Effectiveness of Cucumis sativus extract versus glucosamine-chondroitin in the management of moderate osteoarthritis: a randomized controlled trial

Natural products in osteoarthritis treatment: bridging basic research to clinical applications

Osteoarthritis (OA) is the most prevalent degenerative musculoskeletal disease, severely impacting the function of patients and potentially leading to disability, especially among the elderly population. Natural products (NPs), obtained from components or metabolites of plants, animals, microorganisms etc., have gained significant attention as important conservative treatments for various diseases. Recently, NPs have been well studied in preclinical and clinical researches, showing promising potential in the treatment of OA. In this review, we summed up the main signaling pathways affected by NPs in OA treatment, including NF-κB, MAPKs, PI3K/AKT, SIRT1, and other pathways, which are related to inflammation, anabolism and catabolism, and cell death. In addition, we described the therapeutic effects of NPs in different OA animal models and the current clinical studies in OA patients. At last, we discussed the potential research directions including in-depth analysis of the mechanisms and new application strategies of NPs for the OA treatment, so as to promote the basic research and clinical transformation in the future. We hope that this review may allow us to get a better understanding about the potential bioeffects and mechanisms of NPs in OA therapy, and ultimately improve the effectiveness of NPs-based clinical conservative treatment for OA patients.

Prevention and treatment of inflammatory arthritis with traditional Chinese medicine: Underlying mechanisms based on cell and molecular targets

Inflammatory arthritis, primarily including rheumatoid arthritis, osteoarthritis and ankylosing spondylitis, is a group of chronic inflammatory diseases, whose general feature is joint dysfunction with chronic pain and eventually causes disability in older people. To date, both Western medicine and traditional Chinese medicine (TCM) have developed a variety of therapeutic methods for inflammatory arthritis and achieved excellent results. But there is still a long way to totally cure these diseases. TCM has been used to treat various joint diseases for thousands of years in Asia. In this review, we summarize clinical efficacies of TCM in inflammatory arthritis treatment after reviewing the results demonstrated in meta-analyses, systematic reviews, and clinical trials. We pioneered taking inflammatory arthritis-related cell targets of TCM as the entry point and further elaborated the molecular targets inside the cells of TCM, especially the signaling pathways. In addition, we also briefly discussed the relationship between gut microbiota and TCM and described the role of drug delivery systems for using TCM more accurately and safely. We provide updated and comprehensive insights into the clinical application of TCM for inflammatory arthritis treatment. We hope this review can guide and inspire researchers to further explore mechanisms of the anti-arthritis activity of TCM and make a great leap forward in comprehending the science of TCM.

A novel Atlantic salmon (Salmo salar) bone collagen peptide delays osteoarthritis development by inhibiting cartilage matrix degradation and anti-inflammatory

Nowadays, the biological activity of collagen peptides has been revealed, but the effect of Atlantic salmon (Salmo salar) bone-derived collagen peptide (CPs) on osteoarthritis remains unclear. In this study, CPs was identified as a small molecular weight peptide rich in Gly-X-Y structure. Meanwhile, interleukin-1β (IL-1β)-induced hypertrophic chondrocytes and partial medial meniscectomy (pMMx) surgery model in rats were performed. In IL-1β stimulated chondrocytes, CPs significantly increased the type-II collagen content, reduced the type-X collagen abundance and chondrocytes apoptosis. Meanwhile, CPs reversed the increased expression of matrix metalloproteinase, metalloproteinase with thrombospondin motifs and RUNX family transcription factor 2 in chondrocytes induced by IL-1β. In vivo, CPs increased pain tolerance of rats and without organ toxicity at 1.6 g/kg.bw. CPs significantly decreased the levels of COMP and Helix-II in serum. Furthermore, a significant decrease of IL-1β in synovial fluid and cartilage tissue were observed by CPs intervention. From Micro-CT, CPs (0.8 g/kg.bw) significantly decreased Tb.sp and SMI value. Meanwhile, the expression of tumor necrosis factor and interleukin-6 were reduced by CPs administration both in vitro and in vivo. Together, CPs showed potential to be a novel and safe dietary supplement for helping anti-inflammatory and cartilage regeneration, ultimately hindering osteoarthritis development. However, the clear mechanism of CPs's positive effect on osteoarthritis needs to be further explored.

Iminosugar Amino Acid idoBR1 Reduces Inflammatory Responses in Microglia

(1) Background. Inflammation is reported to be a key factor in neurodegeneration. The microglia are immune cells present in the central nervous system; their activation results in the release of inflammatory cytokines and is thought to be related to aging and neurodegenerative disorders, such as Alzheimer's disease. (2) Methods. A mouse BV-2 microglia cell line was activated using LPS and the anti-inflammatory cucumber-derived iminosugar amino acid idoBR1, (2R,3R,4R,5S)-3,4,5-trihydroxypiperidine-2-carboxylic acid, was used alongside dexamethasone as the control to determine whether it could reduce the inflammatory responses. (3) Results. A dose-dependent reduction in the LPS-induced production of the proinflammatory factors TNFα, IL-6, and nitric oxide and the transcription factor NF-κB was found. (4) Conclusions. Further investigations of the anti-inflammatory effects of idoBR1 in other models of neurodegenerative diseases are warranted.

Self-Management for Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background

Knee osteoarthritis (KOA) is a high incidence chronic joint disease that seriously affects patients' quality of life, and current treatment methods have limited efficacy. Self-management may be an effective strategy for KOA, and clinicians have been showing increased interest recently. However, the effectiveness of self-management for KOA remains controversial.

Purpose

This study aims to systematically evaluate the effectiveness of self-management for KOA.

Methods

We screened articles published in MEDLINE, Cochrane Library, EMBASE, and Web of Science until September 17, 2021. The main outcomes included pain, knee function, stiffness, WOMAC (total), physical function, arthritis self-efficacy (ASE-pain), arthritis self-efficacy (ASE-other symptoms), mental health, and quality of life.

Results

Thirteen randomized controlled trials (RCTs) were finally included (n = 1610). Meta-analysis showed differences in pain, knee function, stiffness, ASE-pain, ASE-other symptoms, mental health, and quality of life between the self-management and control groups. Of the nine outcomes evaluated, four were highly heterogeneous, and the quality of evidence ranged from very low to moderate.

Conclusion

The meta-analysis results showed that self-management might help improve the pain, knee function, stiffness, ASE, mental health, and quality of life in patients with KOA. However, it has no significant effect on WOMAC (total) and physical function. Considering that this study has some limitations, we cannot draw clear conclusions based on the results of this study. Nevertheless, we offer much needed insight and encourage more rigorously designed and implemented RCTs in the future to substantiate our conclusions.

Comparative effectiveness of nonsurgical interventions in the treatment of patients with knee osteoarthritis: A PRISMA-compliant systematic review and network meta-analysis

BACKGROUND

To find out, based on the available recent randomized controlled trials (RCTs), if the nonsurgical interventions commonly used for knee osteoarthritis patients are valid and quantify their efficiency.

METHODS

The database of MEDLINE and EMBASE were searched for RCTs evaluating nonsurgical treatment strategies on patients with mild to moderate knee osteoarthritis. A Bayesian random-effects network meta-analysis was performed. The primary outcome was the mean change from baseline in the Western Ontario and McMaster university (WOMAC) total score at 12 months. Raw mean differences with 95% credibility intervals were calculated. Treatments were ranked by probabilities of each treatment to be the best.

RESULTS

Thirteen trials assessed 7 strategies with WOMAC at 12 months: injection of platelet rich plasma (PRP), corticosteroids, mesenchymal stem cells (MSCs), hyaluronic acid, ozone, administration of nonsteroidal anti-inflammatory drugs with or without the association of physiotherapy. For treatment-specific effect size, a greater association with WOMAC decrease was found significantly for MSCs (mean difference, -28.0 [95% CrI, -32.9 to -22.4]) and PRP (mean difference, -19.9 [95% CrI, -24.1 to -15.8]). Rank probabilities among the treatments indicated that MSCs had a much higher probability (P = .91) of being the best treatment compared with other treatments, while PRP ranked as the second-best treatment (P = .89).

CONCLUSION

In this systematic review and network meta-analysis, the outcomes of treatments using MSCs and PRP for the management of knee osteoarthritis were associated with long-term improvements in pain and function. More high quality RCTs would be needed to confirm the efficiency of MSCs and PRP for the treatment of patients with knee osteoarthritis.

Iminosugar idoBR1 Isolated from Cucumber Cucumis sativus Reduces Inflammatory Activity

Cucumbers have been anecdotally claimed to have anti-inflammatory activity for a long time, but the active principle was not identified. idoBR1, (2R,3R,4R,5S)-3,4,5-trihydroxypiperidine-2-carboxylic acid, is an iminosugar amino acid isolated from fruits of certain cucumbers, Cucumis sativus (Cucurbitaceae). It has no chromophore and analytically behaves like an amino acid making detection and identification difficult. It has anti-inflammatory activity reducing lipopolysaccharide (LPS)-induced tumor necrosis factor alpha (TNF-α) in THP-1 cells and ex vivo human blood. It showed selective inhibition of human α-l-iduronidase and sialidases from both bacteria (Tannerella forsythia) and human THP-1 cells. idoBR1 and cucumber extract reduced the binding of hyaluronic acid (HA) to CD44 in LPS-stimulated THP-1 cells and may function as an anti-inflammatory agent by inhibiting induced sialidase involved in the production of functionally active HA adhesive CD44. Similar to the related iminosugars, idoBR1 is excreted unchanged in urine following consumption. Its importance in the diet should be further evaluated.

Effect of Self-Management Program on Pain and Disability Index in Elderly Men with Osteoarthritis

Background

Osteoarthritis (OA) is a progressive disease of the joints, leading to decreased function and disability.

Objectives

The study aimed to investigate the effect of self-management (SM) program on disability index and pain in aging men with knee OA.

Methods

The study included an SM group and a control group. Given the sample size of the previous studies, 83 patients were recruited. The study tools included a demographic profile questionnaire, visual analogue scale (VAS), and HAQ 8-item DI. The intervention included 10 SM sessions for patients in the SM group (8 sessions of in-person intervention and 2 sessions of telephone intervention). Patients were placed in groups of 7, and the sessions were held weekly each for a period of 45 to 60 minutes. Data were analyzed using descriptive and analytical tests by SPSS V. 16 software.

Results

The two groups(SM and control group) were homogeneous in terms of demographic characteristics (P > 0.05). The mean (SD) disability score was 19.12 (1.92) in the SM group before the intervention, which reduced to 14.70 (1.63) after the intervention (P = 0.000, T = 10.02). The mean (SD) pain score, was 9.19 (0.71) in the SM group before the intervention, which reduced to 6.48 (0.84) after the intervention (P = 0.000, T = 18.15).

Conclusions

Training can help patients perform SM measures and improve their health status by enhancing the information needed for the disease.