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Liu J, Li B, Zhou X, Liu G, Li C, Hu Z, Peng R. Uncovering the mechanisms of Zhubi decoction against rheumatoid arthritis through an integrated study of network pharmacology, metabolomics, and intestinal flora. JOURNAL OF ETHNOPHARMACOLOGY 2025; 336:118736. [PMID: 39186991 DOI: 10.1016/j.jep.2024.118736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 08/28/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Zhubi Decoction (ZBD) is a modified formulation derived from the classic traditional Chinese medicine prescription "Er-Xian Decoction" documented in the esteemed "Clinical Manual of Chinese Medical Prescription". While the utilization of ZBD has exhibited promising clinical outcomes in treating rheumatoid arthritis (RA), the precise bioactive chemical constituents and the underlying mechanisms involved in its therapeutic efficacy remain to be comprehensively determined. AIM OF THE STUDY This study aims to systematically examine ZBD's pharmacological effects and molecular mechanisms for RA alleviation. MATERIALS AND METHODS Utilizing the collagen-induced arthritis (CIA) rat model, we comprehensively evaluated the anti-rheumatoid arthritis effects of ZBD in vivo through various indices, such as paw edema, arthritis index, ankle diameter, inflammatory cytokine levels, pathological conditions, and micro-CT analysis. The UPLC-MS/MS technique was utilized to analyze the compounds of ZBD. The potential therapeutic targets and signaling pathways of ZBD in the management of RA were predicted using network pharmacology. To analyze comprehensive metabolic profiles and identify underlying metabolic pathways, we conducted a serum-based widely targeted metabolomics analysis utilizing LC-MS technology. Key targets and predicted pathways were further validated using immunofluorescent staining, which integrated findings from serum metabolomics and network pharmacology analysis. Additionally, we analyzed the gut microbiota composition in rats employing 16 S rDNA sequencing and investigated the effects of ZBD on the microbiota of CIA rats through bioinformatics and statistical methods. RESULTS ZBD exhibited remarkable efficacy in alleviating RA symptoms in CIA rats without notable side effects. This included reduced paw redness and swelling, minimized joint damage, improved the histopathology of cartilage and synovium, mitigated the inflammatory state, and lowered serum concentrations of cytokines TNF-α, IL-1β and IL-6. Notably, the effectiveness of ZBD was comparable to MTX. Network pharmacology analysis revealed inflammation and immunity-related signaling pathways, such as PI3K/AKT, MAPK, IL-17, and TNF signaling pathways, as vital mediators in the effectual mechanisms of ZBD. Immunofluorescence analysis validated ZBD's ability to inhibit PI3K/AKT pathway proteins. Serum metabolomics studies revealed that ZBD modulates 170 differential metabolites, partially restored disrupted metabolic profiles in CIA rats. With a notable impact on amino acids and their metabolites, and lipids and lipid-like molecules. Integrated analysis of metabolomics and network pharmacology identified 6 pivotal metabolite pathways and 3 crucial targets: PTGS2, GSTP1, and ALDH2. Additionally, 16 S rDNA sequencing illuminated that ZBD mitigated gut microbiota dysbiosis in the CIA group, highlighting key genera such as Ligilactobacillus, Prevotella_9, unclassified_Bacilli, and unclassified_rumen_bacterium_JW32. Correlation analysis disclosed a significant link between 47 distinct metabolites and specific bacterial species. CONCLUSION ZBD is a safe and efficacious TCM formulation, demonstrates efficacy in treating RA through its multi-component, multi-target, and multi-pathway mechanisms. The regulation of inflammation and immunity-related signaling pathways constitutes a crucial mechanism of ZBD's efficacy. Furthermore, ZBD modulates host metabolism and intestinal flora. The integrated analysis presents experimental evidence of ZBD for the management of RA.
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Affiliation(s)
- Jing Liu
- College of Acupuncture-Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, 430061, China.
| | - Bocun Li
- College of Acupuncture-Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, 430061, China.
| | - Xiaohong Zhou
- College of Acupuncture-Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, 430061, China.
| | - Guangya Liu
- College of Acupuncture-Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, 430061, China.
| | - Chao Li
- College of Acupuncture-Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, 430061, China.
| | - Zhaoduan Hu
- College of Acupuncture-Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, 430061, China.
| | - Rui Peng
- College of Acupuncture-Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, 430061, China.
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2
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SADIGURSKY DAVID, MAGNAVITA VICTORFILARDISTOLZE, SÁ CLOUDKENNEDYCOUTODE, MONTEIRO HENRIQUEDESOUSA, BRAGHIROLI ODDONEFREITASMELRO, MATOS MARCOSANTÔNIOALMEIDA. UNDENATURED COLLAGEN TYPE II FOR THE TREATMENT OF OSTEOARTHRITIS OF THE KNEE. ACTA ORTOPEDICA BRASILEIRA 2022; 30:e240572. [PMID: 35765574 PMCID: PMC9210509 DOI: 10.1590/1413-785220223002240572] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/13/2020] [Indexed: 11/30/2022]
Abstract
Objective: To test the hypothesis that undenatured type II collagen (UC-II) relieves pain, quality of life, and joint function in women aged from 60 to 80 years with knee osteoarthritis. Methods: 53 patients in the UC-II treatment group (for 90 days) and 52 in the control group (without UC-II) were evaluated at 1, 30, and 90 days regarding health-related quality of life, pain, and function with questionnaires, anthropometric data, alignment, range of motion, and radiographic analysis. Results: Quality of life increased significantly in the Physical domain in the treatment vs control group. Also, there was a difference between the first and the last evaluation on the pain visual analog scale (−3.8 ± 1.8 versus −1.3 ± 2.0) and on the WOMAC score (−9.5 ± 11.9 versus −1.3 ± 11.1). No variation in the temporal evolution of the Mental domain was found. Conclusion: Pain, joint stiffness, and quality of life (Physical domain) improved with the inclusion of UC-II for 90 days to the therapeutic toolbox for knee osteoarthritis in individuals aged 60 to 80 years. Level of evidence II, Comparative Prospective Study.
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Affiliation(s)
- DAVID SADIGURSKY
- Escola Bahiana de Medicina e Saúde Pública, Brazil; Centro Universitário UniFTC, Brazil
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3
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Sauerland K, Wolf A, Schudok M, Steinmeyer J. A novel model of a biomechanically induced osteoarthritis-like cartilage for pharmacological in vitro studies. J Cell Mol Med 2021; 25:11221-11231. [PMID: 34766430 PMCID: PMC8650028 DOI: 10.1111/jcmm.17044] [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: 08/16/2021] [Revised: 09/28/2021] [Accepted: 10/26/2021] [Indexed: 11/27/2022] Open
Abstract
Excessive pressure or overload induces and aggravates osteoarthritic changes in articular cartilage, but the underlying biomechanical forces are largely ignored in existing pharmacological in vitro models that are used to investigate drugs against osteoarthritis (OA). Here, we introduce a novel in vitro model to perform pathophysiological and pharmacological investigations, in which cartilage explants are subjected to intermittent cyclic pressure, and characterize its ability to mimic OA‐like tissue reactivity. Mechanical loading time‐dependently increased the biosynthesis, content and retention of fibronectin (Fn), whereas collagen metabolism remained unchanged. This protocol upregulated the production and release of proteoglycans (PGs). The release of PGs from explants was significantly inhibited by a matrix metalloproteinase (MMP) inhibitor, suggesting the involvement of such proteinases in the destruction of the model tissue, similar to what is observed in human OA cartilage. In conclusion, the metabolic alterations in our new biomechanical in vitro model are similar to those of early human OA cartilage, and our pharmacological prevalidation with an MMP‐inhibitor supports its value for further in vitro drug studies.
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Affiliation(s)
- Katrin Sauerland
- Institute for Pharmacology and Toxicology, University of Bonn, Bonn, Germany
| | - Amela Wolf
- Institute for Pharmacology and Toxicology, University of Bonn, Bonn, Germany
| | - Manfred Schudok
- R&D, Drug Metabolism & Pharmacokinetics, Sanofi-Aventis Deutschand GmbH, Frankfurt, Germany
| | - Juergen Steinmeyer
- Institute for Pharmacology and Toxicology, University of Bonn, Bonn, Germany.,Laboratory for Experimental Orthopaedics, Department of Orthopaedics, University of Giessen, Giessen, Germany
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4
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Monaco G, El Haj AJ, Alini M, Stoddart MJ. Ex Vivo Systems to Study Chondrogenic Differentiation and Cartilage Integration. J Funct Morphol Kinesiol 2021; 6:E6. [PMID: 33466400 PMCID: PMC7838775 DOI: 10.3390/jfmk6010006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/18/2020] [Accepted: 12/23/2020] [Indexed: 12/21/2022] Open
Abstract
Articular cartilage injury and repair is an issue of growing importance. Although common, defects of articular cartilage present a unique clinical challenge due to its poor self-healing capacity, which is largely due to its avascular nature. There is a critical need to better study and understand cellular healing mechanisms to achieve more effective therapies for cartilage regeneration. This article aims to describe the key features of cartilage which is being modelled using tissue engineered cartilage constructs and ex vivo systems. These models have been used to investigate chondrogenic differentiation and to study the mechanisms of cartilage integration into the surrounding tissue. The review highlights the key regeneration principles of articular cartilage repair in healthy and diseased joints. Using co-culture models and novel bioreactor designs, the basis of regeneration is aligned with recent efforts for optimal therapeutic interventions.
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Affiliation(s)
- Graziana Monaco
- AO Research Institute Davos, Clavadelerstrasse 8, CH-7270 Davos Platz, Switzerland; (G.M.); (M.A.)
- School of Pharmacy & Bioengineering Research, University of Keele, Keele ST5 5BG, UK;
| | - Alicia J. El Haj
- School of Pharmacy & Bioengineering Research, University of Keele, Keele ST5 5BG, UK;
- Healthcare Technology Institute, Translational Medicine, School of Chemical Engineering, University of Birmingham, Birmingham B15 2TH, UK
| | - Mauro Alini
- AO Research Institute Davos, Clavadelerstrasse 8, CH-7270 Davos Platz, Switzerland; (G.M.); (M.A.)
| | - Martin J. Stoddart
- AO Research Institute Davos, Clavadelerstrasse 8, CH-7270 Davos Platz, Switzerland; (G.M.); (M.A.)
- School of Pharmacy & Bioengineering Research, University of Keele, Keele ST5 5BG, UK;
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5
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Wan Y, Li W, Liao Z, Yan M, Chen X, Tang Z. Selective MMP-13 Inhibitors: Promising Agents for the Therapy of Osteoarthritis. Curr Med Chem 2020; 27:3753-3769. [PMID: 30556497 DOI: 10.2174/0929867326666181217153118] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/15/2018] [Accepted: 12/11/2018] [Indexed: 01/02/2023]
Abstract
Osteoarthritis (OA) is an age-related degenerative disease, which is characterized by chronic joint pain, inflammation and the damage of joint cartilage. At present, steroidal drugs and nonsteroidal anti-inflammatory drugs (NSAIDS), selective cyclooxygenase-2 (COX-2) inhibitors, are the first-line drugs for the treatment of OA. However, these drugs could lead to some cardiovascular side effects. Therefore, it is urgent to develop novel agents for the treatment of OA. Matrix metalloproteinase-13 (MMP-13), an important member of matrix metalloproteinases (MMPs) family, plays a vital role by degrading type II collagen in articular cartilage and bone in OA. It is noted that MMP-13 is specially expressed in the OA patients, and not in normal adults. In addition, broadspectrum MMP inhibitors could result in some painful and joint-stiffening side effects, called musculoskeletal syndrome (MSS) in the clinical trials. Thus, developing selective MMP-13 inhibitors is a potential strategy for the therapy of OA. In this review, we summarize the recent progress of selective MMP-13 inhibitors including two subfamilies, namely zinc-binding and non-zinc-binding selective MMP-13 inhibitors.
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Affiliation(s)
- Yichao Wan
- Key Laboratory of Theoretical Organic Chemistry and Functional Molecule, Ministry of Education, Hunan Provincial Key Laboratory of Controllable Preparation and Functional Application of Fine Polymers, School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, Hunan 411201, China.,Hunan Provincial College Key Laboratory of QSAR/QSPR, Hunan Provincial Key Lab of Advanced Materials for New Energy Storage and conversion, Hunan University of Science and Technology, Xiangtan, Hunan 411201, China
| | - Wei Li
- Key Laboratory of Theoretical Organic Chemistry and Functional Molecule, Ministry of Education, Hunan Provincial Key Laboratory of Controllable Preparation and Functional Application of Fine Polymers, School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, Hunan 411201, China.,Hunan Provincial College Key Laboratory of QSAR/QSPR, Hunan Provincial Key Lab of Advanced Materials for New Energy Storage and conversion, Hunan University of Science and Technology, Xiangtan, Hunan 411201, China
| | - Zhipeng Liao
- Key Laboratory of Theoretical Organic Chemistry and Functional Molecule, Ministry of Education, Hunan Provincial Key Laboratory of Controllable Preparation and Functional Application of Fine Polymers, School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, Hunan 411201, China.,Hunan Provincial College Key Laboratory of QSAR/QSPR, Hunan Provincial Key Lab of Advanced Materials for New Energy Storage and conversion, Hunan University of Science and Technology, Xiangtan, Hunan 411201, China
| | - Mi Yan
- Department of Pharmacy, The Second Hospital of Shandong University, Jinan, Shandong 250033, China
| | - Xuwang Chen
- Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
| | - Zilong Tang
- Key Laboratory of Theoretical Organic Chemistry and Functional Molecule, Ministry of Education, Hunan Provincial Key Laboratory of Controllable Preparation and Functional Application of Fine Polymers, School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, Hunan 411201, China.,Hunan Provincial College Key Laboratory of QSAR/QSPR, Hunan Provincial Key Lab of Advanced Materials for New Energy Storage and conversion, Hunan University of Science and Technology, Xiangtan, Hunan 411201, China
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6
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Jerosch J. Konservative Therapie von Knorpelschäden am Sprunggelenk. ARTHROSKOPIE 2020. [DOI: 10.1007/s00142-019-00325-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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7
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Inhibition of cyclooxygenase-2 activity in subchondral bone modifies a subtype of osteoarthritis. Bone Res 2019; 7:29. [PMID: 31666999 PMCID: PMC6804921 DOI: 10.1038/s41413-019-0071-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/25/2019] [Indexed: 12/13/2022] Open
Abstract
Osteoarthritis (OA) causes the destruction of joints. Its pathogenesis is still under investigation, and there is no effective disease-modifying therapy. Here, we report that elevated cyclooxygenase-2 (COX-2) expression in the osteocytes of subchondral bone causes both spontaneous OA and rheumatoid arthritis (RA). The knockout of COX-2 in osteocytes or treatment with a COX-2 inhibitor effectively rescues the structure of subchondral bone and attenuates cartilage degeneration in spontaneous OA (STR/Ort) mice and tumor necrosis factor-α transgenic RA mice. Thus, elevated COX-2 expression in subchondral bone induces both OA-associated and RA-associated joint cartilage degeneration. The inhibition of COX-2 expression can potentially modify joint destruction in patients with arthritis.
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8
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Steinmeyer J, Bock F, Stöve J, Jerosch J, Flechtenmacher J. Pharmacological treatment of knee osteoarthritis: Special considerations of the new German guideline. Orthop Rev (Pavia) 2018; 10:7782. [PMID: 30662685 PMCID: PMC6315310 DOI: 10.4081/or.2018.7782] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/26/2018] [Indexed: 12/31/2022] Open
Abstract
The pharmacological treatment of knee osteoarthritis (OA) is a purely symptomatic therapy, which often ensures that the mobility of the patient is successfully retained. This article refers to the recommendations and opinions regarding the pharmacotherapy of knee OA contained in the new guideline of the Association of the Scientific Medical Societies in Germany (AWMF), highlighting several important aspects and describing the considerations underlying the decision-making process. With this article it is hoped that therapeutic effectiveness can be realistically estimated, that any risks of medication errors and avoidable side effects can be reduced, and that further helpful measures can be taken into consideration.
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Affiliation(s)
- Juergen Steinmeyer
- Laboratory for Experimental Orthopedics, Department of Orthopedics, Justus Liebig University, Giessen
| | - Fritjof Bock
- Orthopaedics at the Green Tower, Ravensburg.,Interdisciplinary Society for Orthopedic/Trauma and General Pain Therapy, Ravensburg
| | - Johannes Stöve
- Orthopaedic and Trauma Surgery Clinic, St. Marienkrankenhaus, Ludwigshafen
| | - Jörg Jerosch
- Clinic for Orthopedics, Traumatology and Sports Medicine, Johanna Etienne Hospital, Neuss
| | - Johannes Flechtenmacher
- Ortho Centre - Orthopedic Community Practice at the Ludwigsplatz, Karlsruhe.,Professional Association for Orthopedics and Trauma Surgery, Berlin, Germany
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9
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Melo G, Casett E, Stuginski-Barbosa J, Guerra ENS, Fernandes DA, Porporatti AL, Flores-Mir C, De Luca Canto G. Effects of glucosamine supplements on painful temporomandibular joint osteoarthritis: A systematic review. J Oral Rehabil 2018; 45:414-422. [DOI: 10.1111/joor.12616] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2018] [Indexed: 11/30/2022]
Affiliation(s)
- G. Melo
- Department of Dentistry; Federal University of Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - E. Casett
- Department of Dentistry; Federal University of Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - J. Stuginski-Barbosa
- Department of Dentistry; Bauru School of Dentistry; University of São Paulo (USP); São Paulo São Paulo Brazil
| | - E. N. S. Guerra
- Department of Dentistry; University of Brasília (UnB); Brasília Federal District Brazil
| | - D. A. Fernandes
- Department of Surgery; Federal University of Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - A. L. Porporatti
- Department of Dentistry; Federal University of Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - C. Flores-Mir
- School of Dentistry; Faculty of Medicine and Dentistry; University of Alberta; Edmonton AB Canada
| | - G. De Luca Canto
- Department of Dentistry; Federal University of Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
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10
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Hamam F, Eldalo A, Abdallah Q, Al-Deeb I, Alzahrani S, Alwagdani A, Alotaibi A, Nasr AR, Gouda Y, Mohamed K. Pharmacological activities of a novel plant species, Huernia Sp. Nov. aff. Boleana growing in the high mountains of southwest Saudi Arabia. Mol Med Rep 2018; 17:6059-6067. [PMID: 29484402 DOI: 10.3892/mmr.2018.8607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 01/05/2018] [Indexed: 11/06/2022] Open
Abstract
Huernia Sp. Nov. aff. Boleana, Apocynaceae, grows in the high mountains of southwest Saudi Arabia and is widely used as a remedy for the treatment of diabetes. The present study investigated the anti‑inflammatory, wound healing and inhibitory effects on migration of Huernia Sp. Nov. aff. Boleana. The anti‑inflammatory effect was assessed in mice using formalin‑induced edema. Wound healing effects were assessed in rats using a circular excision wound model. An in vitro 'scratch' test was used to investigate the inhibitory effects on melanoma cell (B16‑F10) migration. The anti‑inflammatory effects of total extract, hexane and chloroform fractions were greater or equal to indomethacin (control). The relatively non‑polar fractions (hexane and chloroform) exhibited higher anti‑inflammatory activities compared with the aqueous fraction. The percentage of wound contraction among animals treated with the plant extract was higher compared with the control; however, this difference was not statistically significant (P>0.05). The total plant extract increased wound healing by inhibiting the inflammatory response, promoting angiogenesis, and significantly promoting the proliferation of fibroblasts, particularly on days 7 and 14 post‑wounding. Furthermore, the plant extract promoted wound repair via the enhancement of collagen synthesis, and complete epithelization with well‑formed and differentiated epithelial tissues. The in vitro 'scratch' test indicated the inhibitory effects of this plant on melanoma cell migration in a dose‑dependent manner. The present study indicated that Huernia Sp. Nov. aff. Boleana may have potential as an anti‑inflammatory, wound-healing and migration-inhibiting ethno medicine.
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Affiliation(s)
- Fayez Hamam
- Department of Pharmacology and Toxicology, College of Pharmacy, Taif University, Taif, Makkah 21974, Kingdom of Saudi Arabia
| | - Ahmed Eldalo
- Department of Pharmacology and Toxicology, College of Pharmacy, Taif University, Taif, Makkah 21974, Kingdom of Saudi Arabia
| | - Qasem Abdallah
- Department of Pharmacology and Toxicology, College of Pharmacy, Taif University, Taif, Makkah 21974, Kingdom of Saudi Arabia
| | - Ibrahim Al-Deeb
- Department of Pharmacology and Toxicology, College of Pharmacy, Taif University, Taif, Makkah 21974, Kingdom of Saudi Arabia
| | - Saleh Alzahrani
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Makkah 21974, Kingdom of Saudi Arabia
| | - Abdullah Alwagdani
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Makkah 21974, Kingdom of Saudi Arabia
| | - Ahmed Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Makkah 21974, Kingdom of Saudi Arabia
| | - Abdel-Rahman Nasr
- Department of Pharmacology and Toxicology, College of Pharmacy, Taif University, Taif, Makkah 21974, Kingdom of Saudi Arabia
| | - Yaser Gouda
- Department of Pharmacognosy, College of Pharmacy, Taif University, Taif, Makkah 21974, Kingdom of Saudi Arabia
| | - Khaled Mohamed
- Department of Pharmacognosy, Faculty of Pharmacy, Assiut University, Assiut 71526, Egypt
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11
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Metabolic Response of Human Osteoarthritic Cartilage to Biochemically Characterized Collagen Hydrolysates. Int J Mol Sci 2017; 18:ijms18010207. [PMID: 28117674 PMCID: PMC5297837 DOI: 10.3390/ijms18010207] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 01/11/2017] [Accepted: 01/13/2017] [Indexed: 12/13/2022] Open
Abstract
The most frequent disease of the locomotor system is osteoarthritis (OA), which, as a chronic joint disease, might benefit more from nutrition than acute illnesses. Collagen hydrolysates (CHs) are peptidic mixtures that are often used as nutraceuticals for OA. Three CHs were characterized biochemically and pharmacologically. Our biophysical (MALDI-TOF-MS, NMR, AFM) and fluorescence assays revealed marked differences between CHs of fish (Peptan® F 5000, Peptan® F 2000) and porcine (Mobiforte®) origin with respect to the total number of peptides and common peptides between them. Using a novel dual radiolabeling procedure, no CH modulated collagen biosynthesis in human knee cartilage explants. Peptan® F 2000 enhanced the activities of the aggrecanase ADMATS4 and ADMATS5 in vitro without loss of proteoglycan from cartilage explants; the opposite effect was observed with Mobiforte®. Interleukin (IL)-6, matrix metalloproteinase (MMP)-1, -3 and -13 levels were elevated in explants that were treated with Mobiforte® and Peptan® F 5000, but not with Peptan® F 2000. In conclusion, the heterogeneous peptide composition and disparate pharmacological effects between CHs suggest that the effect of a CH preparation cannot be extrapolated to other formulations. Thus, the declaration of a CH as a safe and effective nutraceutical requires a thorough examination of its pleiotropic effects.
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12
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Nara H, Kaieda A, Sato K, Naito T, Mototani H, Oki H, Yamamoto Y, Kuno H, Santou T, Kanzaki N, Terauchi J, Uchikawa O, Kori M. Discovery of Novel, Highly Potent, and Selective Matrix Metalloproteinase (MMP)-13 Inhibitors with a 1,2,4-Triazol-3-yl Moiety as a Zinc Binding Group Using a Structure-Based Design Approach. J Med Chem 2017; 60:608-626. [DOI: 10.1021/acs.jmedchem.6b01007] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Hiroshi Nara
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Akira Kaieda
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Kenjiro Sato
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Takako Naito
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Hideyuki Mototani
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Hideyuki Oki
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Yoshio Yamamoto
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Haruhiko Kuno
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Takashi Santou
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Naoyuki Kanzaki
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Jun Terauchi
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Osamu Uchikawa
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Masakuni Kori
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-26-1, Muraoka-Higashi 2-chome, Fujisawa, Kanagawa 251-8555, Japan
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13
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Ullah RS, Wang L, Yu H, Abbasi NM, Akram M, -ul-Abdin Z, Saleem M, Haroon M, Khan RU. Synthesis of polyphosphazenes with different side groups and various tactics for drug delivery. RSC Adv 2017. [DOI: 10.1039/c6ra27103k] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Polyphosphazenes (PPZs) are hybrid polymers comprising a main chain containing nitrogen and phosphorous linked through interchanging single and double bonds, and side chains.
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Affiliation(s)
- Raja Summe Ullah
- State Key Laboratory of Chemical Engineering
- College of Chemical and Biological Engineering
- Zhejiang University
- Hangzhou 310027
- China
| | - Li Wang
- State Key Laboratory of Chemical Engineering
- College of Chemical and Biological Engineering
- Zhejiang University
- Hangzhou 310027
- China
| | - Haojie Yu
- State Key Laboratory of Chemical Engineering
- College of Chemical and Biological Engineering
- Zhejiang University
- Hangzhou 310027
- China
| | - Nasir M. Abbasi
- State Key Laboratory of Chemical Engineering
- College of Chemical and Biological Engineering
- Zhejiang University
- Hangzhou 310027
- China
| | - Muhammad Akram
- State Key Laboratory of Chemical Engineering
- College of Chemical and Biological Engineering
- Zhejiang University
- Hangzhou 310027
- China
| | - Zain -ul-Abdin
- State Key Laboratory of Chemical Engineering
- College of Chemical and Biological Engineering
- Zhejiang University
- Hangzhou 310027
- China
| | - Muhammad Saleem
- State Key Laboratory of Chemical Engineering
- College of Chemical and Biological Engineering
- Zhejiang University
- Hangzhou 310027
- China
| | - Muhammad Haroon
- State Key Laboratory of Chemical Engineering
- College of Chemical and Biological Engineering
- Zhejiang University
- Hangzhou 310027
- China
| | - Rizwan Ullah Khan
- State Key Laboratory of Chemical Engineering
- College of Chemical and Biological Engineering
- Zhejiang University
- Hangzhou 310027
- China
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Kosinska MK, Mastbergen SC, Liebisch G, Wilhelm J, Dettmeyer RB, Ishaque B, Rickert M, Schmitz G, Lafeber FP, Steinmeyer J. Comparative lipidomic analysis of synovial fluid in human and canine osteoarthritis. Osteoarthritis Cartilage 2016; 24:1470-8. [PMID: 27049029 DOI: 10.1016/j.joca.2016.03.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 02/17/2016] [Accepted: 03/25/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The lipid profile of synovial fluid (SF) is related to the health status of joints. The early stages of human osteoarthritis (OA) are poorly understood, which larger animals are expected to be able to model closely. This study examined whether the canine groove model of OA represents early OA in humans based on the changes in the lipid species profile in SF. Furthermore, the SF lipidomes of humans and dogs were compared to determine how closely canine lipid species profiles reflect the human lipidome. METHODS Lipids were extracted from cell- and cellular debris-free knee SF from nine donors with healthy joints, 17 patients with early and 13 patients with late osteoarthritic changes, and nine dogs with knee OA and healthy contralateral joints. Lipid species were quantified by electrospray ionization tandem mass spectrometry (ESI-MS/MS). RESULTS Compared with control canine SF most lipid species were elevated in canine OA SF. Moreover, the lipid species profiles in the canine OA model resembled early OA profiles in humans. The SF lipidomes between dog and human were generally similar, with differences in certain lipid species in the phosphatidylcholine (PC), lysophosphatidylcholine (LPC) and sphingomyelin (SM) classes. CONCLUSIONS Our lipidomic analysis demonstrates that SF in the canine OA model closely mimics the early osteoarthritic changes that occur in humans. Further, the canine SF lipidome often reflects normal human lipid metabolism.
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Affiliation(s)
- M K Kosinska
- Laboratory for Experimental Orthopaedics, Department of Orthopaedics, Justus-Liebig-University Giessen, Germany.
| | - S C Mastbergen
- Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands.
| | - G Liebisch
- Department of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, Germany.
| | - J Wilhelm
- Medical Clinic II/IV, Justus-Liebig-University Giessen, Germany.
| | - R B Dettmeyer
- Institute of Forensic Medicine, Justus-Liebig-University Giessen, Germany.
| | - B Ishaque
- Laboratory for Experimental Orthopaedics, Department of Orthopaedics, Justus-Liebig-University Giessen, Germany.
| | - M Rickert
- Laboratory for Experimental Orthopaedics, Department of Orthopaedics, Justus-Liebig-University Giessen, Germany.
| | - G Schmitz
- Department of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, Germany.
| | - F P Lafeber
- Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands.
| | - J Steinmeyer
- Laboratory for Experimental Orthopaedics, Department of Orthopaedics, Justus-Liebig-University Giessen, Germany.
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Starek M, Krzek J, Rotkegel P. TLC determination of piroxicam, tenoxicam, celecoxib and rofecoxib in biological material. JOURNAL OF ANALYTICAL CHEMISTRY 2015. [DOI: 10.1134/s106193481503020x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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16
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Haghighat A, Behnia A, Kaviani N, Khorami B. Evaluation of Glucosamine sulfate and Ibuprofen effects in patients with temporomandibular joint osteoarthritis symptom. J Res Pharm Pract 2014; 2:34-9. [PMID: 24991602 PMCID: PMC4076897 DOI: 10.4103/2279-042x.114087] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Ibuprofen - a non-steroidal anti-inflammatory drug (NSAID)- and glucosamine sulfate - a natural compound and a food supplement- are two therapeutic agents which have been widely used for treatment of patients with temporomandibular joint (TMJ) disorders. This study was aimed to compare the effectiveness and safety of these two medications in the treatment of patients suffering from TMJ disorders. METHODS After obtaining informed consent, 60 patients were randomly allocated to two groups. Patients with painful TMJ, TMJ crepitation or limitation of mouth opening entered the study. Exclusion criteria were history of depressive disorders, cardiovascular disease, musculoskeletal disorders, asthma, gastrointestinal problems, kidney or liver dysfunction or diabetes mellitus, dental diseases needing ongoing treatment; taking aspirin or warfarin, or concomitant treatment of TMJ disorder with other agents or methods. Thirty patients were treated with ibuprofen 400 mg twice a day, (mean age 27.12 ± 10.83 years) and 30 patients (mean age 26.60 ± 10) were treated with glucosamine sulfate 1500 mg daily. Patients were visited 30, 60 and 90 days after starting the treatment, pain and mandibular opening were checked and compared within and between two groups. FINDINGS Comparing with baseline measures, both groups had significantly improved post-treatment pain (P < 0.0001 for both groups) and mandibular opening (P value: 0.001 for glucosamine sulfate and 0.03 for ibuprofen). Post treatment pain and mandibular opening showed significantly more improvement in the glucosamine treated patients (P < 0.0001 and 0.01 respectively). Rate of adverse events was significantly lower in the P value glucosamine sulfate group (P < 0.0001). CONCLUSION This investigation demonstrated that comparing with a commonly prescribed NSAID - ibuprofen-, glucosamine sulfate is a more effective and safer therapeutic agent for treatment of patients with TMJ degenerative join disorder.
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Affiliation(s)
- Abbas Haghighat
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Behnia
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Naser Kaviani
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behnam Khorami
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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17
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Yu D, Liu F, Liu M, Zhao X, Wang X, Li Y, Mao Y, Zhu Z. The inhibition of subchondral bone lesions significantly reversed the weight-bearing deficit and the overexpression of CGRP in DRG neurons, GFAP and Iba-1 in the spinal dorsal horn in the monosodium iodoacetate induced model of osteoarthritis pain. PLoS One 2013; 8:e77824. [PMID: 24204985 PMCID: PMC3813732 DOI: 10.1371/journal.pone.0077824] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 09/04/2013] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Chronic pain is the most prominent and disabling symptom of osteoarthritis (OA). Clinical data suggest that subchondral bone lesions contribute to the occurrence of joint pain. The present study investigated the effect of the inhibition of subchondral bone lesions on joint pain. METHODS Osteoarthritic pain was induced by an injection of monosodium iodoacetate (MIA) into the rat knee joint. Zoledronic acid (ZOL), a third generation of bisphosphonate, was used to inhibit subchondral bone lesions. Joint histomorphology was evaluated using X-ray micro computed tomography scanning and hematoxylin-eosin staining. The activity of osteoclast in subchondral bone was evaluated using tartrate-resistant acid phosphatase staining. Joint pain was evaluated using weight-bearing asymmetry, the expression of calcitonin gene-related peptide (CGRP) in the dorsal root ganglion (DRG), and spinal glial activation status using glial fibrillary acidic protein (GFAP) and ionized calcium binding adaptor molecule-1 (Iba-1) immunofluorescence. Afferent neurons in the DRGs that innervated the joints were identified using retrograde fluorogold labeling. RESULTS MIA injections induced significant histomorphological alterations and joint pain. The inhibition of subchondral bone lesions by ZOL significantly reduced the MIA-induced weight-bearing deficit and overexpression of CGRP in DRG neurons, GFAP and Iba-1 in the spinal dorsal horn at 3 and 6 weeks after MIA injection; however, joint swelling and synovial reaction were unaffected. CONCLUSIONS The inhibition of subchondral bone lesions alleviated joint pain. Subchondral bone lesions should be a key target in the management of osteoarthritic joint pain.
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Affiliation(s)
- Degang Yu
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People’s Republic of China
| | - Fengxiang Liu
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People’s Republic of China
| | - Ming Liu
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People’s Republic of China
| | - Xin Zhao
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People’s Republic of China
| | - Xiaoqing Wang
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People’s Republic of China
| | - Yang Li
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People’s Republic of China
| | - Yuanqing Mao
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People’s Republic of China
| | - Zhenan Zhu
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People’s Republic of China
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Schadow S, Siebert HC, Lochnit G, Kordelle J, Rickert M, Steinmeyer J. Collagen metabolism of human osteoarthritic articular cartilage as modulated by bovine collagen hydrolysates. PLoS One 2013; 8:e53955. [PMID: 23342047 PMCID: PMC3546930 DOI: 10.1371/journal.pone.0053955] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 12/04/2012] [Indexed: 02/07/2023] Open
Abstract
Destruction of articular cartilage is a characteristic feature of osteoarthritis (OA). Collagen hydrolysates are mixtures of collagen peptides and have gained huge public attention as nutriceuticals used for prophylaxis of OA. Here, we evaluated for the first time whether different bovine collagen hydrolysate preparations indeed modulate the metabolism of collagen and proteoglycans from human OA cartilage explants and determined the chemical composition of oligopeptides representing collagen fragments. Using biophysical techniques, like MALDI-TOF-MS, AFM, and NMR, the molecular weight distribution and aggregation behavior of collagen hydrolysates from bovine origin (CH-Alpha®, Peptan™ B 5000, Peptan™ B 2000) were determined. To investigate the metabolism of human femoral OA cartilage, explants were obtained during knee replacement surgery. Collagen synthesis of explants as modulated by 0–10 mg/ml collagen hydrolysates was determined using a novel dual radiolabeling procedure. Proteoglycans, NO, PGE2, MMP-1, -3, -13, TIMP-1, collagen type II, and cell viability were determined in explant cultures. Groups of data were analyzed using ANOVA and the Friedman test (n = 5–12). The significance was set to p≤0.05. We found that collagen hydrolysates obtained from different sources varied with respect to the width of molecular weight distribution, average molecular weight, and aggregation behavior. None of the collagen hydrolysates tested stimulated the biosynthesis of collagen. Peptan™ B 5000 elevated NO and PGE2 levels significantly but had no effect on collagen or proteoglycan loss. All collagen hydrolysates tested proved not to be cytotoxic. Together, our data demonstrate for the first time that various collagen hydrolysates differ with respect to their chemical composition of collagen fragments as well as by their pharmacological efficacy on human chondrocytes. Our study underscores the importance that each collagen hydrolysate preparation should first demonstrate its pharmacological potential both in vitro and in vivo before being used for both regenerative medicine and prophylaxis of OA.
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Affiliation(s)
- Saskia Schadow
- Department of Orthopedics, University Hospital Giessen and Marburg, Giessen, Germany
| | | | - Günter Lochnit
- Department of Biochemistry, Justus-Liebig-University Giessen, Giessen, Germany
| | - Jens Kordelle
- Agaplesion Evangelical Hospital Mittelhessen, Giessen, Germany
| | - Markus Rickert
- Department of Orthopedics, University Hospital Giessen and Marburg, Giessen, Germany
| | - Jürgen Steinmeyer
- Department of Orthopedics, University Hospital Giessen and Marburg, Giessen, Germany
- * E-mail:
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Konttinen YT, Kaivosoja E, Stegaev V, Wagner HD, Levón J, Tiainen VM, Mackiewicz Z. Extracellular Matrix and Tissue Regeneration. Regen Med 2013. [DOI: 10.1007/978-94-007-5690-8_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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20
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Che L, Zhou J, Li S, He H, Zhu Y, Zhou X, Jia Y, Liu Y, Zhang J, Li X. Assembled nanomedicines as efficient and safe therapeutics for articular inflammation. Int J Pharm 2012; 439:307-16. [DOI: 10.1016/j.ijpharm.2012.09.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 08/27/2012] [Accepted: 09/09/2012] [Indexed: 01/13/2023]
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McIlwraith CW, Frisbie DD, Kawcak CE. The horse as a model of naturally occurring osteoarthritis. Bone Joint Res 2012; 1:297-309. [PMID: 23610661 PMCID: PMC3626203 DOI: 10.1302/2046-3758.111.2000132] [Citation(s) in RCA: 174] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 09/24/2012] [Indexed: 01/15/2023] Open
Abstract
Osteoarthritis (OA) is an important cause of
pain, disability and economic loss in humans, and is similarly important in
the horse. Recent knowledge on post-traumatic OA has suggested opportunities
for early intervention, but it is difficult to identify the appropriate
time of these interventions. The horse provides two useful mechanisms
to answer these questions: 1) extensive experience with clinical
OA in horses; and 2) use of a consistently predictable model of
OA that can help study early pathobiological events, define targets
for therapeutic intervention and then test these putative therapies.
This paper summarises the syndromes of clinical OA in horses including
pathogenesis, diagnosis and treatment, and details controlled studies
of various treatment options using an equine model of clinical OA.
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Affiliation(s)
- C W McIlwraith
- Orthopaedic Research Center, Colorado State University, 300 West Drake Road, Fort Collins, Colorado 80523, USA
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Boyer KA, Angst MS, Asay J, Giori NJ, Andriacchi TP. Sensitivity of gait parameters to the effects of anti-inflammatory and opioid treatments in knee osteoarthritis patients. J Orthop Res 2012; 30:1118-24. [PMID: 22179861 DOI: 10.1002/jor.22037] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Accepted: 11/10/2011] [Indexed: 02/04/2023]
Abstract
The study aim was to address the need for objective markers of pain-modifying interventions by testing the hypothesis that selective gait measures of knee joint loading can distinguish differences between non-steroidal anti-inflammatory (NSAID), analgesic treatment (opioid-receptor agonist), and placebo in patients medial knee osteoarthritis (OA). A randomized, single-blind washout, double-blind treatment, double-dummy cross-over trial using three treatment arms placebo, opioid (Oxycodone), and NSAID (Celecoxib) in medial compartment knee OA patients. Six patients with Kellgren-Lawrence radiographic severity grades of 2 or 3 completed six testing sessions (gait and pain assessment) at 2-week intervals. A significant increase was found in the knee total reaction moment and vertical ground reaction force (GRF) for Celecoxib compared to placebo (p=0.005, p=0.003), but not for Oxycodone compared to placebo (p=0.20, p=0.27) treatments. Walking speed was significantly higher for the Celecoxib and Oxycodone compared to placebo treatment (p=0.041 and p=0.031, respectively). Self-reported function (WOMAC scores) was not different among treatments (p>0.05). The changes in total reaction moments and GRFs for only the NSAID suggest that greater increases in joint loading occurs when joint inflammation is treated in addition to pain. The total knee reaction moment, representing the magnitude of the extrinsic moment, appears to be a sensitive marker, more so than self-reported metrics, for evaluating knee OA treatment effects.
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Affiliation(s)
- Katherine A Boyer
- Bone and Joint Center, VA Palo Alto Health Care System, Palo Alto, California, USA.
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Kon E, Filardo G, Drobnic M, Madry H, Jelic M, van Dijk N, Della Villa S. Non-surgical management of early knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2012; 20:436-49. [PMID: 22037809 DOI: 10.1007/s00167-011-1713-8] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 10/06/2011] [Indexed: 12/24/2022]
Abstract
Conservative approach is usually the first choice for the management of the knee degeneration processes, especially in the phase of the disease recognized as early osteoarthritis (OA) with no clear lesions or associated abnormalities requiring to be addressed surgically. A wide spectrum of treatments is available, from non-pharmacological modalities to dietary supplements and pharmacological therapies, as well as minimally invasive procedures involving injections of various substances aiming to restore joint homeostasis and provide clinical improvement and possibly a disease-modifying effect. Numerous pharmaceuticals have been proposed, but since no therapy has shown all the characteristic of an ideal treatment, and side effects have been reported at both systemic and local level, the use of pharmacological agents should be considered with caution by assessing the risk/benefit ratio of the drugs prescribed. Both patients and physicians should have realistic outcome goals in pharmacological treatment, which should be considered together with other conservative measures. A combination of these therapeutic options is a more preferable scenario, in particular considering the evidence available for non-pharmacological management. In fact, exercise is an effective conservative approach, even if long-term effectiveness and optimal dose and administration modalities still need to be clarified. Finally, physical therapies are emerging as viable treatment options, and novel biological approaches are under study. Further studies to increase the limited medical evidence on conservative treatments, optimizing results, application modalities, indications, and focusing on early OA will be necessary in the future. Level of evidence IV.
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Affiliation(s)
- Elizaveta Kon
- Biomechanics Laboratory - III Clinic, Rizzoli Orthopaedic Institute, Via Di Barbiano,1/10, 40136, Bologna, Italy.
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Spezielle Arzneimitteltherapie in der Schwangerschaft. ARZNEIMITTEL IN SCHWANGERSCHAFT UND STILLZEIT 2012. [PMCID: PMC7271212 DOI: 10.1016/b978-3-437-21203-1.10002-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Madry H, Grün UW, Knutsen G. Cartilage repair and joint preservation: medical and surgical treatment options. DEUTSCHES ARZTEBLATT INTERNATIONAL 2011; 108:669-77. [PMID: 22114626 DOI: 10.3238/arztebl.2011.0669] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 05/31/2011] [Indexed: 12/13/2022]
Abstract
BACKGROUND Articular cartilage defects are most often caused by trauma and osteoarthritis and less commonly by metabolic disorders of the subchondral bone, such as osteonecrosis and osteochondritis dissecans. Such defects do not heal spontaneously in adults and can lead to secondary osteoarthritis. Medications are indicated for symptomatic relief. Slow-acting drugs in osteoarthritis (SADOA), such as glucosamine and chondroitin, are thought to prevent cartilage degeneration. Reconstructive surgical treatment strategies aim to form a repair tissue or to unload compartments of the joint with articular cartilage damage. METHODS In this article, we selectively review the pertinent literature, focusing on original publications of the past 5 years and older standard texts. Particular attention is paid to guidelines and clinical studies with a high level of evidence, along with review articles, clinical trials, and book chapters. RESULTS There have been only a few randomized trials of medical versus surgical treatments. Pharmacological therapies are now available that are intended to treat the cartilage defect per se, rather than the associated symptoms, yet none of them has yet been shown to slow or reverse the progression of cartilage destruction. Surgical débridement of cartilage does not prevent the progression of osteoarthritis and is thus not recommended as the sole treatment. Marrow-stimulating procedures and osteochondral grafts are indicated for small focal articular cartilage defects, while autologous chondrocyte implantationis mainly indicated for larger cartilage defects. These surgical reconstructive techniques play a lesser role in the treatment of osteoarthritis. Osteotomy near the knee joint is indicated for axial realignment when unilateral osteoarthritis of the knee causes axis deviation. CONCLUSION Surgical reconstructive techniques can improve joint function and thereby postpone the need for replacement of the articular surface with an artificial joint.
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Affiliation(s)
- Henning Madry
- Lehrstuhl für Experimentelle Orthopädie und Arthroseforschung, Universität des Saarlandes, 66421 Homburg, Germany.
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Amoo SO, Finnie JF, Van Staden J. Acetylcholinesterase Inhibition, Antioxidant, Antiinflammatory, Antimicrobial and Phytochemical Properties of Huernia hystrix. Phytother Res 2011; 26:639-45. [DOI: 10.1002/ptr.3614] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Revised: 05/10/2011] [Accepted: 06/22/2011] [Indexed: 11/09/2022]
Affiliation(s)
- Stephen O. Amoo
- Research Centre for Plant Growth and Development; School of Biological and Conservation Sciences; University of KwaZulu-Natal Pietermaritzburg; Private Bag X01; Scottsville; 3209; South Africa
| | - Jeffrey F. Finnie
- Research Centre for Plant Growth and Development; School of Biological and Conservation Sciences; University of KwaZulu-Natal Pietermaritzburg; Private Bag X01; Scottsville; 3209; South Africa
| | - Johannes Van Staden
- Research Centre for Plant Growth and Development; School of Biological and Conservation Sciences; University of KwaZulu-Natal Pietermaritzburg; Private Bag X01; Scottsville; 3209; South Africa
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Steinmeyer J, Kordelle J, Stürz H. In vitro inhibition of aggrecanase activity by tetracyclines and proteoglycan loss from osteoarthritic human articular cartilage. J Orthop Res 2010; 28:828-33. [PMID: 20069635 DOI: 10.1002/jor.21026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Tetracyclines were reported to slow down the progression of cartilage damage both in an animal model of osteoarthritis (OA) and in humans. In search for the underlying mechanisms we examined whether tetracyclines possess an inhibitory potential on the activity of aggrecanases and inflammatory mediators and can thus prevent proteoglycan (PG) loss from human articular cartilage. In vitro activity of aggrecanase-1 and -2 was recorded in the presence of 1-100 microM tetracycline, minocycline, or doxycyline. Human knee articular cartilage explants were sorted according to the degree of OA and treated for 10 days with tetracycline derivatives in the presence of interleukin-1 (IL-1beta). Synthesis and loss of PGs, nitric oxide (NO), and prostaglandin E(2) (PGE(2)), as well as the viability were determined. Tetracyclines derivatives dose-dependently inhibited the activities of both aggrecanases in vitro, whereas no inhibitory effect of tetracyclines on any proteoglycanolytic activities within IL-1beta-treated human cartilage explants were found. Tetracyclines can significantly modulate NO and PGE(2) levels, but have no effect on PG synthesis and loss within the same human cartilage explant cultures. Altogether, our data show that tetracyclines have no inhibitory potential on any proteoglycanolytic activities within mild or moderately affected human OA cartilage at therapeutic achievable plasma levels.
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Affiliation(s)
- Jürgen Steinmeyer
- Department of Orthopaedic Surgery, University Hospital Giessen and Marburg GmbH, Giessen, Germany.
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Frost AB, Larsen F, Ostergaard J, Larsen SW, Lindegaard C, Hansen HR, Larsen C. On the search for in vitro in vivo correlations in the field of intra-articular drug delivery: administration of sodium diatrizoate to the horse. Eur J Pharm Sci 2010; 41:10-5. [PMID: 20580670 DOI: 10.1016/j.ejps.2010.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 04/30/2010] [Accepted: 05/10/2010] [Indexed: 01/14/2023]
Abstract
Development of suitable in vitro release models for formulation development as well as quality control purposes has to be initiated in the early design phase of injectable depots. Optimally, construction of an in vitro release model may lead to the establishment of in vitro in vivo correlations. By using a model compound (sodium diatrizoate, DTZ), the purpose of this study was to investigate the possibility of establishing in vitro in vivo relations between the DTZ disappearance profile obtained from the donor compartment of the rotating dialysis cell model and the joint disappearance profile following intra-articular administration. In vitro experiments were conducted by applying solutions of DTZ to the donor compartment. In the in vivo experiments, five horses were subjected to both intravenous and intra-articular administration of an aqueous solution of 3.9 mg DTZ/kg. A strong relation (R(2)=0.99) was obtained between the disappearance data from the donor compartment of the in vitro model and the disappearance data from the synovial fluid after intra-articular administration of DTZ. Furthermore, a relation (R(2)=0.91) between the appearance data obtained from the acceptor compartment and the deconvolved appearance serum data upon intra-articular administration of DTZ was obtained. The correlations obtained in this study hold promise that the rotating dialysis cell model has a role in the prediction of the intra-articular fate of drugs injected as solutions.
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Affiliation(s)
- Anna Buus Frost
- Department of Pharmaceutics and Analytical Chemistry, Faculty of Pharmaceutical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen Ø, Denmark
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Cappelli A, Nannicini C, Valenti S, Giuliani G, Anzini M, Mennuni L, Giordani A, Caselli G, Stasi LP, Makovec F, Giorgi G, Vomero S. Design, Synthesis, and Preliminary Biological Evaluation of Pyrrolo[3,4-c]quinolin-1-one and Oxoisoindoline Derivatives as Aggrecanase Inhibitors. ChemMedChem 2010; 5:739-48. [DOI: 10.1002/cmdc.200900523] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lamas MC, Leonardi D, Lambri OA, Bassani G, Barrera MG, Bolmaro RE, Salomon CJ. Preparation, characterization and dissolution studies of fast release diclofenac sodium tablets from PVP solid dispersions. Pharm Dev Technol 2010. [DOI: 10.3109/10837450903085400] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mibielli MA, Geller M, Cohen JC, Goldberg SG, Cohen MT, Nunes CP, Oliveira LB, da Fonseca AS. Diclofenac plus B vitamins versus diclofenac monotherapy in lumbago: the DOLOR study. Curr Med Res Opin 2009; 25:2589-99. [PMID: 19731994 DOI: 10.3111/13696990903246911] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To assess the influence of vitamins B1, B6 and B12 on the analgesia success achieved by diclofenac in subjects with acute lumbago. RESEARCH DESIGN AND METHODS A randomised, double blind controlled clinical study in parallel groups, in which subjects received twice-daily oral administration of either the combination therapy, Group DB (50 mg diclofenac plus 50 mg thiamine, 50 mg pyridoxine and 1 mg cyanocobalamin) or diclofenac monotherapy, Group D (50mg diclofenac). The study period lasted a maximum of 7 days. If sufficient pain reduction was achieved (defined as Visual Analogue Scale <20 mm and patient's satisfaction), subjects could withdraw from the treatment after 3 or 5 days. All subjects gave written informed consent to participate in the study. MAIN OUTCOME MEASURES The primary confirmatory study objective was to determine the number of patients with sufficient pain reduction after 3 days of treatment. RESULTS Three hundred and seventy-two subjects were allocated at random to either treatment group: Group DB - 187 subjects and Group D - 185 subjects. After 3 days of treatment, a statistically significant higher proportion of subjects in Group DB (n = 87; 46.5%) than in Group D (n = 55; 29%) terminated the study due to treatment success (chi(2): 12.06; p = 0.0005). Furthermore, the combination therapy yielded superior results in pain reduction, improvement of mobility and functionality. Drug safety monitoring profile throughout the trial was within the expected safety profile of diclofenac. CONCLUSIONS The combination of diclofenac with B vitamins was superior to diclofenac monotherapy in lumbago relief after 3 days of treatment. As a study drawback, daily VAS measurements were only recorded until subject withdrawal from treatment, whether after 3, 5, or 7 days. There were no differences in safety profile between the two study groups.
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Affiliation(s)
- M A Mibielli
- Centro Universitário Serra dos Orgãos (UNIFESO), Rio de Janeiro, Brazil
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The Pharmacokinetics of the Weakly Protein-Bound Anionic Compound Diatrizoate in Serum and Synovial Fluid of the Horse. Pharm Res 2009; 27:143-50. [DOI: 10.1007/s11095-009-9988-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Accepted: 09/23/2009] [Indexed: 11/25/2022]
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From osteoarthritis treatments to future regenerative therapies for cartilage. Drug Discov Today 2009; 14:913-25. [DOI: 10.1016/j.drudis.2009.07.012] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2009] [Revised: 07/20/2009] [Accepted: 07/22/2009] [Indexed: 11/20/2022]
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Kubo M, Ando K, Mimura T, Matsusue Y, Mori K. Chondroitin sulfate for the treatment of hip and knee osteoarthritis: current status and future trends. Life Sci 2009; 85:477-83. [PMID: 19695267 DOI: 10.1016/j.lfs.2009.08.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Revised: 08/03/2009] [Accepted: 08/06/2009] [Indexed: 01/08/2023]
Abstract
AIMS Osteoarthritis (OA) is a common joint disorder and a major socio-economic burden. Chondroitin sulfate (CS), which has chondroprotective properties, is a promising candidate for the therapeutic treatment of OA. Here, we summarize current knowledge as well as future trends of CS for the treatment of hip and knee OA. MAIN METHODS We retrospectively reviewed pharmacokinetics, pharmacodynamics, clinical efficacy, safety and tolerability of CS for the treatment of OA. KEY FINDINGS The safety and tolerability of CS are confirmed. CS is effective, at least in part, for the treatment of OA, and its therapeutic benefits occur through three main mechanisms: 1) stimulation of extracellular matrix production by chondrocytes; 2) suppression of inflammatory mediators; and 3) inhibition of cartilage degeneration. SIGNIFICANCE CS is a safe and tolerable therapeutic agent for the management of OA. Its effects include benefits that are not achieved by current medicines and include chondroprotection and the prevention of joint space narrowing. Such positive effects of CS represent a breakthrough in the treatment of hip and knee OA.
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Affiliation(s)
- Mitsuhiko Kubo
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan
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Abstract
Osteoarthritis (OA) is a common, chronic disease that most frequently affects the knees and is a major cause of disability in the elderly. It is characterized by progressive cartilage loss, accompanied by secondary changes such as osteophyte formation and calcium deposition. Inflammatory processes are also involved, leading to stiffness and pain, for which patients seek treatment. Conventional treatment includes analgesics or non-steroidal anti-inflammatory drugs, however life-style changes should also be recommended, such as weight reduction and specific exercises. Glucosamine and chondroitin, classed as over-the-counter supplements or nutraceuticals, are regularly self-administered by patients with OA. Both agents are produced endogenously in the human body and are essential components of cartilage. This review discusses the evidence that supports the use of these agents either alone or in combination for pain relief and as disease-modifying agents in OA.
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Larsen C, Ostergaard J, Larsen SW, Jensen H, Jacobsen S, Lindegaard C, Andersen PH. Intra-articular depot formulation principles: role in the management of postoperative pain and arthritic disorders. J Pharm Sci 2009; 97:4622-54. [PMID: 18306275 DOI: 10.1002/jps.21346] [Citation(s) in RCA: 210] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The joint cavity constitutes a discrete anatomical compartment that allows for local drug action after intra-articular injection. Drug delivery systems providing local prolonged drug action are warranted in the management of postoperative pain and not least arthritic disorders such as osteoarthritis. The present review surveys various themes related to the accomplishment of the correct timing of the events leading to optimal drug action in the joint space over a desired time period. This includes a brief account on (patho)physiological conditions and novel potential drug targets (and their location within the synovial space). Particular emphasis is paid to (i) the potential feasibility of various depot formulation principles for the intra-articular route of administration including their manufacture, drug release characteristics and in vivo fate, and (ii) how release, mass transfer and equilibrium processes may affect the intra-articular residence time and concentration of the active species at the ultimate receptor site.
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Affiliation(s)
- Claus Larsen
- Department of Pharmaceutics and Analytical Chemistry, Faculty of Pharmaceutical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark.
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Ainola M, Valleala H, Nykänen P, Risteli J, Hanemaaijer R, Konttinen YT. Erosive arthritis in a patient with pycnodysostosis: an experiment of nature. ACTA ACUST UNITED AC 2009; 58:3394-401. [PMID: 18975331 DOI: 10.1002/art.23996] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The excellent poster painter Henri de Toulouse-Lautrec is the most famous patient with cathepsin K-deficient pycnodysostosis. Cathepsin K is believed to play a major role in osteoclast-driven bone resorption. In this study we explored the role of cathepsin K in bone resorption in a patient with a cathepsin K mutation causing pycnodysostosis in whom psoriatic arthritis also developed. We hypothesized that the patient would develop only inflammatory synovitis but would not develop bone erosions or other osteolytic changes. METHODS Monocytes from the patient with pycnodysostosis and normal control monocytes were isolated and stimulated to fuse and form multinuclear osteoclast-like cells, which were identified by evaluating messenger RNA expression of osteoclast markers. The ability to resorb bone was assessed by determining the extent of pit formation and levels of collagen degradation products generated by cathepsin K (C-terminal crosslinking telopeptide of type I collagen [CTX]) and matrix metalloproteinases (pyridinoline crosslinked C-terminal telopeptide of type I collagen). These experiments were also done in normal control cells after incubation with the cathepsin K inhibitor E64 during bone resorption. RESULTS In contrast to our a priori hypothesis, the patient developed a mutilating disease with extensive bony erosions associated with lysis of some of the distal phalanges of her hands and feet. After stimulation of monocytes from this patient, the cells formed multinuclear tartrate-resistant acid phosphatase-positive and calcitonin receptor-positive multikaryons, which, however, totally lacked cathepsin K. These multinuclear cells were able to resorb bone but, in contrast to normal control osteoclasts, did not produce CTX. The resorption pattern was abnormal in that, unlike normal control osteoclasts, both osteoclasts from the patient and E64-inhibited osteoclasts did not leave extensive osteoclast trails, but were relatively sessile. CONCLUSION In this "experiment of nature" we observed that cathepsin K is not necessary for bone degradation. These findings may be pertinent to our understanding of the functions of cathepsin K inhibitors, which are currently being developed as drugs to treat metabolic bone diseases.
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Affiliation(s)
- Mari Ainola
- Helsinki University Central Hospital, Helsinki, Finland
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Lee CL, Huang MH, Chai CY, Chen CH, Su JY, Tien YC. The validity of in vivo ultrasonographic grading of osteoarthritic femoral condylar cartilage: a comparison with in vitro ultrasonographic and histologic gradings. Osteoarthritis Cartilage 2008; 16:352-8. [PMID: 17920940 DOI: 10.1016/j.joca.2007.07.013] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2007] [Accepted: 07/29/2007] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To establish an ultrasonographic (US) grading for semiquantitative evaluation of the femoral condylar cartilage of knee osteoarthritis (OA), in vivo, and compare the in vivo US grading with the in vitro US and histologic gradings. DESIGN Ninety-five patients going to receive total knee arthroplasty because of OA of the knee were recruited. US examination was performed in vivo in the day before operation using a grading system including parameters of margin sharpness, clarity and thickness. Specimens of the medial and lateral distal femoral condyles taken during the operation were graded with in vitro US and histologic evaluation. The correlation between the in vivo US and in vitro US as well as between the in vivo US and histologic gradings was analyzed. RESULTS In 172 femoral condyles (including medial and lateral ones), the distribution of grading ranged from Grade 1 to 6 in in vivo US and from Grade 1 to 4 in histologic examination. The in vivo US grading was significantly correlated to in vitro US grading over anterior and middle areas (p<0.001, Rho=0.35 and 0.45, respectively) and histologic grading over these two areas (p<0.001, Rho=0.40 and 0.36, respectively). When the cases with maximal angle of knee flexion less than 120 degree were excluded, the correlation was better. CONCLUSIONS The significant correlation between in vivo US and histologic gradings might permit semi-quantitative in vivo US assessment of osteoarthritic femoral condylar cartilage.
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Affiliation(s)
- C-L Lee
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Comparative efficacy and tolerability of two sustained-release formulations of diclofenac: results of a double-blind, randomised study in patients with osteoarthritis and a reappraisal of diclofenac's use in this patient population. Curr Med Res Opin 2007; 23:1957-66. [PMID: 17631698 DOI: 10.1185/030079907x223251] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare the analgesic efficacy and tolerability of a sustained-release pellet formulation of diclofenac (Olfen-100 SR Depocaps, SR-CAP, Mepha Ltd, Aesch, Switzerland) with the standard reference formulation (Voltaren retard 100, SR-TAB, Novartis Pharma AG, Basel, Switzerland), both containing 100 mg diclofenac sodium, in patients with osteoarthritis (OA) of the knee and/or hip. In addition, diclofenac's current place in the symptomatic therapy of OA is briefly reviewed. METHODS In this 2-week double-blind, active-controlled, non-inferiority trial, 210 OA patients were randomised to receive either SR-CAP once daily or SR-TAB once daily (n = 105 for both groups). The primary efficacy endpoint was the change in visual analogue scale (VAS) pain score (0-100 mm) at rest at Day 14 compared with baseline. Secondary variables included the change in VAS pain score on movement and global assessments of efficacy and tolerability using verbal rating scales (VRS). RESULTS Between baseline and Day 14, mean +/- SD VAS pain score at rest decreased by 44.4 +/- 18.5 mm in the SR-CAP group (n = 89) compared with 41.2 +/- 19.8 mm in the SR-TAB group (n = 82) based on the per protocol population. Comparable changes were observed in the intention-to-treat population. The lower bound of the 1-sided 97.5% confidence interval was -2.7 mm and greater than the prespecified non-inferiority limit of -10 mm. There was a trend towards a better tolerability with SR-CAP compared with SR-TAB based on mean +/- SD VRS scores (SR-CAP, 0.6 +/- 0.68; SR-TAB, 0.9 +/- 1.0 for assessment by patients; p = 0.063). CONCLUSION SR-CAP is as effective as and possibly better tolerated than SR-TAB in patients suffering from painful OA.
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Zhang JX, Yan MQ, Li XH, Qiu LY, Li XD, Li XJ, Jin Y, Zhu KJ. Local Delivery of Indomethacin to Arthritis-Bearing Rats through Polymeric Micelles Based on Amphiphilic Polyphosphazenes. Pharm Res 2007; 24:1944-53. [PMID: 17530389 DOI: 10.1007/s11095-007-9322-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2007] [Accepted: 04/18/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE Preparation, in vitro and in vivo evaluation of indomethacin-loaded polymeric micelles based on amphiphilic polyphosphazene. METHODS Amphiphilic polyphosphazenes (PNIPAAm/EAB-PPPs) with poly (N-isopropylacrylamide) (PNIPAAm) and ethyl 4-aminobenzoate (EAB) as side groups were synthesized through thermal ring-opening polymerization and subsequent substitution reactions. Indomethacin (IND) loaded polymeric micelles based on PNIPAAm/EAB-PPPs were prepared by dialysis procedure. In vitro IND release kinetics was investigated in 0.1 M PBS (pH 7.4), while in vivo pharmacokinetics was performed in Sprague-Dawley rats. In vivo pharmacodynamic study was carried out based on two animal models, i.e. carrageenan-induced acute paw edema and complete Freund's adjuvant (CFA) induced ankle arthritis model. RESULTS Drug loading capacity of micelles based on this type of amphiphilic copolymers was mainly determined by copolymer composition and the chemical structure of drug. In addition to the compatibility between drug and micellar core, hydrogen bonding interaction between drug and hydrophilic corona may significantly influence drug loading as well. In vitro drug release in PBS suggested that there was no significant difference in release rate between micelles based on copolymers with various EAB content. Compared with the rats administered with free IND aqueous solution, IND concentration in rats' plasma showed a prolonged maintenance in experimental group treated with IND-loaded polymeric micelles. In vivo pharmacodynamic study indicated that sustained therapeutic efficacy could be achieved through topical injection of the aqueous solution of IND-loaded micelles. Local delivery of IND can avoid the severe gastrointestinal stimulation, which was frequently associated with oral administration as evidenced by ulceration evaluation. CONCLUSIONS The promising results of current preliminary study suggest that this type of amphiphilic copolymers could be used as injectable drug carriers for hydrophobic drugs.
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MESH Headings
- Animals
- Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
- Anti-Inflammatory Agents, Non-Steroidal/chemistry
- Anti-Inflammatory Agents, Non-Steroidal/pharmacokinetics
- Arthritis, Experimental/chemically induced
- Arthritis, Experimental/prevention & control
- Arthritis, Rheumatoid/chemically induced
- Arthritis, Rheumatoid/prevention & control
- Carrageenan
- Chemistry, Pharmaceutical
- Disease Models, Animal
- Drug Carriers
- Drug Compounding
- Edema/chemically induced
- Edema/prevention & control
- Freund's Adjuvant
- Hydrophobic and Hydrophilic Interactions
- Indomethacin/administration & dosage
- Indomethacin/chemistry
- Indomethacin/pharmacokinetics
- Injections, Intra-Articular
- Injections, Subcutaneous
- Male
- Micelles
- Organophosphorus Compounds/chemical synthesis
- Polymers/chemical synthesis
- Rats
- Rats, Sprague-Dawley
- Solubility
- Surface-Active Agents/chemical synthesis
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Affiliation(s)
- Jian Xiang Zhang
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310068, People's Republic of China
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Costa C, Incio J, Soares R. Angiogenesis and chronic inflammation: cause or consequence? Angiogenesis 2007; 10:149-66. [PMID: 17457680 DOI: 10.1007/s10456-007-9074-0] [Citation(s) in RCA: 329] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2006] [Accepted: 03/20/2007] [Indexed: 12/19/2022]
Abstract
Evidence has been gathered regarding the association between angiogenesis and inflammation in pathological situations. These two phenomena have long been coupled together in many chronic inflammatory disorders with distinct etiopathogenic origin, including psoriasis, rheumatoid arthritis, Crohn's disease, diabetes, and cancer. Lately, this concept has further been substantiated by the finding that several previously established non-inflammatory disorders, such as osteoarthritis and obesity, display both inflammation and angiogenesis in an exacerbated manner. In addition, the interplay between inflammatory cells, endothelial cells and fibroblasts in chronic inflammation sites, together with the fact that inflammation and angiogenesis can actually be triggered by the same molecular events, further strengthen this association. Therefore, elucidating the underlying cellular and molecular mechanisms that gather together the two processes is mandatory in order to understand their synergistic effect, and to develop new therapeutic approaches for the management of these disorders that cause a great deal of discomfort, disability, and in some cases death.
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Affiliation(s)
- Carla Costa
- Laboratory for Molecular Cell Biology, Faculty of Medicine of the University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
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