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Heydari Nasrabadi M, Parsivand M, Mohammadi N, Asghari Moghaddam N. Comparison of Elaeagnus angustifolia L. extract and quercetin on mouse model of knee osteoarthritis. J Ayurveda Integr Med 2021; 13:100529. [PMID: 34862093 PMCID: PMC8728052 DOI: 10.1016/j.jaim.2021.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 01/21/2023] Open
Abstract
Osteoarthritis (OA) is the most commonly observed arthritic disease causing severe pain and impairing patient's quality of life. This study aimed to investigate and compare the effect of Elaeagnus angustifolia extract and quercetin on the mouse model of knee osteoarthritis (OA). Sixty Balb-C mice were used to establish the monosodium iodoacetate (MIA) model of OA. Then, they were randomized into untreated OA group (normal nutrition), E. angustifolia extract-treated group (32 mg/kg by gavage), quercetin-treated group (20 mg/kg by gavage) and ibuprofen- treated group (20 mg/kg). Fifteen mice with no MIA treatment were considered as the normal controls. The mice were treated for 28 days. The histopathological analysis was performed on knee joints. Expression levels of matrix metalloproteinase 3 and 13 (MMP-1 and MMP-13) in serum were assessed in addition. Histopathological study indicated that in the quercetin-treated group, the thickness of femur and tibia were significantly increased (P < 0.05). Among groups treated by E. angustifolia extract, quercetin and ibuprofen, the concentration of MMP-3 was 5.47 ± 1.75 ng/ml, 4.38 ± 1.78 ng/ml and 4.86 ± 1.40 ng/ml, respectively. The level of MMP-13 in sera was 3.32 ± 1.64 ng/ml, 2.67 ± 1.73 ng/ml and 5.31 ± 1.68 ng/ml in the same order (P < 0.05). The results of this study suggest that the quercetin was useful in the reduction of symptoms of OA and raised the improvement of damaged cartilage. Hence, it can be a beneficial medical supplement in OA treatment. Besides, E. angustifolia extract and quercetin significantly reduced the serum MMP-3 and MMP-13 concentrations. It could be one of the mechanisms through that E. angustifolia plays a role in remission of OA.
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Affiliation(s)
| | - Malahat Parsivand
- Department of Biology, Parand Branch, Islamic Azad University, Tehran, Iran
| | - Narges Mohammadi
- Department of Biology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
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Craciunescu O, Icriverzi M, Florian PE, Roseanu A, Trif M. Mechanisms and Pharmaceutical Action of Lipid Nanoformulation of Natural Bioactive Compounds as Efficient Delivery Systems in the Therapy of Osteoarthritis. Pharmaceutics 2021; 13:1108. [PMID: 34452068 PMCID: PMC8399940 DOI: 10.3390/pharmaceutics13081108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 12/13/2022] Open
Abstract
Osteoarthritis (OA) is a degenerative joint disease. An objective of the nanomedicine and drug delivery systems field is to design suitable pharmaceutical nanocarriers with controllable properties for drug delivery and site-specific targeting, in order to achieve greater efficacy and minimal toxicity, compared to the conventional drugs. The aim of this review is to present recent data on natural bioactive compounds with anti-inflammatory properties and efficacy in the treatment of OA, their formulation in lipid nanostructured carriers, mainly liposomes, as controlled release systems and the possibility to be intra-articularly (IA) administered. The literature regarding glycosaminoglycans, proteins, polyphenols and their ability to modify the cell response and mechanisms of action in different models of inflammation are reviewed. The advantages and limits of using lipid nanoformulations as drug delivery systems in OA treatment and the suitable route of administration are also discussed. Liposomes containing glycosaminoglycans presented good biocompatibility, lack of immune system activation, targeted delivery of bioactive compounds to the site of action, protection and efficiency of the encapsulated material, and prolonged duration of action, being highly recommended as controlled delivery systems in OA therapy through IA administration. Lipid nanoformulations of polyphenols were tested both in vivo and in vitro models that mimic OA conditions after IA or other routes of administration, recommending their clinical application.
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Affiliation(s)
- Oana Craciunescu
- National Institute of R&D for Biological Sciences, 296 Splaiul Independentei, 060031 Bucharest, Romania;
| | - Madalina Icriverzi
- The Institute of Biochemistry of the Romanian Academy, 296 Splaiul Independentei, 060031 Bucharest, Romania; (M.I.); (P.E.F.); (A.R.)
| | - Paula Ecaterina Florian
- The Institute of Biochemistry of the Romanian Academy, 296 Splaiul Independentei, 060031 Bucharest, Romania; (M.I.); (P.E.F.); (A.R.)
| | - Anca Roseanu
- The Institute of Biochemistry of the Romanian Academy, 296 Splaiul Independentei, 060031 Bucharest, Romania; (M.I.); (P.E.F.); (A.R.)
| | - Mihaela Trif
- The Institute of Biochemistry of the Romanian Academy, 296 Splaiul Independentei, 060031 Bucharest, Romania; (M.I.); (P.E.F.); (A.R.)
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Effects of Psidium guajava Linn. leaf extract in Japanese subjects with knee pain: a randomized, double-blind, placebo-controlled, parallel pilot study. Aging Clin Exp Res 2018; 30:1391-1398. [PMID: 29687303 DOI: 10.1007/s40520-018-0953-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/17/2018] [Indexed: 12/15/2022]
Abstract
The extract of Psidium guajava Linn. (guava) leaf was recently revealed to suppress the advance of osteoarthritis (OA) in rat anterior cruciate ligament-transection models. To investigate the efficacy of guava leaf extract in improving knee pain, which is a common symptom of OA, we conducted a double-blind parallel pilot clinical study in Japanese subjects with knee pain. The subjects, who had no medical history of knee treatment, were randomly assigned to two groups with similar total Japanese Knee Osteoarthritis Measure (JKOM) scores. During the 12-week intake period, the subjects in each group ingested 1 g of guava leaf extract (the guava group) or placebo (the placebo group) daily. At week 12, pain and stiffness in knees (one subcategory of JKOM score) in the guava group was significantly lower than that in the placebo group. Using the visual analogue scale (VAS) for knee pain, a significant association between treatment effect and test period was shown, and the guava group had a lower VAS score at week 12 than the placebo group. In conclusion, continuous intake of guava leaf extract might relieve knee pain, suggesting a potential preventive effect against OA symptoms.
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Durney K, Sharifi Kia D, Wang T, Singh A, Karbowski L, Koo HJ, Ateshian GA, Albro M. Physiologic Medium Maintains the Homeostasis of Immature Bovine Articular Cartilage Explants in Long-Term Culture. J Biomech Eng 2018; 141:2712943. [PMID: 30383167 DOI: 10.1115/1.4041901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Indexed: 11/08/2022]
Abstract
The ability to maintain living articular cartilage tissue in long-term culture can serve as a valuable analytical research tool, allowing for direct examination of mechanical or chemical perturbations on tissue behavior. A fundamental challenge for this technique is the recreation of the salient environmental conditions of the synovial joint in culture that are required to maintain native cartilage homeostasis. Interestingly, conventional media formulations used in explanted cartilage tissue culture investigations often consist of levels of metabolic mediators that deviate greatly from their concentrations in synovial fluid. Here, we hypothesize that the utilization of a culture medium consisting of near-physiologic levels of several highly influential metabolic mediators (glucose, amino acids, cortisol, insulin, and ascorbic acid) will maintain the homeostasis of cartilage explants as assessed by their mechanical properties and extracellular matrix contents. Results demonstrate that the aforementioned mediators have a strong effect on the mechanical and biochemical stability of skeletally immature bovine cartilage explants. Most notably, 1) in the absence of cortisol, explants exhibit extensive swelling and tissue softening and 2) in the presence of supraphysiologic levels of anabolic mediators (glucose, amino acids, insulin), explants exhibit increased matrix accumulation and tissue stiffening. In contrast, the administration of physiologic levels of these mediators (as present in native synovial fluid) greatly improves the stability of live cartilage explants over one month of culture. These results may have broad applicability for articular cartilage and other musculoskeletal tissue research, setting the foundation for important culture formulations required for examinations into tissue behavior.
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Affiliation(s)
- Krista Durney
- Department of Biomedical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027
| | - Danial Sharifi Kia
- Department of Mechanical Engineering, Boston University, 110 Cummington Mall, Boston, MA 02215
| | - Tianbai Wang
- Department of Mechanical Engineering, Boston University, 110 Cummington Mall, Boston, MA 02215
| | - Akaljot Singh
- Department of Biomedical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027
| | - Lucie Karbowski
- Department of Biomedical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027
| | - Hyeon Jin Koo
- Department of Biomedical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027
| | - Gerard A Ateshian
- Department of Biomedical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027
| | - Michael Albro
- Department of Mechanical Engineering, Boston University, 110 Cummington Mall, Boston, MA 02215
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Lee H, Nguyen TT, Jeong JH, Park JB. Evaluation of the Effects of Biodegradable Microspheres Loaded with Quercetin on Adipogenic and Chondrogenic Differentiation of Cellular Spheroids. Macromol Res 2018. [DOI: 10.1007/s13233-018-6073-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Kawasaki K, Fushimi T, Nakamura J, Ota N. Guava leaf extract suppresses osteoarthritis progression in a rat anterior cruciate ligament transection model. Food Sci Nutr 2018; 6:800-805. [PMID: 29983942 PMCID: PMC6021720 DOI: 10.1002/fsn3.601] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 12/01/2017] [Accepted: 01/10/2018] [Indexed: 02/06/2023] Open
Abstract
Guava leaf extract and ellagic acid, one of its polyphenolic components, inhibit the activity of a disintegrin and metalloproteinase with thrombospondin type 5 (ADAMTS-5), which is associated with aggrecan degeneration during the early stage of osteoarthritis (OA). To investigate the efficacy of guava leaf extract for preventing OA, we examined the effect of its dietary intake on cartilage destruction in anterior cruciate ligament-transected (ACLT) rats. Rats were randomly assigned to four groups: ACLT control rats fed with control diet, ACLT rats fed with diet containing 0.2% guava leaf extract, ACLT rats fed with diet containing 0.5% guava leaf extract, and sham-operated rats fed with control diet. Mankin's scores, an index of cartilage damage, were higher in rats that underwent ACLT. Guava leaf extract treatment dose-dependently led to lower Mankin's scores and higher concentrations of ellagic acid in the serum and synovial membrane. Ellagic acid levels in the synovial membrane negatively correlated with cartilage destruction scores. These results suggest that dietary guava leaf extract suppresses OA progression in ACLT rats through ellagic acid-mediated inhibition of early joint destruction.
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Affiliation(s)
- Keiko Kawasaki
- Biological Science Research LaboratoriesKao CorporationTochigiJapan
| | - Takashi Fushimi
- Biological Science Research LaboratoriesKao CorporationTochigiJapan
| | - Junji Nakamura
- Kansei Science Research LaboratoriesKao CorporationTochigiJapan
| | - Noriyasu Ota
- Biological Science Research LaboratoriesKao CorporationTochigiJapan
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Jessberger S, Högger P, Genest F, Salter DM, Seefried L. Cellular pharmacodynamic effects of Pycnogenol® in patients with severe osteoarthritis: a randomized controlled pilot study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:537. [PMID: 29246219 PMCID: PMC5732384 DOI: 10.1186/s12906-017-2044-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 12/05/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND The standardized maritime pine bark extract (Pycnogenol®) has previously shown symptom alleviating effects in patients suffering from moderate forms of knee osteoarthritis (OA). The cellular mechanisms for this positive impact are so far unknown. The purpose of the present randomized pilot controlled study was to span the knowledge gap between the reported clinical effects of Pycnogenol® and its in vivo mechanism of action in OA patients. METHODS Thirty three patients with severe OA scheduled for a knee arthroplasty either received 100 mg of Pycnogenol® twice daily or no treatment (control group) three weeks before surgery. Cartilage, synovial fluid and serum samples were collected during surgical intervention. Relative gene expression of cartilage homeostasis markers were analyzed in the patients' chondrocytes. Inflammatory and cartilage metabolism mediators were investigated in serum and synovial fluid samples. RESULTS The oral intake of Pycnogenol® downregulated the gene expression of various cartilage degradation markers in the patients' chondrocytes, the decrease of MMP3, MMP13 and the pro-inflammatory cytokine IL1B were statistically significant (p ≤ 0.05). Additionally, protein concentrations of ADAMTS-5 in serum were reduced significantly (p ≤ 0.05) after three weeks intake of the pine bark extract. CONCLUSIONS This is the first report about positive cellular effects of a dietary supplement on key catabolic and inflammatory markers in patients with severe OA. The results provide a rational basis for understanding previously reported clinical effects of Pycnogenol® on symptom scores of patients suffering from OA. TRIAL REGISTRATION ISRCTN10754119 . Retrospectively registered 08/10/2015.
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Affiliation(s)
- Steffen Jessberger
- Institut für Pharmazie und Lebensmittelchemie, Universität Würzburg, Am Hubland C7, 97074 Würzburg, Germany
| | - Petra Högger
- Institut für Pharmazie und Lebensmittelchemie, Universität Würzburg, Am Hubland C7, 97074 Würzburg, Germany
| | - Franca Genest
- Department of Orthopedics, Universität Würzburg, Orthopedic Center for Musculoskeletal Research, Brettreichstraße 11, 97074 Würzburg, Germany
| | - Donald M. Salter
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Osteoarticular Research Group, Crewe Road, Edinburgh, EH4 2XU UK
| | - Lothar Seefried
- Department of Orthopedics, Universität Würzburg, Orthopedic Center for Musculoskeletal Research, Brettreichstraße 11, 97074 Würzburg, Germany
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Natarajan V, Madhan B, Tiku ML. Intra-Articular Injections of Polyphenols Protect Articular Cartilage from Inflammation-Induced Degradation: Suggesting a Potential Role in Cartilage Therapeutics. PLoS One 2015; 10:e0127165. [PMID: 26046639 PMCID: PMC4457493 DOI: 10.1371/journal.pone.0127165] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 04/12/2015] [Indexed: 01/21/2023] Open
Abstract
Arthritic diseases, such as osteoarthritis and rheumatoid arthritis, inflict an enormous health care burden on society. Osteoarthritis, a degenerative joint disease with high prevalence among older people, and rheumatoid arthritis, an autoimmune inflammatory disease, both lead to irreversible structural and functional damage to articular cartilage. The aim of this study was to investigate the effect of polyphenols such as catechin, quercetin, epigallocatechin gallate, and tannic acid, on crosslinking type II collagen and the roles of these agents in managing in vivo articular cartilage degradation. The thermal, enzymatic, and physical stability of bovine articular cartilage explants following polyphenolic treatment were assessed for efficiency. Epigallocatechin gallate and tannic acid-treated explants showed >12 °C increase over native cartilage in thermal stability, thereby confirming cartilage crosslinking. Polyphenol-treated cartilage also showed a significant reduction in the percentage of collagen degradation and the release of glycosaminoglycans against collagenase digestion, indicating the increase physical integrity and resistance of polyphenol crosslinked cartilage to enzymatic digestion. To examine the in vivo cartilage protective effects, polyphenols were injected intra-articularly before (prophylactic) and after (therapeutic) the induction of collagen-induced arthritis in rats. The hind paw volume and histomorphological scoring was done for cartilage damage. The intra-articular injection of epigallocatechin gallate and tannic acid did not significantly influence the time of onset or the intensity of joint inflammation. However, histomorphological scoring of the articular cartilage showed a significant reduction in cartilage degradation in prophylactic- and therapeutic-groups, indicating that intra-articular injections of polyphenols bind to articular cartilage and making it resistant to degradation despite ongoing inflammation. These studies establish the value of intra-articular injections of polyphenol in stabilization of cartilage collagen against degradation and indicate the unique beneficial role of injectable polyphenols in protecting the cartilage in arthritic conditions.
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Affiliation(s)
- Venkatachalam Natarajan
- Council of Scientific and Industrial Research—Central Leather Research Institute, Adyar, Chennai, Tamil Nadu, India
| | - Balaraman Madhan
- Council of Scientific and Industrial Research—Central Leather Research Institute, Adyar, Chennai, Tamil Nadu, India
- * E-mail:
| | - Moti L. Tiku
- Rutgers, Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
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Oleuropein or rutin consumption decreases the spontaneous development of osteoarthritis in the Hartley guinea pig. Osteoarthritis Cartilage 2015; 23:94-102. [PMID: 25219641 DOI: 10.1016/j.joca.2014.08.016] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 06/25/2014] [Accepted: 08/28/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the potential protective effects of three polyphenols oleuropein, rutin and curcumin, on joint ageing and osteoarthritis (OA) development. DESIGN Sixty 4-week-old Dunkin-Hartley guinea pigs were randomized into four groups and received daily during 31 weeks either standard guinea pig diet (control group) or a standard guinea pig diet enriched with oleuropein (0.025%), rutin (0.5%) or rutin/curcumin (0.5%/0.25%) association. Biomarkers of OA (Coll2-1, Coll2-1NO2, Fib3-1, Fib3-2, ARGS), as well as inflammation prostaglandin E2 (PGE2) were quantified in the serum. Histological assessments of knee cartilage and synovial membrane were performed at week 4 (five young reference guinea pigs) and week 35. RESULTS At week 35, guinea pigs in the control group spontaneously developed significant cartilage lesions with mild synovial inflammation. The histological scores of cartilage lesions and synovitis were well correlated with the increased level of serum biomarkers. Histologically, all treatments significantly reduced the cartilage degradation score (P < 0.01), but only oleuropein significantly decreased the synovial histological score (P < 0.05) and serum PGE2 levels (P < 0.01) compared to the control group. Coll2-1 was decreased by rutin and the combination of rutin/curcumin, Fib3-1 and Fib3-2 were only decreased by the rutin/curcumin mixture, while Coll2-1NO2 was significantly decreased by all treatments (P < 0.05). CONCLUSION Oleuropein and rutin ± curcumin significantly slowed down the progression of spontaneous OA lesions in guinea pigs. While no additive effect was seen in the curcumin + rutin group, the differential effects of oleuropein and rutin on inflammatory and cartilage catabolic markers suggest an interesting combination for future studies in OA protection.
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Kalinski T, Sel S, Hütten H, Röpke M, Roessner A, Nass N. Curcumin blocks interleukin-1 signaling in chondrosarcoma cells. PLoS One 2014; 9:e99296. [PMID: 24901233 PMCID: PMC4047106 DOI: 10.1371/journal.pone.0099296] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 05/13/2014] [Indexed: 02/07/2023] Open
Abstract
Interleukin (IL)-1 signaling plays an important role in inflammatory processes, but also in malignant processes. The essential downstream event in IL-1 signaling is the activation of nuclear factor (NF)-κB, which leads to the expression of several genes that are involved in cell proliferation, invasion, angiogenesis and metastasis, among them VEGF-A. As microenvironment-derived IL-1β is required for invasion and angiogenesis in malignant tumors, also in chondrosarcomas, we investigated IL-1β-induced signal transduction and VEGF-A expression in C3842 and SW1353 chondrosarcoma cells. We additionally performed in vitro angiogenesis assays and NF-κB-related gene expression analyses. Curcumin is a substance which inhibits IL-1 signaling very early by preventing the recruitment of IL-1 receptor associated kinase (IRAK) to the IL-1 receptor. We demonstrate that IL-1 signaling and VEGF-A expression are blocked by Curcumin in chondrosarcoma cells. We further show that Curcumin blocks IL-1β-induced angiogenesis and NF-κB-related gene expression. We suppose that IL-1 blockade is an additional treatment option in chondrosarcoma, either by Curcumin, its derivatives or other IL-1 blocking agents.
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Affiliation(s)
- Thomas Kalinski
- Department of Pathology, Otto-von-Guericke-University, Magdeburg, Germany
- * E-mail:
| | - Saadettin Sel
- Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Heiko Hütten
- Department of Hematology and Oncology, Klinikum Braunschweig, Braunschweig, Germany
| | - Martin Röpke
- Department of Orthopedics, Otto-von-Guericke-University, Magdeburg, Germany
| | - Albert Roessner
- Department of Pathology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Norbert Nass
- Department of Pathology, Otto-von-Guericke-University, Magdeburg, Germany
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Green JA, Hirst-Jones KL, Davidson RK, Jupp O, Bao Y, MacGregor AJ, Donell ST, Cassidy A, Clark IM. The potential for dietary factors to prevent or treat osteoarthritis. Proc Nutr Soc 2014; 73:278-88. [PMID: 24572502 DOI: 10.1017/s0029665113003935] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Osteoarthritis (OA) is a degenerative joint disease for which there are no disease-modifying drugs. It is a leading cause of disability in the UK. Increasing age and obesity are both major risk factors for OA and the health and economic burden of this disease will increase in the future. Focusing on compounds from the habitual diet that may prevent the onset or slow the progression of OA is a strategy that has been under-investigated to date. An approach that relies on dietary modification is clearly attractive in terms of risk/benefit and more likely to be implementable at the population level. However, before undertaking a full clinical trial to examine potential efficacy, detailed molecular studies are required in order to optimise the design. This review focuses on potential dietary factors that may reduce the risk or progression of OA, including micronutrients, fatty acids, flavonoids and other phytochemicals. It therefore ignores data coming from classical inflammatory arthritides and nutraceuticals such as glucosamine and chondroitin. In conclusion, diet offers a route by which the health of the joint can be protected and OA incidence or progression decreased. In a chronic disease, with risk factors increasing in the population and with no pharmaceutical cure, an understanding of this will be crucial.
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Affiliation(s)
- Jonathan A Green
- School of Biological Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | | | - Rose K Davidson
- School of Biological Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - Orla Jupp
- School of Biological Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - Yongping Bao
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | | | - Simon T Donell
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Aedín Cassidy
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Ian M Clark
- School of Biological Sciences, University of East Anglia, Norwich NR4 7TJ, UK
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