1
|
Wang Z, Jones G, Blizzard L, Aitken D, Zhou Z, Wang M, Balogun S, Cicuttini F, Antony B. Prevalence and correlates of the use of complementary and alternative medicines among older adults with joint pain. Int J Rheum Dis 2023; 26:1760-1769. [PMID: 37431712 DOI: 10.1111/1756-185x.14822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/04/2022] [Accepted: 06/26/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND There is increasing use of complementary and alternative medicines (CAMs) alone or as an adjuvant therapy to conventional medicines in osteoarthritis (OA) patients. OBJECTIVES This study aimed to describe the prevalence and correlates of the use of CAMs among community-dwelling older adults. METHODS Data from the Tasmania Older Adult Cohort Study (TASOAC, n = 1099) were used to describe the prevalence of CAM use. Correlates of CAM use were assessed by comparing CAM users and non-users. To further assess correlates of CAM use, participants with at least one joint with pain were classified into four categories: CAM-only, analgesics-only, co-therapy, and "neither CAMs nor analgesics" (NCNA). RESULTS In all, 385 (35.0%) of our participants reported use of CAMs, among which vitamins/minerals were used most (22.6%, n = 232). Compared with CAM non-users, CAM users were more likely to be female, were less likely to be overweight, were better educated, had more joints with OA, had fewer WOMAC scores, and did more steps per day. Among participants with any joint pain, the CAM-only group were less likely to be overweight, consumed more alcohol, had higher quality of life, had more steps per day, and had fewer pain-related symptoms compared with the analgesic-only group. CONCLUSION Complementary and alternative medicines were commonly used among Tasmanian older adults, with 35% of the population using CAMs either alone or in combination with conventional analgesics. CAM users were more likely to be female, be better educated, have more joints with OA, and had healthier lifestyles, including lower body mass index and higher number of steps per day.
Collapse
Affiliation(s)
- Zhiqiang Wang
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Zhen Zhou
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Mengmeng Wang
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Saliu Balogun
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- College of Health & Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| |
Collapse
|
2
|
Alnaimat F, Alduraidi H, Alhafez L, Abu Raddad L, Haddad BI, Hamdan M, Alajlouni J, Afifi FU. Rates, patterns, and predictors of complementary medicine use among patients with musculoskeletal diseases. PLoS One 2023; 18:e0287337. [PMID: 37352251 PMCID: PMC10289458 DOI: 10.1371/journal.pone.0287337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 06/03/2023] [Indexed: 06/25/2023] Open
Abstract
AIM To investigate the extent of complementary medicine (CM) use and the most common therapies utilized by Jordanian patients with musculoskeletal (MSK) diseases. METHODS A semi-structured questionnaire was used to conduct a cross-sectional survey of outpatient orthopedic and rheumatology patients at an academic medical center in Amman, Jordan between January and September 2020. RESULTS A convenience sample of 1001 patients was interviewed (82% females). Pearson's chi-square comparisons showed that nutritional CM was used by 43.4% of patients, while 29.8% used physical CM, and 16% used both. Almost all used the nutritional or physical CM in addition to their prescribed treatment. Nutritional form use was significantly higher among females, older age groups, married people, and those who worked (p < .05). Physical form use was statistically more prevalent in older age groups and those with a higher level of education (p < .05). Family income and urban residence were not significantly associated with the use of either form of CM therapy. Olive oil was the most frequently reported nutritional type (22.9%), and cupping was the most reported physical type (41.6%). Recommendations to use CM came primarily from family members or friends (64% of nutritional CM users and 59% of physical CM users). A physician or pharmacist was cited more frequently with physical CM (24% versus 8% for the nutritional form). In contrast, media sources were cited more for nutritional than physical form (28% versus 7%). Over half of the patients believed they received the desired effect from CM. Surprisingly, only 9.5% of the patients admitted to discussing their CM use with their physician. CONCLUSION CM use is prevalent among Jordanian patients with MSK disorders. Most patients rely on family and friends for recommendations, and they rarely inform their physician of the CM use. Physicians should routinely inquire about CM to provide patients with information regarding their benefits and risks.
Collapse
Affiliation(s)
- Fatima Alnaimat
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan
| | - Hamza Alduraidi
- School of Nursing, The University of Jordan, Amman, Jordan
- Aqaba Medical Sciences University, Aqaba, Jordan
| | - Laila Alhafez
- School of Medicine, The University of Jordan, Amman, Jordan
| | | | - Bassem I. Haddad
- Division of Orthopedics, Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Mohammad Hamdan
- Division of Orthopedics, Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Jihad Alajlouni
- Division of Orthopedics, Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Fatma U. Afifi
- Department of Pharmaceutical Chemistry and Pharmacognosy, Applied Science Private University, Amman, Jordan
| |
Collapse
|
3
|
Canbolat Seyman Ç, Ünlü H. The Use of Complementary and Alternative Medicine and Quality of Life in Patients With Hip and Knee Osteoarthritis. Holist Nurs Pract 2022; 36:356-362. [PMID: 33741758 DOI: 10.1097/hnp.0000000000000447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The use of complementary and alternative medicine (CAM) practices was common among patients with osteoarthritis (OA) since the patients experienced severe problems. The aim of this study was to determine the prevalence of CAM use and quality of life in pre-arthroplasty patients. This study was designed as a descriptive, consecutive survey of pre-arthroplasty patients due to hip and knee OA. Data were collected by the Personal Information Form, Western Ontario and McMaster Universities (WOMAC) Index, and EQ-5D-5L quality-of-life scale. Logistic regression was used to determine the risk factors of CAM usage; 74.4% of the patients used CAM methods. The most frequently used methods of CAM were biologically based herbal therapies. All patients indicated that they did not disclose CAM methods they used to their physicians. The median EQ-5D-5L index value of the patients was 0.08 and the median WOMAC score was 96.8. Furthermore, patients with right knee OA were found to have a higher risk of using CAM. This study demonstrated that communication between patients and health care professionals is generally poor, and there is an urgent need to develop patient education to minimize the risks and maximize the benefits of using CAM.
Collapse
Affiliation(s)
- Çiğdem Canbolat Seyman
- Department of Surgical Nursing, Faculty of Nursing, Hacettepe University, Ankara, Turkey (Dr. Canbolat Seyman); and Nursing Department, Faculty of Health Science, Alaaddin Keykubat University, Alanya, Antalya, Turkey, and President of Orthopedic and Traumatology Nurses Association, Ankara, Turkey (Dr Ünlü)
| | | |
Collapse
|
4
|
Jhun J, Na HS, Cho KH, Kim J, Moon YM, Lee SY, Lee JS, Lee AR, Kim SJ, Cho ML, Park SH. A green-lipped mussel reduces pain behavior and chondrocyte inflammation and attenuated experimental osteoarthritis progression. PLoS One 2021; 16:e0259130. [PMID: 34855756 PMCID: PMC8638931 DOI: 10.1371/journal.pone.0259130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/14/2021] [Indexed: 11/24/2022] Open
Abstract
The green-lipped mussel (GLM) contains novel omega-3 polyunsaturated fatty acids, which exhibit anti-inflammatory and joint-protecting properties. Osteoarthritis (OA) is a degenerative joint disease characterized by a progressive loss of cartilage; oxidative stress plays a role in the pathogenesis of OA. The objectives of this study were to investigate the in vivo effects of the GLM on pain severity and cartilage degeneration using an experimental rat OA model, and to explore the mode of action of GLM. OA was induced in rats by intra-articular injection of monosodium iodoacetate (MIA) into the knee. Oral GLM was initiated on the day after 3dyas of MIA injection. Limb nociception was assessed by measuring the paw withdrawal latency and threshold. Samples were analyzed both macroscopically and histologically. Immunohistochemistry was used to investigate the expression of interleukin-1β (IL-1β), IL-6, nitrotyrosine, and inducible nitric oxide synthase (iNOS) in knee joints. Also, the GLM was applied to OA chondrocyte, and the expression on catabolic marker and necroptosis factor were evaluated by real-time polymerase chain reaction. Administration of the GLM improved pain levels by preventing cartilage damage and inflammation. GLM significantly attenuated the expression levels of mRNAs encoding matrix metalloproteinase-3 (MMP-3), MMP-13, and ADAMTS5 in IL-1β-stimulated human OA chondrocytes. GLM decreased the expression levels of the necroptosis mediators RIPK1, RIPK3, and the mixed lineage kinase domain-like protein (MLKL) in IL-1β-stimulated human OA chondrocytes. Thus, GLM reduced pain and cartilage degeneration in rats with experimentally induced OA. The chondroprotective properties of GLM included suppression of oxidative damage and inhibition of catabolic factors implicated in the pathogenesis of OA cartilage damage. We suggest that GLM may usefully treat human OA.
Collapse
Affiliation(s)
- JooYeon Jhun
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul, South Korea
| | - Hyun Sik Na
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul, South Korea
| | - Keun-Hyung Cho
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul, South Korea
| | - Jiyoung Kim
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul, South Korea
| | - Young-Mee Moon
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul, South Korea
| | - Seung Yoon Lee
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul, South Korea
| | - Jeong Su Lee
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul, South Korea
| | - A. Ram Lee
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul, South Korea
| | - Seok Jung Kim
- Department of Orthopedic Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mi-La Cho
- The Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul, South Korea
- * E-mail: (M-LC); (S-HP)
| | - Sung-Hwan Park
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- * E-mail: (M-LC); (S-HP)
| |
Collapse
|
5
|
Alinaghizadeh M, Hawkins J, Abbassian A, Seif Barghi T, Ayati MH, Alizadeh Vaghasloo M. Effect of Persian acupressure (Ghamz) on Patients with Knee Osteoarthritis: A Single-Blinded Parallel Clinical Trial. Pain Manag Nurs 2021; 22:820-827. [PMID: 34261600 DOI: 10.1016/j.pmn.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 05/16/2021] [Accepted: 06/03/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Many patients choose complementary and alternative medicine (CAM) to treat various conditions. Among osteoarthritis patients, acupressure is a popular CAM treatment. In Iran, Ghamz (a Persian acupressure technique) uses for musculoskeletal ailments like knee pain. AIMS To examine the potential efficacy of Ghamz on osteoarthritis outcomes. DESIGN Clinical Trial. SETTINGS Randomized, single-blind, sham-controlled clinical trial. Participants/Subjects: Eighty patients with diagnosed knee osteoarthritis, age over 35 years old. METHODS Eighty adult patients with confirmed knee osteoarthritis from three outpatient clinics were recruited. Participants were randomly assigned either to intervention or placebo groups using sham acupressure. The primary outcomes included Knee injury and Osteoarthritis Outcome Score (KOOS) parameters and pain scores measured using the visual analog scales (VAS). RESULTS Seventy-two individuals completed the trial and were included in the analysis. At baseline, there was no difference between the mean scores of both outcomes. After the intervention, the group receiving Ghamz therapy experienced an improvement in KOOS parameters, including symptoms, pain, activity daily livings, sport, recreation function, and quality of life. The mean pain score in the intervention group was significantly decreased from 5.89 at the beginning study to 4.11 at the end of the study, while the pain score did not change substantially in the sham group. These findings remained consistent after adjusting for covariates of age, weight, and pre-treatment. CONCLUSIONS This study supports evidence that Ghamz therapy provides an effective option for short-term knee pain relief in patients with knee osteoarthritis. Additional studies are recommended to confirm these findings.
Collapse
Affiliation(s)
- Maryam Alinaghizadeh
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Jessie Hawkins
- Integrative Health, Franklin School of Integrative Health Sciences, Franklin, Tennessee
| | - Alireza Abbassian
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Tohid Seif Barghi
- Department of Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Ayati
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Alizadeh Vaghasloo
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
The quality of online consumer health information at the intersection of complementary and alternative medicine and arthritis. Adv Rheumatol 2021; 61:6. [PMID: 33468233 DOI: 10.1186/s42358-021-00162-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Complementary and alternative medicine (CAM) use is prevalent among patients living with arthritis. Such patients often seek information online, for the purpose of gaining a second opinion to their healthcare provider or even self-medication. Little is known about the quality of web-based consumer health information at the intersection of CAM and arthritis; thus, investigating the quality of websites containing this information was the purpose of this study. METHODS Four unique search terms were searched on Google across four English-speaking countries. We assessed the first 20 results of each search, including them if they contained CAM consumer health information for the treatment and/or management of arthritis. Eligible websites were assessed in duplicate using the DISCERN instrument, which consists of 16-items designed to assess quality. RESULTS Of total of 320 webpages, 239 were duplicates, and a total of 38 unique websites were deemed eligible and assessed using the DISCERN instrument. The mean summed DISCERN scores across all websites was 55.53 (SD = 9.37). The mean score of the overall quality of each website was 3.71 (SD = 0.63), thus the majority of websites are ranked as slightly above 'fair' quality. CONCLUSION Eligible websites generally received scores better than 'moderate' in terms of overall quality. Several shortcomings included a lack of transparency surrounding references used and underreporting of risks associated with treatment options. These results suggest that health providers should be vigilant of the variable quality of information their patients may be accessing online and educate them on how to identify high quality resources.
Collapse
|
7
|
Liu X, Robbins S, Eyles J, Fedorova T, Virk S, Deveza LA, McLachlan A, Hunter D. Efficacy and safety of a supplement combination for hand osteoarthritis pain: protocol for an internet-based randomised placebo-controlled trial (The RADIANT study). BMJ Open 2020; 10:e035672. [PMID: 32075845 PMCID: PMC7044939 DOI: 10.1136/bmjopen-2019-035672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Hand osteoarthritis (HOA) is a highly prevalent disabling joint disease. The current management regimens are limited. Potentially as a consequence, many people turn to complementary and alternative medicines for symptomatic relief. A combination of two or more supplements is common in clinical practice; however, evidence for the efficacy of this approach is lacking. The aim of this study is to investigate the efficacy of a supplement combination for treating symptomatic HOA in comparison to placebo. METHODS AND ANALYSIS The RADIANT study is an internet-based, parallel, superiority, double-blind, placebo-controlled, randomised, two-arm clinical trial. A participatory design is used to facilitate the study procedures. One hundred and six participants aged over 40 years with painful HOA and structural change on X-ray (Kellgren and Lawrence grade (KLG) ≥2) will be recruited from the community and randomly allocated to receive either a supplement combination composed of: (1) combined supplement containing Boswellia serrata extract, pine bark extract and methylsulfonylmethane and (2) curcumin or placebo for 12 weeks. The primary outcome will be 12-week change in hand pain on a visual analogue scale (VAS). Main secondary outcomes include adverse events, change in hand function, patient global assessment of disease activity and quality of life. A range of additional measures will be recorded, and an individual patient placebo response will be performed. The primary analysis will be conducted using an intention-to-treat approach. Adverse events will be monitored weekly throughout the study. ETHICS AND DISSEMINATION This protocol has been approved by the University of Sydney Human Research Ethics Committee (HREC No. 2018/766). Dissemination will occur through conferences, social media, scientific publications and PhD thesis. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12619000835145); Pre-results.
Collapse
Affiliation(s)
- Xiaoqian Liu
- Northern Clinical School, Institute of Bone and Joint Research, Kolling Institute of Medical Research, Rheumatology Department, Royal North Shore Hospital, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Sarah Robbins
- Northern Clinical School, Institute of Bone and Joint Research, Kolling Institute of Medical Research, Rheumatology Department, Royal North Shore Hospital, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Jillian Eyles
- Northern Clinical School, Institute of Bone and Joint Research, Kolling Institute of Medical Research, Rheumatology Department, Royal North Shore Hospital, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Tatyana Fedorova
- Northern Clinical School, Institute of Bone and Joint Research, Kolling Institute of Medical Research, Rheumatology Department, Royal North Shore Hospital, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Sonika Virk
- Northern Clinical School, Institute of Bone and Joint Research, Kolling Institute of Medical Research, Rheumatology Department, Royal North Shore Hospital, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Leticia A Deveza
- Northern Clinical School, Institute of Bone and Joint Research, Kolling Institute of Medical Research, Rheumatology Department, Royal North Shore Hospital, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Andrew McLachlan
- School of Pharmacy, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - David Hunter
- Northern Clinical School, Institute of Bone and Joint Research, Kolling Institute of Medical Research, Rheumatology Department, Royal North Shore Hospital, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| |
Collapse
|
8
|
Nik Shafii NAH, Yaacob LH, Ishak A, Kadir AA. Traditional and Complementary Medicine Use in Knee Osteoarthritis and its Associated Factors Among Patients in Northeast Peninsular Malaysia. Oman Med J 2018; 33:148-153. [PMID: 29657684 DOI: 10.5001/omj.2018.27] [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] [Indexed: 11/03/2022] Open
Abstract
Objectives We sought to determine the prevalence of traditional and complementary medicine (TCM) use for knee osteoarthritis and its associated factors among patients attending a referral hospital in an eastern coastal state of Malaysia. Methods This cross-sectional study included 214 patients with knee osteoarthritis. A universal sampling method was applied to patients who attended the outpatient clinic in Hospital Universiti Sains Malaysia from May 2013 to October 2013. Participants were given a questionnaire to determine their sociodemographic information and a validated Bahasa Malaysia version of the Western Ontario and McMaster Universities Arthritis Index (WOMAC). This questionnaire was used to assess the severity of knee osteoarthritis (i.e., pain, stiffness, and disturbances in daily activity). Results Over half (57.9%) of patients reported using TCM to treat knee osteoarthritis. Factors associated with TCM use were gender (odd ratio (OR) = 2.47; 95% confidence interval (CI): 1.28-4.77), duration of knee osteoarthritis (OR = 1.51; 95% CI: 1.03-2.23), and the severity of knee pain (OR = 2.56; 95% CI: 1.71-3.86). Conclusions The prevalence of TCM use among eastern Malaysian patients with knee osteoarthritis was high. Physicians caring for these patients should be aware of these findings so that inquiries regarding TCM use can be made and patients can be appropriately counseled.
Collapse
Affiliation(s)
- Nik Abdul Hafiz Nik Shafii
- Department of Family Medicine, School of Medical Sciences, Health Campus Universiti Sains Malaysia, Kubang Kerian Kelantan, Malaysia
| | - Lili Husniati Yaacob
- Department of Family Medicine, School of Medical Sciences, Health Campus Universiti Sains Malaysia, Kubang Kerian Kelantan, Malaysia
| | - Azlina Ishak
- Department of Family Medicine, School of Medical Sciences, Health Campus Universiti Sains Malaysia, Kubang Kerian Kelantan, Malaysia
| | - Azidah Abdul Kadir
- Department of Family Medicine, School of Medical Sciences, Health Campus Universiti Sains Malaysia, Kubang Kerian Kelantan, Malaysia
| |
Collapse
|
9
|
Protective Effects of Garlic-Derived S-Allylmercaptocysteine on IL-1 β-Stimulated Chondrocytes by Regulation of MMPs/TIMP-1 Ratio and Type II Collagen Expression via Suppression of NF- κB Pathway. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8686207. [PMID: 29333456 PMCID: PMC5733130 DOI: 10.1155/2017/8686207] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/16/2017] [Accepted: 10/25/2017] [Indexed: 11/24/2022]
Abstract
Background Garlic-derived S-allylmercaptocysteine (SAMC) has widely been used in many disease therapies. However, the potential effects and mechanism of SAMC on IL-1β-stimulated chondrocytes are unclear. Methods Chondrocytes were isolated, and 5 ng/mL of IL-1β was added to mimic the in vitro osteoarthritis (OA) model. SAMC (20 and 60 μM) was used for the treatment in OA model. Cell viability was assessed by MTT method. Western blotting, Quantitative RT-PCR, and ELISA were performed to evaluate the mechanisms in SAMC treated OA model. Results Following 48 h of IL-1β exposure, SAMC exhibited protection effect on IL-1β-injured chondrocyte viability. Type II collagen was elevated with reduced degradation products, as a consequence of altered MMPs/TIMP-1 ratio after SAMC treatment in IL-1β-treated chondrocytes. The protein and mRNA level of TNF-α in cellular supernatant and cells were downregulated in a dose-dependent manner. Besides, IκBα in cytoplasmic fraction was increased, while p65 level in nuclear fraction was decreased after SAMC treatment in OA. Conclusions This study showed that SAMC may play a protective role in IL-1β induced osteoarthritis (OA) model. This effect may be through inhibiting the NF-κB signaling pathway, therefore altering the MMPs/TIMP-1 ratio change which induced type II collagen destruction and decreasing inflammatory cytokine secretion such as TNF-α.
Collapse
|
10
|
Stebbings S, Gray A, Schneiders AG, Sansom A. A randomized double-blind placebo-controlled trial to investigate the effectiveness and safety of a novel green-lipped mussel extract -BioLex® -for managing pain in moderate to severe osteoarthritis of the hip and knee. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:416. [PMID: 28830491 PMCID: PMC5568208 DOI: 10.1186/s12906-017-1907-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 08/02/2017] [Indexed: 01/22/2023]
Abstract
Background Extracts from perna canaliculus, the Green Lipped Mussel (GLM) are widely used as a complimentary therapy by patients with osteoarthritis (OA). The current study investigated the potential of a novel GLM formulation as a treatment for OA. A randomized double-blind placebo-controlled trial was undertaken to assess potential impacts on pain and quality of life following 12 weeks of treatment. Methods Eighty patients with moderate to severe OA of the hip or knee were randomized to receive either 600 mg of BioLex®-GLM daily or placebo for 12 weeks. Entry criteria included a minimum 100 mm Visual Analogue Scale pain score (VAS) of 30 mm at baseline. The primary outcome was patient reported pain, measured by the Western Ontario and McMasters OA Index (WOMAC) pain subscale and VAS pain scale. Secondary outcomes included: quality of life (OAQol), total WOMAC score, WOMAC −20 responder criteria, and change in medication use over the study period. Participants were assessed at baseline, 12 weeks (end of therapy) and 15 weeks (3-weeks post-intervention). Results At week 12, there were no significant differences in VAS or WOMAC pain subscale between active and placebo groups, nor significant improvement in the WOMAC-20 responder criteria or OAQol. Joint stiffness (measured by WOMAC-B stiffness) in the GLM group improved compared with placebo (p = 0.046). There was a significant difference in paracetamol use between the GLM treated group and the placebo group after week 12 (p = 0.001). Conclusions BioLex® -GLM extract did not confer clinical benefit in moderate to severe OA over the intervention period, however, a significant difference in paracetamol use in the post-intervention period was observed between the BioLex® -GLM group and placebo group. Higher doses and/or longer treatment periods are worthy of future investigation. Trial registration Australia and New Zealand Clinical Trials Registry: no. ACTRN12611000256976.
Collapse
|
11
|
Ayaz SB, Rathore FA, Ahmad K, Matee S. The use of complementary health approaches among patients with knee osteoarthritis in Pakistan: A hospital based survey. EGYPTIAN RHEUMATOLOGIST 2016. [DOI: 10.1016/j.ejr.2015.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
12
|
Andrioti D, Kyprianou K, Charalambous G. How much do rheumatologists and orthopaedists doctors' modalities impact the cost of arthritis in Cyprus? BMC Musculoskelet Disord 2015; 16:193. [PMID: 26268588 PMCID: PMC4535390 DOI: 10.1186/s12891-015-0643-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 07/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoarthritis is one of the primary causes of long-term functional disability. With an estimated 13.5% prevalence in the general population contributes to a significant financial burden both for patients and healthcare systems. The purpose of this research is to highlight the direct annual cost of the disease to the private healthcare sector of Nicosia. METHODS A questionnaire based on Greek and international research was completed between 10/1/2012 and 11/30/2012, with a sample of 20 doctors specialists in orthopaedics and rheumatology (50% of practising physicians in the private sector). An assessment of the annual cost of medical procedures and tests, pharmacologic therapies (modalities) and supplies per patient followed, based on current costs. Direct costs were assessed through the micro-costing "bottom-up" approach. We isolated and separately priced the original diagnosis, followed by each stage of the disease. RESULTS The cost for the six predominant medical tests to establish a diagnosis and exclude mainly RA such as ESR, CPR, and X-ray as well as a physician's office visit was 150€ per patient. The average direct cost per patient during stages 1, 2 and 3 of the disease was 280.54€, 1,834.64€ and 5,641.72€ annually, respectively, with an annual average of 2,573€ per patient. CONCLUSIONS Even though during the period of the study, the country had not yet established clinical guidelines, the participating physicians followed international practices. Significant rise in the cost in each stage of the disease was found, with additional increases in the following years as a result of the expected increased prevalence of the disease. It is noted here that uninsured patients, as well as those who qualified for free medical care, they seek these services in the private sector, and had to pay out of pocket money for examination and treatment. These patients, thus, contended with a serious financial burden. Therefore, it is important to inform them very extensively regarding evidence-based management of the disease to aid them in coping with this chronic illness.
Collapse
Affiliation(s)
- Despena Andrioti
- Centre of Maritime Health and Society, University of Southern Denmark, Niels Bohrs vej 9, 6700, Esbjerg, Denmark.
| | - Kypros Kyprianou
- Fredrick University, 7, Y. Frederickou Str., Pallouriotisa, Nicosia, 1036, Cyprus.
| | - George Charalambous
- Fredrick University, 7, Y. Frederickou Str., Pallouriotisa, Nicosia, 1036, Cyprus.
| |
Collapse
|
13
|
Berman B, Lewith G, Manheimer E, Bishop FL, D'Adamo C. Complementary and alternative medicine. Rheumatology (Oxford) 2015. [DOI: 10.1016/b978-0-323-09138-1.00048-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
14
|
Basedow M, Runciman WB, March L, Esterman A. Australians with osteoarthritis; the use of and beliefs about complementary and alternative medicines. Complement Ther Clin Pract 2014; 20:237-42. [DOI: 10.1016/j.ctcp.2014.08.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 08/11/2014] [Accepted: 08/12/2014] [Indexed: 10/24/2022]
|
15
|
Arjmandi BH, Ormsbee LT, Elam ML, Campbell SC, Rahnama N, Payton ME, Brummel-Smith K, Daggy BP. A combination of Scutellaria baicalensis and Acacia catechu extracts for short-term symptomatic relief of joint discomfort associated with osteoarthritis of the knee. J Med Food 2014; 17:707-13. [PMID: 24611484 PMCID: PMC4060778 DOI: 10.1089/jmf.2013.0010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 12/10/2013] [Indexed: 01/01/2023] Open
Abstract
The extracts of Scutellaria baicalensis and Acacia catechu have been shown in previous studies to alleviate joint discomfort, reduce stiffness, and improve mobility by reducing the production of proinflammatory molecules over long periods of supplementation. The acute effects of intake of these extracts have not yet been investigated. Thus, we carried out a 1 week clinical trial to examine the extent to which UP446-a natural proprietary blend of S. baicalensis and A. catechu (UP446)-decreases knee joint pain, mobility, and biomarkers of inflammation in comparison to naproxen. Seventy-nine men and women (40-90 years old) diagnosed as having mild to moderate osteoarthritis (OA) consumed either 500 mg/day of the UP446 supplement or 440 mg/day of naproxen for 1 week in a double-blind randomized control trial. Pain, knee range of motion (ROM), and overall physical activity were evaluated at the start and at the end of treatment. Fasting blood was collected to determine serum interleukins 1β and 6, tumor necrosis factor-α, C-reactive protein, and hyaluronic acid. The UP446 group experienced a significant decrease in perceived pain (P=.009) time dependently. Stiffness was significantly reduced by both treatments (P=.002 UP446, P=.008 naproxen). Significant increases in mean ROM over time (P=.04) were found in the UP446 group. These findings suggest that UP446 is effective in reducing the physical symptoms associated with knee OA.
Collapse
Affiliation(s)
- Bahram H. Arjmandi
- Department of Nutrition, Food, and Exercise Sciences, the Florida State University, Tallahassee, Florida, USA
- Center for Advancing Exercise and Nutrition Research on Aging, the Florida State University, Tallahassee, Florida, USA
| | - Lauren T. Ormsbee
- Department of Nutrition, Food, and Exercise Sciences, the Florida State University, Tallahassee, Florida, USA
- Center for Advancing Exercise and Nutrition Research on Aging, the Florida State University, Tallahassee, Florida, USA
| | - Marcus L. Elam
- Department of Nutrition, Food, and Exercise Sciences, the Florida State University, Tallahassee, Florida, USA
- Center for Advancing Exercise and Nutrition Research on Aging, the Florida State University, Tallahassee, Florida, USA
| | - Sara C. Campbell
- Department of Exercise Science and Sport Studies, Rutgers University, the State University of New Jersey, New Brunswick, New Jersey, USA
| | - Nader Rahnama
- Department of Nutrition, Food, and Exercise Sciences, the Florida State University, Tallahassee, Florida, USA
- Center for Advancing Exercise and Nutrition Research on Aging, the Florida State University, Tallahassee, Florida, USA
- Faculty of Sports Sciences, University of Isfahan, Isfahan, Iran
| | - Mark E. Payton
- Department of Statistics, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Ken Brummel-Smith
- Department of Geriatrics, College of Medicine, the Florida State University, Tallahassee, Florida, USA
| | - Bruce P. Daggy
- Department of Nutrition, Food, and Exercise Sciences, the Florida State University, Tallahassee, Florida, USA
- Center for Advancing Exercise and Nutrition Research on Aging, the Florida State University, Tallahassee, Florida, USA
| |
Collapse
|
16
|
Bussmann RW. The globalization of traditional medicine in northern peru: from shamanism to molecules. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:291903. [PMID: 24454490 PMCID: PMC3888705 DOI: 10.1155/2013/291903] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 10/22/2013] [Indexed: 11/18/2022]
Abstract
Northern Peru represents the center of the Andean "health axis," with roots going back to traditional practices of Cupisnique culture (1000 BC). For more than a decade of research, semistructured interviews were conducted with healers, collectors, and sellers of medicinal plants. In addition, bioassays were carried out to evaluate the efficacy and toxicity of plants found. Most of the 510 species encountered were native to Peru (83%). Fifty percent of the plants used in colonial times have disappeared from the pharmacopoeia. Market vendors specialized either on common and exotic plants, plants for common ailments, and plants only used by healers or on plants with magical purposes. Over 974 preparations with up to 29 different ingredients were used to treat 164 health conditions. Almost 65% of the medicinal plants were applied in these mixtures. Antibacterial activity was confirmed in most plants used for infections. Twenty-four percent of the aqueous extracts and 76% of the ethanolic extracts showed toxicity. Traditional preparation methods take this into account when choosing the appropriate solvent for the preparation of a remedy. The increasing demand for medicinal species did not increase the cultivation of medicinal plants. Most species are wild collected, causing doubts about the sustainability of trade.
Collapse
Affiliation(s)
- Rainer W. Bussmann
- William L. Brown Center, Missouri Botanical Garden, P.O. Box 299, St. Louis, MO 63166-0299, USA
| |
Collapse
|
17
|
Efficacy of a Chinese herbal medicine in the treatment for patients with knee osteoarthritis: A randomised, double blind, placebo controlled pilot trial. Eur J Integr Med 2013. [DOI: 10.1016/j.eujim.2013.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
18
|
Hunter DJ, Riordan EA. The impact of arthritis on pain and quality of life: an Australian survey. Int J Rheum Dis 2013; 17:149-55. [DOI: 10.1111/1756-185x.12232] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- David J. Hunter
- Department of Rheumatology; Royal North Shore Hospital and Kolling Institute; University of Sydney; Sydney New South Wales Australia
| | - Edward A. Riordan
- School of Medicine; University of Sydney; Sydney New South Wales Australia
| |
Collapse
|
19
|
Schencking M, Wilm S, Redaelli M. A comparison of Kneipp hydrotherapy with conventional physiotherapy in the treatment of osteoarthritis: a pilot trial. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2013; 11:17-25. [PMID: 23464642 DOI: 10.3736/jintegrmed2013004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND An increasingly aging population implies an increasing prevalence of osteoarthritis (OA) of hip or knee. It has been ascertained that unspecific hydrotherapy of OA according to Sebastian Kneipp not only improves the range of mobility but also reduces pain significantly and increases the quality of life of the patients affected. OBJECTIVE The main aim of this pilot study was to determine the effects of hydrotherapy in comparison to conventional physiotherapy, and to analyze the feasibility of the study design under clinical circumstances. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS The study design is a prospective randomized controlled three-arm clinical pilot trial, carried out at a specialist clinic for integrative medicine. Thirty patients diagnosed with symptomatic OA of hip or knee and radiologic findings were randomly assigned to one of two intervention groups and a control group: hydrotherapy (group 1), physiotherapy (group 2), and both physiotherapy and hydrotherapy (group 3, control group) of the affected joint. MAIN OUTCOME MEASURES PRIMARY OUTCOME pain intensity of the affected joint in the course of inpatient treatment; secondary outcome: health-related quality of life, joint-specific pain and mobility in the course of the study. RESULTS Concerning the main outcome, intervention group 1 showed most beneficial effects in the course of inpatient treatment, followed by groups 3 and 2, and also the indirect flexion ability of hip or knee together with the general patient mobility through the "timed up and go" test were mainly improved within group 1 followed by groups 3 and 2. CONCLUSION The results of this pilot study demonstrate beneficial effects of hydrotherapy. The study design is feasible. For statistically significant evidence and a robust conclusion of efficacy of Kneipp's hydrotherapy, a larger sample size is necessary. TRIAL REGISTRATION NUMBER NCT 00950326.
Collapse
Affiliation(s)
- Martin Schencking
- Institute for General Practice and Family Medicine, University Witten/Herdecke, Germany.
| | | | | |
Collapse
|
20
|
Leach MJ, Kumar S. The clinical effectiveness of Ginger (Zingiber officinale) in adults with osteoarthritis. INT J EVID-BASED HEA 2012; 6:311-20. [PMID: 21631828 DOI: 10.1111/j.1744-1609.2008.00106.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Osteoarthritis (OA) is a degenerative joint disease, which is associated with increased pain and disability, and a simultaneous decline in the quality of life of sufferers. While there is no cure for OA, there are numerous treatments that aim to reduce sufferers' symptoms and disability, and improve their quality of life. Medications, which have long been integral interventions for the management of OA, have recently been found to cause harm in some patients. Simultaneously, the increasing recognition of complementary and alternative therapies as part of mainstream health care, has seen many sufferers of OA use these therapies. Ginger has been commonly prescribed by herbalists for sufferers of OA due to its anti-inflammatory and circulatory stimulant effects. However, to date there has been no systematic review of the literature to evaluate the clinical effectiveness of Ginger for OA. Objective The objective of this systematic review was to evaluate the safety and effectiveness of Ginger in adults with OA. Data sources A comprehensive search was undertaken on 18 electronic databases from their inception to January 2007, including AARP Ageline, AMED, AMI, BioMed central gateway, CAM on PubMed, CENTRAL, CINAHL, Cochrane library, Current controlled trials, Current contents connect, DARE, Dissertations Abstract International, EMBASE, Health Source Nursing/Academic edition, International Pharmaceutical Abstract, MEDLINE, Natural medicines comprehensive database and TRIP. Review methods Randomised controlled trials or clinical controlled trials were sought, which evaluated the effectiveness of mono-preparations of ginger in adults with OA of the knee or hip. Critical appraisal of study quality was undertaken using Joanna Briggs Institute critical appraisal instruments. Data extraction was via the Joanna Briggs Institute standard data extraction form for evidence of effectiveness. Results Five randomised controlled trials were identified from the search, of which three met the inclusion criteria. The methodological quality of the included studies was good. However, given that studies were clinically and methodologically heterogeneous, meta-analysis could not be conducted. Instead, evidence was summarised in narrative form. For changes in pain severity, studies comparing ginger extract (n = 110) to placebo (n = 111) reported mixed findings in support of the use of Ginger. Studies comparing ginger to an active control found participants who received Ibuprofen (n = 96) had a greater change in median pain intensity compared with participants who received Ginger (n = 110), and while findings were statistically significant for only one of the two studies, the results had limited clinical significance. Similarly, while two placebo-controlled studies reported differences between ginger (n = 70) and placebo (n = 71) for changes in disability and functional capacity, the difference was statistically and clinically significant for only one study. In one study comparing ginger to an active control, participants receiving Ibuprofen (n = 56) reported a statistically significant improvement in disability and functional capacity over time when compared with participants receiving Ginger (n = 56). In terms of safety, Ginger was well tolerated when compared with Ibuprofen, with infrequent reports of mild, and predominantly gastrointestinal, adverse effects. Conclusion Current evidence is weak for the use of Ginger in adults with OA of the knee and/or hip. Much of this can be attributed to significant heterogeneity between studies. Improvements in research design, instrumentation and ginger dosage, which more closely reflect current clinical practice, may help to demonstrate the safe and effective use of Ginger in OA sufferers.
Collapse
Affiliation(s)
- Matthew J Leach
- Centre for Allied Health Evidence: a collaborating centre of the Joanna Briggs Institute, The University of South Australia, Adelaide, Australia
| | | |
Collapse
|
21
|
Fioravanti A, Giannitti C, Bellisai B, Iacoponi F, Galeazzi M. Efficacy of balneotherapy on pain, function and quality of life in patients with osteoarthritis of the knee. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2012; 56:583-90. [PMID: 21573819 DOI: 10.1007/s00484-011-0447-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 04/15/2011] [Accepted: 04/26/2011] [Indexed: 05/21/2023]
Abstract
The aims of this study were to evaluate whether balneotherapy with mineral sulphate-bicarbonate-calcium water could determine substantial symptomatic improvement, and to detect any changes in the quality of life (QoL) of patients with symptomatic knee osteoarthritis (OA). This was a prospective randomized, single blind controlled trial. Sixty outpatients with primary bilateral knee OA, according to ACR criteria, were included in the study and randomized to one of two groups: group I (30 patients) was treated with a daily sulphate-bicarbonate-calcium mineral water bath; group II (30 patients), the control group, continued their regular outpatient care routine. At baseline, after 15 days and after 12 weeks, patients were evaluated by Visual Analogue Scale (VAS) for spontaneous pain, Lequesne and Womac Index for gonarthrosis, SF-36, Arthritis Impact Measurement Scale (AIMS) and symptomatic drugs consumption. We observed a significant improvement of all parameters at the end of the cycle of balneotherapy which persisted throughout the follow-up period, whereas in the control group no significant differences were noted. This symptomatic effect was confirmed by the significant reduction of symptomatic drugs consumption. The differences between the two groups were significant for all considered parameters already from the 15th day and persisted during follow-up. Tolerability of balneotherapy seemed to be good, with light and transitory side effects. Our results confirm that the beneficial effects of balneotherapy in patients with knee OA last over time, with positive effects on the painful symptomatology, a significant improvement on functional capacities and QoL. Balneotherapy can represent a useful backup to pharmacological treatment of knee OA or a valid alternative for patients who do not tolerate pharmacological treatments.
Collapse
Affiliation(s)
- Antonella Fioravanti
- Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy.
| | | | | | | | | |
Collapse
|
22
|
Gore M, Tai KS, Sadosky A, Leslie D, Stacey BR. Use and Costs of Prescription Medications and Alternative Treatments in Patients with Osteoarthritis and Chronic Low Back Pain in Community-Based Settings. Pain Pract 2012; 12:550-60. [DOI: 10.1111/j.1533-2500.2012.00532.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
23
|
Milder TY, Lipworth WL, Williams KM, Ritchie JE, Day RO. "It looks after me": how older patients make decisions about analgesics for osteoarthritis. Arthritis Care Res (Hoboken) 2011; 63:1280-6. [PMID: 21671423 DOI: 10.1002/acr.20514] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore the key motivators behind selection of analgesics (nonsteroidal antiinflammatory drugs [NSAIDs], acetaminophen, and complementary medications [CMs]) by patients with osteoarthritis (OA). METHODS We performed a qualitative study in which in-depth semistructured interviews were conducted with 15 OA patients recruited from 4 general practices in Sydney, Australia. Patients were ages ≥65 years, and were currently taking or had recently taken an NSAID for OA. RESULTS Three key themes emerged from the data: reliance, routine, and pill load. Patients were strongly reliant upon NSAIDs because they consistently satisfied their needs. By contrast, they were much less reliant upon acetaminophen because of uncertainty or skepticism about its effectiveness. They were not reliant upon CMs but were willing to take them indefinitely because they were perceived as being without risk. Many patients took an NSAID as well as CMs as part of a "daily routine." By contrast, patients had difficulty developing a routine around using acetaminophen at the recommended maximum dose because of the implicit frequency of dosing required and an aversion to the associated "pill load." CONCLUSION The results highlight the importance of exploring the perceptions and preferences of patients with regard to analgesics for OA. Clinician advice regarding analgesia for OA should take account of the possible reliance of the patient upon an NSAID, their medicine routines, and their potential concern about the pill load associated, in particular, with acetaminophen.
Collapse
|
24
|
Fioravanti A, Bellisai B, Iacoponi F, Manica P, Galeazzi M. Phytothermotherapy in Osteoarthritis: A Randomized Controlled Clinical Trial. J Altern Complement Med 2011; 17:407-12. [DOI: 10.1089/acm.2010.0294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Antonella Fioravanti
- Rheumatology Unit, Department of Clinical Medicine and Immunology, University of Siena, Siena, Italy
| | - Barbara Bellisai
- Rheumatology Unit, Department of Clinical Medicine and Immunology, University of Siena, Siena, Italy
| | | | | | - Mauro Galeazzi
- Rheumatology Unit, Department of Clinical Medicine and Immunology, University of Siena, Siena, Italy
| |
Collapse
|
25
|
|
26
|
The assessment of bee venom responses in an experimental model of mono-arthritis using Tc-99m DPD bone scintigraphy. Ann Nucl Med 2010; 24:455-60. [PMID: 20379856 DOI: 10.1007/s12149-010-0380-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Accepted: 03/20/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Several recent studies have shown that bee venom (BV) has an anti-nociceptive and anti-inflammatory effect on arthritis. However, objective methods for evaluation of the therapeutic effect of BV is insufficient in animal studies and clinical trials. Our purpose was to determine the usefulness of bone scintigraphy using Tc-99m DPD (3,3-diphosphono-1,2-propan-dicarbonacid) about effects of BV applied to carrageenan-induced mono-arthritis (CIA) model. METHODS Mono-arthritis was induced by an intra-articular injection of carrageenan in Sprague-Dawley rats. Administration of BV (0.8 mg/kg) was performed at 30 min before and at 4 h after the induction of mono-arthritis. We assigned rats to BV-before, BV-after, control-before and control-after groups and compared the results of each group by the weight-loading test and bone scintigraphy. The rats received an intravenous injection of 37 MBq of Tc-99m DPD by the tail vein and then scanning was performed at 4 and 24 h after the injection. Visual assessment and quantitative analysis were performed for both knees. RESULTS The BV-before and BV-after groups were more improved than the control groups on the weight load test (p < 0.05). Bone scintigraphy showed lower activity in the BV-before group than in the control-before group (p < 0.05) on the 4 h imaging. However, a significant difference in the BV-before and BV-after groups was not observed on the 24 h imaging. CONCLUSIONS BV had therapeutic effects by anti-nociceptive and anti-inflammatory activity in the CIA and bone scintigraphy performed on 4 h imaging provided visual and quantitative information for the assessment of the therapeutic response to BV as an objective method in mono-arthritis model.
Collapse
|
27
|
|
28
|
Phytalgic, a food supplement, vs placebo in patients with osteoarthritis of the knee or hip: a randomised double-blind placebo-controlled clinical trial. Arthritis Res Ther 2009; 11:R192. [PMID: 20015358 PMCID: PMC3003499 DOI: 10.1186/ar2891] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2009] [Revised: 11/27/2009] [Accepted: 12/16/2009] [Indexed: 11/10/2022] Open
Abstract
Introduction The medicinal treatment of osteoarthritis (OA) is mostly symptomatic to relieve pain and incapacity with analgesics and non-steroidal anti-inflammatory drugs (NSAIDs), drugs with well-known risks. Complementary medicines might reduce the symptoms of OA and decrease the need for NSAIDs. This study tested the effects of a food supplement, Phytalgic®, on pain and function in patients with osteoarthritis and their use of analgesic and NSAIDs. Methods A randomized double-blind parallel-groups clinical trial compared Phytalgic® (fish-oil, vitamin E, Urtica dioica) to a placebo for three months, in 81 patients with OA of the knee or hip using NSAIDs and/or analgesics regularly. The main outcome measures were use of NSAIDs (in Defined Daily Doses per day - DDD/day) or analgesics (in 500 mg paracetamol-equivalent tablets per week (PET/week) measured each month, and Western Ontario-McMaster University Osteo-Arthritis Index (WOMAC) function scales. Results After three months of treatment, the mean use of analgesics in the active arm (6.5 PET/week) vs. the placebo arm (16.5) was significantly different (P < 0.001) with a group mean difference of -10.0 (95% CI: -4.9 to -15.1). That of NSAIDs in the active arm (0.4 DDD/day) vs the placebo arm (1.0 DDD/day) was significantly different (P = 0.02) with a group mean difference of - 0.7 DDD/day (95% CI: -0.2 to -1.2). Mean WOMAC scores for pain, stiffness and function in the active arm (respectively 86.5, 41.4 and 301.6) vs the placebo arm (resp. 235.3, 96.3 and 746.5) were significantly different (P < 0.001) with group mean differences respectively of -148.8 (95% CI: -97.7 to -199.9), -54.9 (95% CI: -27.9 to -81.9) and -444.8 (95% CI: -269.1 to -620.4). Conclusions The food supplement tested appeared to decrease the need for analgesics and NSAIDs and improve the symptoms of osteoarthritis. Trial registration Clinicaltrials.gov NCT00666523.
Collapse
|
29
|
Guendling P, Schaedle S, Jork K. Therapeutic effects of mud packs on joint ailment and quality of life from patients with gonarthrosis—A controlled clinical study. Eur J Integr Med 2009. [DOI: 10.1016/j.eujim.2009.08.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
30
|
Schencking M, Otto A, Deutsch T, Sandholzer H. A comparison of Kneipp hydrotherapy with conventional physiotherapy in the treatment of osteoarthritis of the hip or knee: protocol of a prospective randomised controlled clinical trial. BMC Musculoskelet Disord 2009; 10:104. [PMID: 19689824 PMCID: PMC2736923 DOI: 10.1186/1471-2474-10-104] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Accepted: 08/19/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The increasing age of the population, especially in the western world, means that the prevalence of osteoarthritis is also increasing, with corresponding socioeconomic consequences. Although there is no curative intervention at present, in accordance with US and European guidelines, pharmacotherapeutic and non-pharmacological approaches aim at pain control and the reduction of functional restriction.It has been established that hydrotherapy for osteoarthritis of the hip or knee joint using serial cold and warm water stimulation not only improves the range of movement but also reduces pain significantly and increases quality of life over a period of up to three months. Weight reduction is important for patients with osteoarthritis of the hip or knee. In addition, conventional physiotherapy and exercise therapy have both been shown, at a high level of evidence, to be cost-effective and to have long-term benefits for pain relief, movement in the affected joint, and patient quality of life. METHODS/DESIGN The study design consists of a prospective randomised controlled three-armed clinical trial, which will be carried out at a specialist clinic for integrative medicine, to investigate the clinical effects of hydrotherapy on osteoarthritis of the knee or hip joint, in comparison with conventional physiotherapy.One hundred and eighty patients diagnosed with osteoarthritis of hip or knee will be randomly assigned to one of three intervention groups: hydrotherapy, physiotherapy, and both physiotherapy and hydrotherapy of the affected joint. In the first group, patients will receive Kneipp hydrotherapy daily, with water applied in the form of alternate cold and warm thigh affusions (alternating cold and warm water stimulation is particularly relevant to the knee and hip regions).Patients in the second group will receive physiotherapy of the hip or knee joint three times a week. Patients in the physiotherapy-hydrotherapy combination group will receive both joint-specific physiotherapy three times a week and alternate cold and warm thigh affusions every day. Follow-up assessments will be on three levels: clinical assessment by the investigator; subjective patient assessment consisting of a patient diary, and questionnaires on admission and at the end of the treatment phase; and a final telephone assessment by the external evaluation centre. Assessments will be made at baseline, after two weeks of inpatient treatment, and finally after a further ten weeks of follow-up. The primary outcome measure will be pain intensity of the affected joint in the course of inpatient treatment, judged by the patient and the investigator. Secondary outcomes include health-related quality of life and joint-specific pain and mobility in the course of the study. Statistical analysis of the results will be on an intention-to-treat basis. CONCLUSION This study methodology has been conceived according to the standards of the CONSORT recommendations. The results will contribute to establishing hydrotherapy as a non-invasive, non-interventional, reasonably priced, therapeutic option with few side effects, in the concomitant treatment of osteoarthritis of the hip or knee. TRIAL REGISTRATION TRIAL REGISTRATION NUMBER NCT 00950326.
Collapse
Affiliation(s)
- Martin Schencking
- Kneipp Clinic (Sebastianeum & Kneippianum) Bad Wörishofen, Kneippstrasse 08, D-86825 Bad Wörishofen, Germany
- Dept of Primary Care, University of Leipzig Medical School, Ph.-Rosenthal-Strasse 55, D-04103 Leipzig, Germany
| | - Adriane Otto
- Dept of Primary Care, University of Leipzig Medical School, Ph.-Rosenthal-Strasse 55, D-04103 Leipzig, Germany
| | - Tobias Deutsch
- Dept of Primary Care, University of Leipzig Medical School, Ph.-Rosenthal-Strasse 55, D-04103 Leipzig, Germany
| | - Hagen Sandholzer
- Dept of Primary Care, University of Leipzig Medical School, Ph.-Rosenthal-Strasse 55, D-04103 Leipzig, Germany
| |
Collapse
|
31
|
Kikuchi M, Matsuura K, Matsumoto Y, Inagaki T, Ueda R. Bibliographical investigation of complementary alternative medicines for osteoarthritis and rheumatoid arthritis. Geriatr Gerontol Int 2009; 9:29-40. [PMID: 19260977 DOI: 10.1111/j.1447-0594.2008.00503.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND A variety of complementary and alternative medicine (CAM) treatments are provided to the elderly. We investigated the efficacy and safety of CAM substances that are available to patients with osteoarthritis (OA) and rheumatoid arthritis (RA), both in Japan and overseas. METHODS Information on CAM products was collected from the World Wide Web, using the keywords "arthritis" and "supplement" in five languages (Japanese, English, French, Italian and German) using a popular search engine for each of the languages. References to published work on the products were researched using PubMed with the keywords of "arthritis", "anti-inflammatory" and "analgesics". Such published work was classified according to the evidence levels established by the Cochrane Library. RESULTS Two-hundred and sixty CAM products for OA or RA were available in Japan, of which 41 CAM products had been tested in randomized controlled trials (RCT); there was no scientific evidence for the remaining 219 CAM products. Most of the previous RCT suggested that CAM was effective in OA or RA. Herein, we confirmed the significant OA relieving effects of chondroitin sulfate through a meta-analysis. Effectiveness was assessed using subjective scores, not disease-specific immunological or serological markers for assessment. Toxicological investigations had only been performed for a few CAM products. CONCLUSION Some CAM products that are effective against RA may be used together with biological therapy. However, some of the CAM products available in Japan should be tested using objective markers. Some CAM products for OA could be used for the relief of pain.
Collapse
Affiliation(s)
- Motoo Kikuchi
- Department of Medicine, Fujita Health University, Nanakuri Sanatorium, Tsu, Mie, Japan.
| | | | | | | | | |
Collapse
|
32
|
Hung LF, Lai JH, Lin LC, Wang SJ, Hou TY, Chang DM, Liang CCT, Ho LJ. Retinoid Acid Inhibits IL-1-Induced iNOS, COX-2 and Chemokine Production in Human Chondrocytes. Immunol Invest 2009; 37:675-93. [DOI: 10.1080/08820130802307237] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
33
|
Abstract
AIM This paper reports on a study conducted to describe what traditional and non-traditional treatments older adults with osteoarthritis use for pain management, their reported pain relief, and factors associated with use of recommended initial gold standard treatment (acetaminophen/paracetamol or non-steroidal anti-inflammatory drugs, and exercise and/or physical therapy) as designated by conventional western medicine. BACKGROUND Osteoarthritis is characterized by joint pain, stiffness and limited range of motion and has been designated an international health burden by the World Health Organization. Demographic and cultural factors have been shown to affect both traditional and non-traditional osteoarthritis treatment decisions. METHOD A descriptive correlational design was used, with secondary analysis of data collected between July 2006 and July 2007 in two randomized controlled studies using the Brief Pain Inventory Short Form and testing older adults' pain communication. RESULTS The frequency of use of gold standard treatment was 28.0% (n = 128). Both traditional and non-traditional treatments were used by 46.4% (n = 212) of the participants. Logistic regression revealed that those with higher education (odds ratio 1.56, CI 1.24-1.96, P = 0.001), and non-White race, regardless of educational level (odds ratio 2.02, CI 1.20-3.40, P = 0.008), were more likely to use gold standard treatment. CONCLUSION Factors influencing older adults' use of gold standard treatment for their osteoarthritis pain need to be identified so that greater numbers of older adults can be supported to use recommended treatment to obtain greater pain relief.
Collapse
Affiliation(s)
- Diane Merkle
- School of Nursing, University of Connecticut, USA
| | | |
Collapse
|
34
|
Hill C, Gill TK, Appleton S, Cleland LG, Taylor AW, Adams RJ. The use of fish oil in the community: results of a population-based study. Rheumatology (Oxford) 2009; 48:441-2. [DOI: 10.1093/rheumatology/ken498] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
35
|
Alvarez-Nemegyei J, Bautista-Botello A, Dávila-Velázquez J. Association of complementary or alternative medicine use with quality of life, functional status or cumulated damage in chronic rheumatic diseases. Clin Rheumatol 2009; 28:547-51. [DOI: 10.1007/s10067-008-1082-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2008] [Revised: 10/31/2008] [Accepted: 12/20/2008] [Indexed: 11/29/2022]
|
36
|
Chatfield SM, Dharmage SC, Boers A, Martin BJ, Buchanan RRC, Maksymowych WP, Schachna L. Complementary and alternative medicines in ankylosing spondylitis: a cross-sectional study. Clin Rheumatol 2008; 28:213-7. [DOI: 10.1007/s10067-008-1029-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2008] [Accepted: 10/22/2008] [Indexed: 11/30/2022]
|
37
|
|
38
|
Use of Conventional and Nonconventional Treatments for Osteoarthritis in the Family Medicine Setting. South Med J 2008; 101:252-9. [PMID: 18364653 DOI: 10.1097/01.smj.0000308363.10237.54] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
39
|
Leach MJ, Kumar S. The clinical effectiveness of Ginger (Zingiber Officinale) in adults with osteoarthritis. ACTA ACUST UNITED AC 2008; 6:310-323. [PMID: 27819836 DOI: 10.11124/01938924-200806080-00001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Osteoarthritis (OA) is a degenerative joint disease, which is associated with increased pain and disability, and a simultaneous decline in the quality of life of sufferers. While there is no cure for OA, there are numerous treatments that aim to reduce sufferers' symptoms and disability, and improve their quality of life. Medications, which have long been integral interventions for the management of OA, have recently been found to cause harm in some patients. Simultaneously, the increasing recognition of complementary and alternative therapies as part of mainstream health care, has seen many sufferers of OA use these therapies. Ginger has been commonly prescribed by herbalists for sufferers of OA due to its anti- inflammatory and circulatory stimulant effects. However, to date there has been no systematic review of the literature to evaluate the clinical effectiveness of Ginger for OA. OBJECTIVE The objective of this systematic review was to evaluate the safety and effectiveness of Ginger in adults with OA. DATA SOURCES A comprehensive search was undertaken on 18 electronic databases from their inception to January 2007, including AARP Ageline, AMED, AMI, BioMed central gateway, CAM on PubMed, CENTRAL, CINAHL, Cochrane library, Current controlled trials, Current contents connect, DARE, Dissertations Abstract International, EMBASE, Health Source Nursing/Academic edition, International Pharmaceutical Abstract, MEDLINE, Natural medicines comprehensive database and TRIP. REVIEW METHODS Randomised controlled trials or clinical controlled trials were sought, which evaluated the effectiveness of mono-preparations of ginger in adults with OA of the knee or hip. Critical appraisal of study quality was undertaken using Joanna Briggs Institute critical appraisal instruments. Data extraction was via the Joanna Briggs Institute standard data extraction form for evidence of effectiveness. RESULTS Five randomised controlled trials were identified from the search, of which three met the inclusion criteria. The methodological quality of the included studies was good. However, given that studies were clinically and methodologically heterogeneous, meta-analysis could not be conducted. Instead, evidence was summarised in narrative form. For changes in pain severity, studies comparing ginger extract (n = 110) to placebo (n = 111) reported mixed findings in support of the use of Ginger. Studies comparing ginger to an active control found participants who received Ibuprofen (n = 96) had a greater change in median pain intensity compared with participants who received Ginger (n = 110), and while findings were statistically significant for only one of the two studies, the results had limited clinical significance. Similarly, while two placebo-controlled studies reported differences between ginger (n = 70) and placebo (n = 71) for changes in disability and functional capacity, the difference was statistically and clinically significant for only one study. In one study comparing ginger to an active control, participants receiving Ibuprofen (n = 56) reported a statistically significant improvement in disability and functional capacity over time when compared with participants receiving Ginger (n = 56). In terms of safety, Ginger was well tolerated when compared with Ibuprofen, with infrequent reports of mild, and predominantly gastrointestinal, adverse effects. CONCLUSION Current evidence is weak for the use of Ginger in adults with OA of the knee and/or hip. Much of this can be attributed to significant heterogeneity between studies. Improvements in research design, instrumentation and ginger dosage, which more closely reflect current clinical practice, may help to demonstrate the safe and effective use of Ginger in OA sufferers.
Collapse
Affiliation(s)
- Matthew J Leach
- 1. Centre for Allied Health Evidence: a collaborating centre of the Joanna Briggs Institute, The University of South Australia, Adelaide, Australia
| | | |
Collapse
|
40
|
Jüni P, Reichenbach S, Dieppe P. Osteoarthritis: rational approach to treating the individual. Best Pract Res Clin Rheumatol 2007; 20:721-40. [PMID: 16979535 DOI: 10.1016/j.berh.2006.05.002] [Citation(s) in RCA: 157] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Osteoarthritis (OA) is the most common form of joint disease and the leading cause of pain and physical disability in older people. Risk factors for incidence and progression of osteoarthritis vary considerably according to the type of joint. Disease assessment is difficult and the relationship between the radiographic severity of joint damage and the incidence and severity of pain is only modest. Psychosocial and socio-economic factors play an important role. This chapter will discuss four main guiding principles to the management of OA: (1) to avoid overtreating people with mild symptoms; (2) to attempt to avoid doing more harm than good ('primum non nocere'); (3) to base patient management on the severity of pain, disability and distress, and not on the severity of joint damage or radiographic change; and (4) to start with advice about simple measures that patients can take to help themselves, and only progress to interventions that require supervision or specialist knowledge if simple measures fail. Effect sizes derived from meta-analyses of large randomized trials in OA are only small to moderate for most therapeutic interventions, but they are still valuable for patients and clinically relevant for physicians. Joint replacement may be the only option with a large effect size, but is only appropriate for the relatively small number of people with OA who have advanced disease and severe symptoms. The key to successful management involves patient and health professionals working together to develop optimal treatment strategies for the individual.
Collapse
Affiliation(s)
- Peter Jüni
- Department of Social and Preventive Medicine, University of Berne, Berne, Switzerland.
| | | | | |
Collapse
|
41
|
Ho LJ, Lin LC, Hung LF, Wang SJ, Lee CH, Chang DM, Lai JH, Tai TY. Retinoic acid blocks pro-inflammatory cytokine-induced matrix metalloproteinase production by down-regulating JNK-AP-1 signaling in human chondrocytes. Biochem Pharmacol 2005; 70:200-8. [PMID: 15946654 DOI: 10.1016/j.bcp.2005.04.039] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2005] [Accepted: 04/13/2005] [Indexed: 12/31/2022]
Abstract
The development of osteoarthritis (OA) has recently been implicated as a result of immune-mediated damage of chondrocytes and their supporting matrixes. Pro-inflammatory cytokines like interleukin (IL)-1 and tumor necrosis factor alpha (TNF-alpha) play pivotal roles in immunopathogenesis of OA. Because vitamins preserving anti-oxidative effects are suggested to provide protection in OA patients from joint damage, in the present study, we examined the effects and mechanisms of all-trans retinoic acid (t-RA) in suppressing pro-inflammatory cytokine-induced matrix metalloproteinases (MMPs) production in human chondrocytes. Chondrocytes were prepared from cartilage specimens of OA patients receiving total hip or total knee replacement. The protein concentration was measured by ELISA, the mRNA expression by reverse transcriptase-polymerase chain reaction, the protein expression by Western blotting, the transcription factor DNA-binding activity by electrophoretic mobility shift assay and the protein kinase activity by kinase assay. We showed that both MMP-1 and MMP-13 mRNA expression, protein production and enzyme activity induced by either IL-1 or TNF-alpha were suppressed by t-RA or different retinoid derivatives. The molecular investigation revealed that the t-RA-mediated suppression was likely through blocking p38 kinase and c-Jun N-terminal kinase-activator protein-1 signaling pathways. In contrast, t-RA had no effect on extracellular signal-regulated kinase activity, nuclear factor (kappa)B (NF-(kappa)B) DNA-binding activity and I(kappa)B(alpha) degradation. Furthermore, we showed that t-RA could reduce IL-1-induced TNF-alpha production in chondrocytes. Our results suggest that vitamin A may protect OA patients from pro-inflammatory cytokine-mediated damage of chondrocytes and their supporting matrixes.
Collapse
Affiliation(s)
- Ling-Jun Ho
- Division of Gerontology Research, National Health Research Institute, Taipei, Taiwan, ROC.
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Lee JD, Park HJ, Chae Y, Lim S. An Overview of Bee Venom Acupuncture in the Treatment of Arthritis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2005; 2:79-84. [PMID: 15841281 PMCID: PMC1062163 DOI: 10.1093/ecam/neh070] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2004] [Accepted: 01/04/2005] [Indexed: 12/21/2022]
Abstract
Bee venom acupuncture (BVA), as a kind of herbal acupuncture, exerts not only pharmacological actions from the bioactive compounds isolated from bee venom but also a mechanical function from acupuncture stimulation. BVA is growing in popularity, especially in Korea, and is used primarily for pain relief in many kinds of diseases. We aimed to summarize and evaluate the available evidence of BVA for rheumatoid arthritis and osteoarthritis. Computerized literature searches for experimental studies and clinical trials of BVA for arthritis were performed on the databases from PUBMED, EMBASE and the Cochrane Library. In addition, two leading Korean journals (The Journal of Korean Society for Acupuncture and Moxibustion and The Journal of Korean Oriental Medicine) were searched for relevant studies. The search revealed 67 studies, 15 of which met our criteria. The anti-inflammation and analgesic actions of BVA were proved in various kinds of animal arthritic models. Two randomized controlled trials and three uncontrolled clinical trials showed that BVA was effective in the treatment of arthritis. It is highly likely that the effectiveness of BVA for arthritis is a promising area of future research. However, there is limited evidence demonstrating the efficacy of BVA in arthritis. Rigorous trials with large sample size and adequate design are needed to define the role of BVA for these indications. In addition, studies on the optimal dosage and concentration of BVA are recommended for future trials.
Collapse
Affiliation(s)
- Jae-Dong Lee
- Department of Acupuncture and Moxibustion, Seoul College of Korean Medicine, Kyung Hee UniversitySeoul, South Korea
| | - Hi-Joon Park
- Department of Meridian and Acupuncture, Seoul College of Korean Medicine, Kyung Hee UniversitySeoul, South Korea
| | - Younbyoung Chae
- Department of Meridian and Acupuncture, Seoul College of Korean Medicine, Kyung Hee UniversitySeoul, South Korea
| | - Sabina Lim
- Department of Meridian and Acupuncture, Seoul College of Korean Medicine, Kyung Hee UniversitySeoul, South Korea
- For reprints and all correspondence: Sabina Lim, Department of Meridian and Acupuncture, College of Korean Medicine, Kyung-Hee University, 1 Hoegidong, Dongdaemungu, Seoul 130–701, South Korea. Tel: +822 961 0324. Fax: +822 961 7831; E-mail:
| |
Collapse
|