​​​​​​​​​​December 2018, Vol. 3, No. 12, pp. 241-252. 

​​​Chondroprotective effect of Glucosamine sulfate and Chondroitin sulfate in Osteoarthritis: A Review

O. Anusha, T. Baral, K. Raj Kiran, M. Vinod Kumar
Department of Pharmacy Practice, Vignan Institute of Pharmaceutical Technology,Visakhapatnam, Andhra Pradesh, India- 530049.

​​​*Corresponding author’s e-mail: anushaommi@gmail.com

​Abstract

​Aim of the study is to review the chondroprotective effect of glucosamine sulfate (GS) and chondroitin sulfate (CS) in osteoarthritis (OA). The search terms included in this review are glucosamine, chondroitin, and osteoarthritis. We performed a literature review using electronic databases PubMed, Biomed Central, Science Direct and JAMA. The inclusion criteria are studies of OA of knee and hip, research articles, human studies and Quality of life of OA patient. The exclusion criteria are editorials, letters to editor, review articles, commentaries, conference presentations, comorbid conditions (e.g. cancer, rheumatoid disease), other nutraceuticals and animal studies. A three-phase process was performed in screening the articles. Two in-vitro studies stated that the combination of glucosamine and chondroitin had a positive effect in treating osteoarthritis and one in-vitro study provided novel evidence of anti-angiogenic, anti-inflammatory and anti-catabolic properties of CS and chondrocyte changes by chondroitin. Three studies showed the benefit of using GS in treating osteoarthritis and among three, one study showed that GS reduced the use of NSAIDs. Four studies stated that a combination of GS and CS showed improvement in treating osteoarthritis and among them one study showed that usage of CS results in significant improvement in knee joint swelling. There are studies showing benefits of glucosamine and chondroitin supplementation for people suffering from osteoarthritis. Based on in vitro and human studies discussed in this review, it has been suggested that glucosamine and chondroitin sulfate may be effective in preserving cartilage and might slow down disease progression.

Keywords: Glucosamine, Chondroitin; Osteoarthritis; Chondroprotective.

​References

  1. ​​Koopman W, Moreland L. Arthritis and allied conditions. Philadelphia: Lippincott Williams & Wilkins; 2005.
  2. Bijlsma J, Berenbaum F, Lafeber F. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011;377(9783):2115-26.
  3. Black C, Clar C, Henderson R, MacEachern C, McNamee P, Quayyum Z, Royle P, Thomas S. The clinical effectiveness of glucosamine and chondroitin supplements in slowing or arresting the progression of osteoarthritis of the knee: a systematic review and economic evaluation. Health Technol Assess. 2009;13(52)1-148.
  4. Arden N, Nevitt M. Osteoarthritis: Epidemiology. Best Pract Res Clin Rheumatol. 2006;20(1):3-25.
  5. Fautrel B, Hilliquin P, Rozenberg S, Allaert F, Coste P, Leclerc A, Rossignol M. Impact of osteoarthritis: results of a nationwide survey of 10,000 patients consulting for OA. Joint Bone Spine. 2005;72(3):235-40.
  6. Corti M, Rigon C. Epidemiology of osteoarthritis: Prevalence, risk factors, and functional impact. Aging Clin Exp Res. 2003;15(5):359-63.
  7. White A. Osteoarthritis of the knee - an introduction. Acupuncture in Medicine. 2006;24(Suppl):1-6.
  8. Bookwala J, Harralson T, Parmelee P. Effects of Pain on Functioning and Well-Being in Older Adults with Osteoarthritis of the Knee. Psychol Aging. 2003;18(4):844-50.
  9. Scotto d'Abusco A, Calamia V, Cicione C, Grigolo B, Politi L, Scandurra R. Glucosamine affects intracellular signalling through inhibition of mitogen-activated protein kinase phosphorylation in human chondrocytes. Arthritis Res Ther. 2007;9(5):R104.
  10. Goldring M, Berenbaum F. The Regulation of Chondrocyte Function by Proinflammatory Mediators. Clin Orthop Relat Res. 2004;427:S37-46.
  11. Burrage P. Matrix Metalloproteinases: Role In Arthritis. Front Biosci. 2006;11(1):529.
  12. Kusano K. Regulation of Matrix Metalloproteinases (MMP-2, -3, -9, and -13) by Interleukin-1 and Interleukin-6 in Mouse Calvaria: Association of MMP Induction with Bone Resorption. Endocrinology. 1998;139(3):1338-45.
  13. Inada M, Wang Y, Byrne M, Rahman M, Miyaura C, Lopez-Otin C, Krane SM. Critical roles for collagenase-3 (Mmp13) in development of growth plate cartilage and in endochondral ossification. Proc Natl Acad Sci U S A. 2004;101(49):17192-7.
  14. Ng N, Heesch K, Brown W. Efficacy of a progressive walking program and glucosamine sulphate supplementation on osteoarthritic symptoms of the hip and knee: a feasibility trial. Arthritis Res Ther. 2010;12(1):R25.
  15. Alcaraz M, Megías J, García-Arnandis I, Clérigues V, Guillén M. New molecular targets for the treatment of osteoarthritis. Biochem Pharmacol. 2010;80(1):13-21.
  16. Roberts E, Delgado Nunes V, Buckner S, Latchem S, Constanti M, Miller P  Doherty M, Zhang W, Birrell F, Porcheret M, Dziedzic K, Bernstein I, Wise E, Conaghan PG. Paracetamol: not as safe as we thought? A systematic literature review of observational studies. Ann Rheum Dis 2015;75(3):552-59.
  17. Sawitzke A, Shi H, Finco M, Dunlop D, Harris C, Singer N, Bradley J, Silver D, Jackson C, Lane N, Oddis C, Wolfe F, Lisse J, Furst D, Bingham C, Reda D, Moskowitz R, Williams H, Clegg D. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis. 2010;69(8):1459-1464.
  18. Bruyère O, Cooper C, Pelletier J, Branco J, Luisa Brandi M, Guillemin F,  Hochberg M, Kanis J, Kvien TK, Martel-Pelletier J, Rizzoli R, Silverman S, Reginster J. An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: A report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Semin Arthritis Rheum. 2014;44(3):253-63.
  19. Clegg D, Reda D, Harris C, Klein M, O'Dell J, Hooper M, Bradley J, Bingham C, Weisman M, Jackson C, Lane N, Cush J, Moreland L, Schumacher H, Oddis C, Wolfe F, Molitor J, Yocum D, Schnitzer T, Furst D, Sawitzke A, Shi H, Brandt K, Moskowitz R, Williams H. Glucosamine, Chondroitin Sulfate, and the Two in Combination for Painful Knee Osteoarthritis. N Engl J Med. 2006;354(8):795-808.
  20. McCarty M. The neglect of glucosamine as a treatment for osteoarthritis - A personal perspective. Med Hypotheses. 1994;42(5):323-27.
  21. Sherman A, Ojeda-Correal G, Mena J. Use of Glucosamine and Chondroitin in Persons with Osteoarthritis. PM R. 2012;4(5):S110-6.
  22. Huskisson E. Glucosamine and Chondroitin for Osteoarthritis. J Int Med Res.  2008;36(6):1161-79.
  23. Wandel S, Juni P, Tendal B, Nuesch E, Villiger P, Welton N, Reichenbach S, Trelle S. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ. 2010;341:c4675.
  24. Tat S, Pelletier J, Vergés J, Lajeunesse D, Montell E, Fahmi H, Lavigne M, Martel-Pelletier J. Chondroitin and glucosamine sulfate in combination decrease the pro-resorptive properties of human osteoarthritis subchondral bone osteoblasts: a basic science study. Arthritis Res Ther. 2007;9(6):R117.
  25. Calamia V, Ruiz-Romero C, Rocha B, Fernández-Puente P, Mateos J, Montell E, Vergés J, Blanco F. Pharmacoproteomic study of the effects of chondroitin and glucosamine sulfate on human articular chondrocytes. Arthritis Res Ther. 2010;12(4):R138.
  26. Calamia V, Lourido L, Fernández-Puente P, Mateos J, Rocha B, Montell E,  Vergés J, Ruiz-Romero C, Blanco F. Secretome analysis of chondroitin sulfate-treated chondrocytes reveals anti-angiogenic, anti-inflammatory and anti-catabolic properties. Arthritis Res Ther. 2012;14(5):R202.
  27. Hochberg M, Clegg D. Potential effects of chondroitin sulfate on joint swelling: a GAIT report. Osteoarthritis Cartilage. 2008;16:S22-4.
  28. Bruyere O, Pavelka K, Rovati L, Gatterová J, Giacovelli G, Olejarová M,  Deroisy R, Reginster J. Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomized, placebo-controlled trials. Osteoarthritis Cartilage. 2008;16(2):254-60.
  29. Provenza J, Shinjo S, Silva J, Peron C, Rocha F. Combined glucosamine and chondroitin sulfate, once or three times daily, provides clinically relevant analgesia in knee osteoarthritis. Clin Rheumatol. 2014;34(8):1455-62.
  30. Fransen M, Agaliotis M, Nairn L, Votrubec M, Bridgett L, Su S, S. Jan, L. March, J. Edmonds, R. Norton, M. Woodward, R.O. Day. Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomized controlled clinical trial evaluating single and combination regimens. Osteoarthritis Cartilage. 2014;22:S457.
  31. Rovati L, Girolami F, D’Amato M, Giacovelli G. Effects of glucosamine sulfate on the use of rescue non-steroidal anti-inflammatory drugs in knee osteoarthritis: Results from the Pharmaco-Epidemiology of GonArthroSis (PEGASus) study. Semin Arthritis Rheum. 2016;45(4):S34-41.
  32. Raynauld J, Pelletier J, Abram F, Dodin P, Delorme P, Martel-Pelletier J. Long-Term Effects of Glucosamine and Chondroitin Sulfate on the Progression of Structural Changes in Knee Osteoarthritis: Six-Year Follow-up Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken). 2016;68(10):1560-66.
  33. Sowers M, Zobel D, Hawthorne V, Carman W, Weissfeld L. Progression of osteoarthritis of the hand and metacarpal bone loss. A twenty-year follow up of incident cases. Arthritis Rheum. 1991;34(1):36-42.
  34. Li B, Marshall D, Roe M, Aspden R. The electron microscope appearance of the subchondral bone plate in the human femoral head in osteoarthritis and osteoporosis. J Anat. 1999;195(1):101-10.
  35. Lories R, Luyten F. The bone–cartilage unit in osteoarthritis. Nat Rev Rheumatol. 2010;7(1):43-9.
  36. Kwan Tat S, Pelletier J. The differential expression of osteoprotegerin (OPG) and receptor activator of nuclear factor kappaB ligand (RANKL) in human osteoarthritic subchondral bone osteoblasts is an indicator of the metabolic state of these disease cells. Clin Exp Rheumatol 2008;26(2):295-304.
  37. Pecchi E, Priam S, Mladenovic Z, Gosset M, Saurel A, Aguilar L,  Berenbaum F, Jacques C. A potential role of chondroitin sulfate on bone in osteoarthritis: inhibition of prostaglandin E2 and matrix metalloproteinases synthesis in interleukin-1β- stimulated osteoblasts. Osteoarthritis Cartilage. 2012;20(2):127-35.
  38. McAlindon T, LaValley M, Gulin J, Felson D. Glucosamine and Chondroitin for Treatment of Osteoarthritis. JAMA. 2000;283(11):1469.
  39. Trelle S, Reichenbach S, Jüni P. Chondroitin for Osteoarthritis of the Knee or Hip. Ann Intern Med. 2007;147(12):884.
  40. Clegg D, Reda D, Harris C, Klein M, O'Dell J, Hooper M, Bradley J, Bingham C, Weisman M, Jackson C, Lane N, Cush J, Moreland L, Schumacher H, Oddis C, Wolfe F, Molitor J, Yocum D, Schnitzer T, Furst D, Sawitzke A, Shi H, Brandt K, Moskowitz R, Williams H. Glucosamine, Chondroitin Sulfate, and the Two in Combination for Painful Knee Osteoarthritis. N Engl J Med. 2006;354(8):795-808.
  41. Fernandes J, Martel-Pelletier J, Pelletier J. The role of cytokines in osteoarthritis pathophysiology. Biorheology 2002;39(1-2):237-46.
  42. Ivanovska N, Dimitrova P. Bone resorption and remodeling in murine collagenase-induced osteoarthritis after administration of glucosamine. Arthritis Res Ther. 2011;13(2):R44.
  43. Reginster J, Deroisy R, Rovati L, Lee R, Lejeune E, Bruyere O, Giacovelli G, Henrotin Y, Dacre J, Gossett C. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomized, placebo-controlled clinical trial. Lancet. 2001; 357(9252):251-6.
  44. Altman R, Abadie E, Avouac B, Bouvenot G, Branco J, Bruyere O,  Calvo G, Devogelaer J, Dreiser R, Herrero-Beaumont G, Kahan A, Kreutz G, Laslop A, Lemmel E, Menkes C, Pavelka K, Van De Putte L, Vanhaelst L, Reginster J. Total joint replacement of hip or knee as an outcome measure for structure modifying trials in osteoarthritis. Osteoarthritis Cartilage. 2005;13(1):13-19.
  45. Van Baar M, Assendelft W, Dekker J, Oostendorp R, Bijlsma J. Effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: A systematic review of randomized clinical trials. Arthritis Rheum. 1999;42(7):1361-9.
  46. Minor M, Webel R, Kay D, Hewett J, Anderson S. Efficacy of physical conditioning exercise in patients with rheumatoid arthritis and osteoarthritis. Arthritis Rheum. 1989;32(11):1396-405.
  47. Kovar P. Supervised Fitness Walking in Patients with Osteoarthritis of the Knee. Ann Intern Med. 1992;116(7):529.
  48. Ettinger W. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA: The Journal of the American Medical Association. 1997;277(1):25-31.
  49. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. Arthritis Rheum. 2000;43(9):1905-15.
  50. Jordan K. EULAR Recommendations 2003: an evidence-based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis. 2003;62(12):1145-55.
  51. Thomas J. Over-the-counter nonsteroidal anti-inflammatory drugs and risk of gastrointestinal symptoms. Am J Gastroenterol. 2002;97(9):2215-19.
  52. Roddy E. Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review. Ann Rheum Dis. 2005;64(4):544-8.
  53. Bjordal J, Ljunggren A, Klovning A, Slørdal L. Non-steroidal anti-inflammatory drugs, including cyclooxygenase-2 inhibitors, in osteoarthritic knee pain: a meta-analysis of randomized placebo-controlled trials. BMJ. 2004; 329(7478):1317.
  54. Deanna Westby M. A health professional's guide to exercise prescription for people with arthritis: A review of aerobic fitness activities. Arthritis Rheum. 2001; 45(6):501-11.

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International Journal of Modern Science and Technology

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