138:327-34. [DOI: 10.1016/j.carbpol.2015.11.071] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 11/24/2015] [Accepted: 11/26/2015] [Indexed: 12/13/2022]
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Gibson M, Li H, Coburn J, Moroni L, Nahas Z, Bingham C, Yarema K, Elisseeff J. Intra-articular delivery of glucosamine for treatment of experimental osteoarthritis created by a medial meniscectomy in a rat model. J Orthop Res 2014; 32:302-9. [PMID: 24600703 PMCID: PMC8396408 DOI: 10.1002/jor.22445] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Glucosamine (GlcN) is a naturally occurring amino-monosaccharide with putative chondroprotective activity. Optimum responses to GlcN are achieved at concentrations which are impractical with oral dosing. Intra-articular delivery of a bolus dose of GlcN is one way to overcome these pharmacokinetic obstacles. In this study we report the effects of exposing primary human chondrocytes to a bolus dose of GlcN. We also locally administered GlcN in the context of a meniscal transection model of rat osteoarthritis (OA). The knees of male rats were subjected to medial meniscal transection and developed arthritic changes over 4 weeks.Treatment groups were then given thrice weekly 100mL injections of 35 μg, 350 μg, 1.8 mg, or 3.5mg of GlcN dissolved in normal saline. Gross images, modified Mankin scores, and histomorphometric measurements were used as outcome measures. The 350 μg dosage of GlcN had the most significant positive impact on all components of the modified Mankin score. Together, these findings suggest the local delivery of high concentrations of GlcN is well tolerated and can suppress experimental OA through influences on both bone and cartilage.
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Affiliation(s)
- Matthew Gibson
- Translational Tissue Engineering Center, Wilmer Eye Institute and Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland 21287
| | - Hanwei Li
- Translational Tissue Engineering Center, Wilmer Eye Institute and Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland 21287
| | - Jeannine Coburn
- Department of Chemical and Biomolecular Engineering, The Johns Hopkins University, Baltimore, Maryland 21287
| | - Lorenzo Moroni
- Translational Tissue Engineering Center, Wilmer Eye Institute and Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland 21287
| | - Zayna Nahas
- Translational Tissue Engineering Center, Wilmer Eye Institute and Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland 21287
| | - Clifford Bingham
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, MD 21224
| | - Kevin Yarema
- Translational Tissue Engineering Center, Wilmer Eye Institute and Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland 21287
| | - Jennifer Elisseeff
- Translational Tissue Engineering Center, Wilmer Eye Institute and Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland 21287
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Woehl MA, Ono L, Riegel Vidotti IC, Wypych F, Schreiner WH, Sierakowski MR. Bioactive nanocomposites of bacterial cellulose and natural hydrocolloids. J Mater Chem B 2014; 2:7034-7044. [DOI: 10.1039/c4tb00706a] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Bacterial cellulose–natural hydrocolloid bionanocomposites were developed as cell growth substrates. The surface free energy of the composites is related to fibroblast viability. Surface properties of the bionanocomposites can be adjusted purely by changing the component proportions.
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Affiliation(s)
| | - Lucy Ono
- Departamento de Patologia Básica
- Curitiba 81531-980, Brazil
| | | | | | - Wido Herwig Schreiner
- Departamento de Física
- Universidade Federal do Paraná (UFPR)
- Curitiba 81531-980, Brazil
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Migliore A, Bizzi E, Massafra U, Bella A, Piscitelli P, Laganà B, Tormenta S. The impact of treatment with hylan G-F 20 on progression to total hip arthroplasty in patients with symptomatic hip OA: a retrospective study. Curr Med Res Opin 2012; 28:755-60. [PMID: 22126424 DOI: 10.1185/03007995.2011.645563] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION There is scarce data available on intra-articular hyaluronan's ability to modify the progression of osteoarthritis (OA). OBJECTIVE The purpose of this retrospective pilot study was to assess the impact of treatment with hylan G-F 20 on progression to total hip replacement (THR) in patients with symptomatic hip OA. RESEARCH DESIGN AND METHODS The records of patients presenting with symptomatic hip OA and treated with hylan G-F 20 were analysed. Endpoints were the number of THRs performed and the survival time (in months) between commencement of treatment and THR, if performed. Endpoints were evaluated for the entire study population and for those sub-groups of patients which were, or were not, defined as candidates for THR prior to intra-articular treatment. Predictive factors of progression to THR were also assessed. RESULTS A total of 850 patients' records were evaluated and 224 patients' data were included in the study and evaluated. Eighty-four patients (37.5%) progressed to THR, 206 patients (92.0%) achieved 12 months survival, 170 patients (75.9%) achieved 24 months survival, and 69 patients (30.8%) achieved 5 years survival. Mean survival time was 36 months. Classification as a THR candidate, Lequesne score, ultrasound pattern and the presence of diabetes were predictive factors for progression to THR. CONCLUSIONS These results suggest that hylan G-F 20 could be included in the management of symptomatic hip OA before recommendation for THR, particularly in patients presenting with milder symptoms, or in patients where, due to comorbidities or personal choice, THR is not a feasible option. Limitations of this study include the retrospective study design and the lack of a control group to determine any placebo effect of hylan G-F 20. Further prospective studies are therefore needed to corroborate these results.
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Affiliation(s)
- A Migliore
- Department of Rheumatology, San Pietro Fatebenefratelli Hospital, Rome, Italy.
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Oleynikov DN, Rohin AV. Galactomannan from the seeds of chinese honey locust (Gleditsia sinensis Lam.). APPL BIOCHEM MICRO+ 2010. [DOI: 10.1134/s0003683810010187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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