The role of glucosamine and chondroitin sulfate in treatment and prevention of osteoarthritis in animals
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... GlcN is a precursor and structural component of CS, and after oral administration it is rapidly absorbed by glucose transporters (GLUTs), demonstrating a wide tissue distribution and a tropism for articular cartilage (Trumble, 2005;Neil et al., 2005). In horses, the currently recommended doses for oral administration result in incipient plasma concentrations, requiring doses 5 to 10 times higher to increase their bioavailability (Neil et al., 2005). ...
... GlcN is a precursor and structural component of CS, and after oral administration it is rapidly absorbed by glucose transporters (GLUTs), demonstrating a wide tissue distribution and a tropism for articular cartilage (Trumble, 2005;Neil et al., 2005). In horses, the currently recommended doses for oral administration result in incipient plasma concentrations, requiring doses 5 to 10 times higher to increase their bioavailability (Neil et al., 2005). ...
... In turn, CS is the predominant GAG in connective tissues and the exogenous molecule can influence the metabolism of healthy and diseased cartilages. Its metabolic destination after oral administration is variable according to its size and molecular weight, as well as intestinal degradation and hepatic biotransformation (Neil et al., 2005;Trumble, 2005;Du et al., 2004). Although it demonstrates rapid absorption and tropism for cartilage and synovial fluid, when administered orally, it is unknown whether the therapeutic effect is due to the intact or fragmented molecule or to disaccharides. ...
... Glucosamine (2-amino-2-deoxy-D-glucose) is an amino monosaccharide with essential roles in the biochemical synthesis of glycosylated proteins and lipids [1]. Intensive studies have proved that the exogenous use of glucosamine can relieve osteoarthritis (OA) symptoms and restore articular functions [2][3][4][5]. It also has many antiinfammatory and antioxidative efects with minimal adverse impact on human health [6][7][8][9][10]. ...
The need for analytical methods that are fast, affordable, and ecologically friendly is expanding. Because of its low solvent consumption, minimal waste production, and speedy analysis, capillary electrophoresis is considered a “green” choice among analytical separation methods. With these “green” features, we have utilized the capillary electrophoresis method with capacitively coupled contactless conductivity detection (CE-C4D) to simultaneously determine glucosamine and Ca2+ in dietary supplements. The CE analysis was performed in fused silica capillaries (50 μm inner diameter, 40 cm total length, 30 cm effective length), and the analytical time was around 5 min. After optimization, the CE conditions for selective determination of glucosamine and Ca2+ were obtained, including a 10 mM tris (hydroxymethyl) aminomethane/acetic acid (Tris/Ace) buffer of p H 5.0 as the background electrolyte; separation voltage of 20 kV; and hydrodynamic injection (siphoning) at 25 cm height for 30 s. The method illustrated good linearity over the concentration range of 5.00 to 200 mg/L of for glucosamine (R2 = 0.9994) and 1.00 to 100 mg/L for Ca2+ (R2 = 0.9994). Under the optimum conditions, the detection limit of glucosamine was 1.00 mg/L, while that of Ca2+ was 0.05 mg/L. The validated method successfully analyzed glucosamine and Ca2+ in seven dietary supplement samples. The measured concentrations were generally in line with the values of label claims and with cross-checking data from reference methods (HPLC and ICP-OES).
... [62,72] On the other hand, GAS increases both serum and synovial fluid sulfate concentrations that increase GAG synthesis. [105] Therefore, the gene expression of PCM5G composite scaffold illustrated that this method study was a potential therapeutic target for cartilage tissue engineering. ...
... GS is the most abundant monosaccharide, mainly located in articular cartilage [51]. Glucosamine sulfate is the most known and used formula in OA patients [52,53]. It shows anti-inflammatory activity and helps to restore proteoglycan matrix of the cartilage. ...
The most prevalent form of arthritis is osteoarthritis (OA) of the knee, which is characterized by a degeneration of articular cartilage resulting in the development of osteophytes, or bone spurs. Main goals of OA treatment are to reduce pain, slow the disease progression, and improve joint function and the quality of life. The purpose of this study was to verify all the therapies recommended by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) from the biochemical point of view. Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit the synthesis of eicosanoids, whereas paracetamol prevents the production of prostaglandin (PG) by interacting with peroxidase (POX) site of the prostaglandin H2 synthase complex. Tramadol is an opioid that has a dual mechanism of action: it binds to the μ-opioid receptor and it inhibits serotonin and adrenaline. Corticosteroids, which are also prescribed for OA pain, inhibit the activity of phospholipase A2 and block the synthesis of arachidonate-derived eicosanoids. Symptomatic slow-acting drugs for osteoarthritis (SYSADOA) are drugs that are well tolerated by patients and help to restore proteoglycan matrix of the cartilage. These drugs include compounds that naturally build articular cartilage. The articular cartilage, as well as the bone located around the cartilage, are destroyed as osteoarthritis progresses. Thus, bisphosphonates, commonly used in the treatment of osteoporosis, were evaluated as potential therapy. However, there is no official recommendation for their use in therapy. The aim of the study was to analyze the biochemical mechanisms of principal drugs used for the treatment of knee OA. Therefore, a narrative review summarizing the current knowledge regarding the applied therapies was prepared.
... Glycosaminoglycans are special type of glycoprotein (Neil et al., 2005) that are prevalent in cartilages, vasculature, cell surfaces, intracellular granules, and plasma and other vertebrate's organs (Clarke, 2004;Im et al., 2013). All of these are by-products of the meat and animal industries (Volpi and Maccari, 2002) from guts and lung of cows and pigs (Linhardt and Claude, 2003). ...
Fishery wastes are one of natural resources to extract bioactive substances such as collagen and glycosaminoglycan (GAG). The anticoagulant activity of glycosaminoglycans extracted from Binni fish, Mesopotamichthys sharpeyi scales was the aim of this study. The cationic salt of cetyl pyridinium chloride was used to extract the glycosaminoglycan. The structure of the isolated glycosaminoglycan was identified by ELISE glycosaminoglycan kit and compared to that of heparin. Prothrombin time (PT), and thrombin time (TT) on plasma of male mice at three concentrations of 20, 40, and 100 g/ml were used to determine the coagulant property of the extracted substance. The extracted glycosaminoglycan was calculated to be around 27.7 mg/g of dry tissue. The presence of heparin-like molecules in the glycosaminoglycan isolated from fish scales was confirmed by ELISE GAG kit. When the concentration of isolated glycosaminoglycan was increased, the time to coagulate rose. The PT and TT coagulation times were 4:1 and 2:1. Times faster than the control at 100 g/ml. When compared to synthetic anticoagulant substances like heparin, the glycosaminoglycan isolated from fish scales displayed good anticoagulation qualities.
... Treatment of these pathological conditions often requires a long-term pharmacological therapy. Therefore, a prolonged treatment or maintenance period of months or even years can be obtained with the use of drugs with a high safety profile [5]. The fatty acid amide Palmitoylethanolamide (PEA), with the chemical structure (2-hydroxyethyl) esadecanamide, is naturally present in animals and plants and is a natural endogenous mediator with a "pro-homeostatic" role, produced and released in response to different stimuli, from different cell types and tissues. ...
Background: Four show jumping horses were evaluated for non-responsive lameness, which caused their withdrawal from show jumping competitions. The clinical evaluation was performed by radiographic examination, flexion tests, diagnostic anesthesia and lameness evaluation using the American Association of Equine Practitioners (AAEP) scale. The diagnoses were a case of navicular syndrome, a complicated case of chronic navicular syndrome and arthrosis of the distal interphalangeal joint of the right anterior limb and two cases of distal intertarsal joint arthritis. Nutraceuticals are often an important management strategy or coadjutant of pharmacological therapies in joint disease. Ultramicronized Palmitoylethanolamide (PEA-um) is an endogenous fatty acid amide that is well-known for its anti-inflammatory and analgesic proprieties widely used in human medicine and small animal veterinary medicine. Although it includes a small number of cases, our study describes for the first time the efficacy of the use of PEA-um in horses. The four horses with non-responsive lameness and significant impairment in athletic performance were daily treated with PEA-um into their normal diet. After four months of PEA-um supplementation, all horses showed remissions of lameness that led to their reintroduction into showjumping competitions without disease recurrence. Therefore, despite the small number of cases included in this study, these observations suggest a good prospective for developing a controlled experiment to test PEA in a larger cohort of horses.
Blend nanofibres composed of synthetic polymers with biological macromolecules, such as natural biopolymers, and 3D structures created via electrospinning technique, have a high potential for modification to promote cell growth and function. In this study, 5 and 7 wt% of glucosamine sulfate (GAS), as one of the key components in the extracellular matrix (ECM) of natural cartilage tissue, were added to poly (3-hydroxybutyrate)-chitosan (PHB-CS)/functionalized multiwalled carbon nanotubes (f-MWCNTs) solution (100:20:1) for production of electrospun scaffolds. Prepared fibrous scaffolds are characterized by SEM, FTIR, XRD, TGA, and DSC. Tensile tests are used to study their mechanical properties and their hydrophilicity is also assessed. subsequently, the drug release profile of the scaffolds, adipose stem cell proliferation, cell viability, and the differentiation of adipose stem cells to chondrocyte cells were evaluated for further cartilage tissue engineering application. Our results showed that the addition GAS has a positive effect on the hydrophilicity of the fibers and the initiation of chondrogenic differentiation. Without, effects on tensile strength of the scaffolds by adding 5%. So, that PHB-CS/f-MWCNTs scaffold containing GAS has more acceptable properties than the PHB or PHB-CS for cartilage tissue engineering.
Aim
The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) algorithm for the management of knee osteoarthritis (OA) is available worldwide from 2014, but in 2019 an update was published. Based on this algorithm, a Working Group (WG), including ESCEO members and Chinese experts, wished to see how the new ESCEO algorithm was perceived by Chinese experts in knee OA and how it was integrated into their clinical practice.
Methods
A WG was held between members of the international ESCEO task force and a group of Chinese experts.
Results
Non-pharmacological approach should be combined with pharmacological interventions. In step 1, symptomatic slow-acting drugs for osteoarthritis (SYSADOA) are the most important background drugs. Evidence, supported by high-quality research, is available only for crystalline glucosamine sulfate (pCGS) and chondroitin sulfate. Topical NSAIDs could be used as an additional option. In step 2, oral NSAIDs could be useful, but cardiovascular/renal/gastrointestinal profiles of the patients should be considered. Intra-articular hyaluronic acid and corticosteroids are alternative to oral NSAIDs, but the evidence is still limited. If steps 1 and 2 are not sufficient, weak opioids could be used. Overall, the conclusions of the ESCEO algorithm are accepted in China for products available in this country. The WG suggests the importance of economic studies, specifically made in China.
Conclusion
This work provides evidence-based advice to establish a treatment algorithm in knee OA, for practical implementation in clinical practice in China.
Background
Since 2014, the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) algorithm for the management of knee osteoarthritis (OA) is available worldwide.
Aim
Based on this document, a Southeast Asia Working Group (SEAWG) wished to see how the new ESCEO algorithm developed in 2019 was perceived by Southeast Asian experts and how it was integrated into their clinical practice.
Methods
A SEAWG was set up between members of the international ESCEO task force and a group of Southeast Asian experts.
Results
Non-pharmacological management should always be combined with pharmacological management. In step 1, symptomatic slow-acting drugs for osteoarthritis are the main background therapy, for which high-quality evidence is available only for the formulations of patented crystalline glucosamine sulfate and chondroitin sulfate. In step 2, oral NSAIDs are a useful option, considering the cardiovascular/renal/gastrointestinal profiles of the individual patient. Intra-articular hyaluronic acid and corticosteroids are a possible alternative to oral NSAIDs, but limited evidence is available. If steps 1 and 2 do not give adequate relief of symptoms, tramadol can be used, but its safety is debated. In general, the indications of the ESCEO algorithm are important in Southeast Asian countries, but the reimbursement criteria of local health systems are an important aspect for adherence to the ESCEO algorithm.
Conclusion
This guidance provides evidence-based and easy-to-follow advice on how to establish a treatment algorithm in knee OA, for practical implementation in clinical practice in Southeast Asian countries.
This chapter deals with the various of forms of therapies given for treating equine lameness. The treatment types include systemic and parenteral therapies, topical and local therapies, intrasynovial therapies, intralesional therapies, oral and nutritional therapies, corrective shoeing and therapeutic shoeing, acupuncture treatments, manual therapies, and rehabilitation and physical therapy. Systemic administration of medications to treat musculoskeletal diseases in the horse mainly encompasses intravenous nonsteroidal anti‐inflammatory drugs (NSAIDS), intramuscular polysulfated glycosaminoglycans, and intravenous hyaluronan. The most commonly used IV NSAIDs are phenylbutazone and flunixin meglumine. The need for systemic NSAID therapy can be reduced and associated edema and tissue damage minimized with effective use of topical therapy. Equine practitioners currently have several options available to treat intrasynovial inflammation. Intrasynovial therapies, specifically corticosteroids, are used frequently in horses to minimize or control pain associated with synovitis and osteoarthritis.
The main goal of the medical therapy of DJD is to restore and maintain normal joint function by alleviating joint pain, decreasing joint inflammation, and protecting the cartilage from further injury. The role of substances termed "chondroprotective agents" that counter the destructive inflammatory process and encourage normalization of the synovial fluid and cartilage matrix is explored in this paper.
Twenty-five horses with degenerative joint disease that fit the conditions of the study were treated with a glucosamine-chrondroitin sulfate compound (CosequinR:Nutramax Laboratories Inc., Baltimore, MD) to evaluate its effectives in decreasing lameness. All horses were confirmed to have degenerative joint disease (DJD) by physical examination, diagnostic intra-articular anesthesia, and radiographs or fluoroscopy of the distal interphalangeal, metacarpophalangeal, tarsometatarsal or carpal joints. All horses weighing less than 545 kg were given 9 g of the glucosamine-chondroitin sulfate compound orally twice daily for 6 weeks. Horses weighing more than 545 kg were given 12 g twice daily for 6 weeks. Each 3 g measure included 1,800 mg of glucosamine hydrochloride, 600 mg of purified chondroitin sulfate, 16 mg of manganese, and 104 mg of ascorbate. Lameness grade, flexion test grade and stride length (cm) were measured at an initial examination and re-evaluated at 2, 4, and 6 week follow-up examinations. Repeated measurement analysis was implemented to assess the lameness using SAS computer package (Statistical Analysis System, Cary, NC). Within 2 weeks of the start of administration of the glucosamine-chondroitin sulfate compound, the lameness grade, flexion test, and stride length were significantly (P < 0.0001) improved. A further significant improvement in lameness was evident at 4 weeks (p = 0.04), while flexion score (p = 0.2) and stride length (P = 1.0) did not show further improvement. The age of horses was not a significant factor in the improvement of the lameness grade, flexion test, or stride length (p = 0.2, p = 0.07 and p = 0.2, respectively), implying that the achieved results were true irrespective of horse age.
Context Glucosamine and chondroitin preparations are widely touted in the lay
press as remedies for osteoarthritis (OA), but uncertainty about their efficacy
exists among the medical community.Objective To evaluate benefit of glucosamine and chondroitin preparations for
OA symptoms using meta-analysis combined with systematic quality assessment
of clinical trials of these preparations in knee and/or hip OA.Data Sources We searched for human clinical trials in MEDLINE (1966 to June 1999)
and the Cochrane Controlled Trials Register using the terms osteoarthritis, osteoarthrosis, degenerative arthritis, glucosamine, chondroitin, and glycosaminoglycans.
We also manually searched review articles, manuscripts, and supplements from
rheumatology and OA journals and sought unpublished data by contacting content
experts, study authors, and manufacturers of glucosamine or chondroitin.Study Selection Studies were included if they were published or unpublished double-blind,
randomized, placebo-controlled trials of 4 or more weeks' duration that tested
glucosamine or chondroitin for knee or hip OA and reported extractable data
on the effect of treatment on symptoms. Fifteen of 37 studies were included
in the analysis.Data Extraction Reviewers performed data extraction and scored each trial using a quality
assessment instrument. We computed an effect size from the intergroup difference
in mean outcome values at trial end, divided by the SD of the outcome value
in the placebo group (0.2, small effect; 0.5, moderate; 0.8, large), and applied
a correction factor to reduce bias. We tested for trial heterogeneity and
publication bias and stratified for trial quality and size. We pooled effect
sizes using a random effects model.Data Synthesis Quality scores ranged from 12.3% to 55.4% of the maximum, with a mean
(SD) of 35.5% (12%). Only 1 study described adequate allocation concealment
and 2 reported an intent-to-treat analysis. Most were supported or performed
by a manufacturer. Funnel plots showed significant asymmetry (P≤.01) compatible with publication bias. Tests for heterogeneity
were nonsignificant after removing 1 outlier trial. The aggregated effect
sizes were 0.44 (95% confidence interval [CI], 0.24-0.64) for glucosamine
and 0.78 (95% CI, 0.60-0.95) for chondroitin, but they were diminished when
only high-quality or large trials were considered. The effect sizes were relatively
consistent for pain and functional outcomes.Conclusions Trials of glucosamine and chondroitin preparations for OA symptoms demonstrate
moderate to large effects, but quality issues and likely publication bias
suggest that these effects are exaggerated. Nevertheless, some degree of efficacy
appears probable for these preparations.