Nutraceuticals for Osteoarthritis (OA)

Diagnosis of OA is based on clinical and radiological findings. The first manifestations are pain, stiffness, swelling, crepitus, and restriction of joint movement. Pharmacologic treatment begins with acetaminophen, adding a low-dose NSAIDs (Nonsteriodal anti-inflammatory drug), salicylate, selective COX-2 inhibitor, or topical capsaicin cream if needed.

Drawbacks to the patient of long term use of NSAIDs have inspired researchers to investigate agents that have minimal or no side effect. Studies have been conducted on the nutraceuticals such as chondroitin sulfate and glucosamine to demonstrate their efficacy in the symptomatic treatment of OA.

Glucosamine
The amino-monosaccharide glucosamine is precursor of the disaccharide unit of glucosamineglycan (GAG) and is reported to stimulate the production of proteoglycans, the ground substance of articular cartilage. Glucosamine also stimulates synovial production of hyaluronic acid (HA), which is responsible for the lubricating and shock-absorbing properties of synovial fluid.Improvement in the symptoms of OA associated (including knee OA) with the use of glucosamine has been observed in several clinical trials.

Chondroitin Sulfate
Chondroitin sulfate is an important component of cartilage. Two types, chondroitin-4-sulfate and chondroitin-6-sulfate, vary in molecular weight and thus differ in their bioavailability and purity. Studies suggested that a reduction of the proteoglycan content of cartilage, the same process associated with OA, can be inhibited by chondroitin sulfate. and also inhibitory effects of chondroitin sulfate on many degradative enzymes.

Radiolabelled chondroitin sulfate given orally to humans was 70% absorbed. Its affinity for synovial fluid and articular cartilage has also been demonstrated.

COMBINED THERAPY
Over the years the combined use of these nutraceuticals has become extremely popular. It is important to note that experimental studies have documented a synergistics effect when glucosamine and chondroitin sulfate are administered together.Studies reported that the body responds best when glucosamine and chondroitin sulfate are consumed simultaneously.