Sodium Chondroitin Sulfate Research Articles

UP-01.074 Recurrent Bacterial Cystitis, Bladder Instillation with a Combined Solution of Sodium Halurate and Chondroitin Sulfate (IALURIL): One Year of Follow-Up

Chronic cystitis in women is a big problem. The pathogenesis is not very clear, but the bladder epithelium defect has a fundamental role. In the genesis of bladder flogosis the defect of glycosaminoglycans (GAGs) plays, probably, a role of the “primo movens”. In this study we evaluated the role of bladder instillation with a combined solution of sodium halurate and chondroitin sulphate (IALURIL) in patients with recurrent bacterial cystitis.

Comparison of Synovial Fluid in Middle Carpal Joints Undergoing Needle Aspiration, Infusion with Saline, and Infusion with a Combination of N-Acetyl-d-Glucosamine, Hyaluronic Acid, and Sodium Chondroitin Sulfate

Synovial fluid white blood cell (WBC) count and total protein (TP) concentration were evaluated in the midcarpal joints of horses to not only determine the effects of needle aspiration, infusion with saline, and infusion with a combination of N-acetyl-d-glucosamine, hyaluronan, and sodium chondroitin sulfate (GHCS) at two different doses to evaluate the latter for safety, but to also provide information on saline injection as a control in joints. The midcarpal joints from 24 horses were used for this study. One midcarpal joint served as an untreated control, in which only synovial fluid was aspirated, whereas the opposite joint received either 2.5 mL isotonic saline (n = 8 horses), 2.5 mL of GHCS (n = 8 horses), or 7.5 mL of GHCS (n = 8 horses). Synovial fluid WBC and TP concentration were measured on days 1, 3, 5, 7, 14, and 21. Needle aspiration caused a transient increase in synovial fluid WBC and TP levels after 1 day. Instillation of fluid (2.5 mL), whether saline or GHCS, caused significantly higher WBC and TP concentrations. GHCS at a dose of 7.5 mL created an elevation in TP level for an additional 48 hours; however, after 48 hours, WBC and TP were at concentrations that were not statistically different from controls. Even though an increase in WBC and TP concentrations occurred because of intra-articular saline and GHCS administration, these results were transient demonstrating that GHCS is no different than saline on synovial fluid, WBC, and TP parameters and that as previously described short-term elevation in synovial fluid inflammatory parameters should be expected when saline is used as a control.

Effects of diet type and supplementation of glucosamine, chondroitin, and MSM on body composition, functional status, and markers of health in women with knee osteoarthritis initiating a resistance-based exercise and weight loss program

BackgroundThe purpose of this study was to determine whether sedentary obese women with knee OA initiating an exercise and weight loss program may experience more beneficial changes in body composition, functional capacity, and/or markers of health following a higher protein diet compared to a higher carbohydrate diet with or without GCM supplementation.MethodsThirty sedentary women (54 ± 9 yrs, 163 ± 6 cm, 88.6 ± 13 kg, 46.1 ± 3% fat, 33.3 ± 5 kg/m2) with clinically diagnosed knee OA participated in a 14-week exercise and weight loss program. Participants followed an isoenergenic low fat higher carbohydrate (HC) or higher protein (HP) diet while participating in a supervised 30-minute circuit resistance-training program three times per week for 14-weeks. In a randomized and double blind manner, participants ingested supplements containing 1,500 mg/d of glucosamine (as d-glucosamine HCL), 1,200 mg/d of chondroitin sulfate (from chondroitin sulfate sodium), and 900 mg/d of methylsulfonylmethane or a placebo. At 0, 10, and 14-weeks, participants completed a battery of assessments. Data were analyzed by MANOVA with repeated measures.ResultsParticipants in both groups experienced significant reductions in body mass (-2.4 ± 3%), fat mass (-6.0 ± 6%), and body fat (-3.5 ± 4%) with no significant changes in fat free mass or resting energy expenditure. Perception of knee pain (-49 ± 39%) and knee stiffness (-42 ± 37%) was decreased while maximal strength (12%), muscular endurance (20%), balance indices (7% to 20%), lipid levels (-8% to -12%), homeostasis model assessment for estimating insulin resistance (-17%), leptin (-30%), and measures of physical functioning (59%), vitality (120%), and social function (66%) were improved in both groups with no differences among groups. Functional aerobic capacity was increased to a greater degree for those in the HP and GCM groups while there were some trends suggesting that supplementation affected perceptions of knee pain (p < 0.08).ConclusionsCircuit style resistance-training and weight loss improved functional capacity in women with knee OA. The type of diet and dietary supplementation of GCM provided marginal additive benefits.Trial RegistrationClinicalTrials.gov: NCT01271218

Incidence of low bioavailability of leuprolide acetate after percutaneous administration to rats by dissolving microneedles

Two-layered dissolving microneedles of which acral portion contained leuprolide acetate (LA) as solid dispersion were prepared with sodium chondroitin sulfate as the base and the systemic absorption efficiency of LA was studied in rats after administration to their abdominal skin. A patch contained 100 dissolving microneedles of which length and basement diameter were 469.8 ± 4.7 μm and 284.5 ± 9.8 μm, where LA content was 14.3 ± 1.6 μg. In vitro dissolution experiment showed that LA was released from dissolving microneedle patch within 3 min. LA was stable in the patch, % recoveries for 3 months were 102.2 ± 1.9–95.3 ± 1.9%. One and half-patch of LA dissolving microneedles were administered to the rat skin and plasma LA concentrations were measured by LC–MS/MS. Plasma LA concentrations increased immediately after administration, and reached to the maximum level at 15 min, where C max were 6.0 ± 0.7 and 16.4 ± 0.9 μg/ml, respectively. The AUC were 5.8 ± 0.8 and 14.5 ± 0.4 μg h/ml and BA were 33.8 ± 4.3% and 31.7 ± 0.8%. When LA solution was subcutaneously (s.c.) injected to rats, 50 μg/kg, the BA was 32.0 ± 2.1%. Relative BA of LA from dissolving microneedles against s.c. solution was 105.6 ± 13.5%. The degradation rate of LA in the rat skin tissue homogenate was very fast where the half-life was 16.3 ± 5.7 min. The degradation of LA in the skin tissue was the cause of the low BA of LA after percutaneous administration to rats.

Protective effect of different ophthalmic viscosurgical devices on corneal endothelial cells during phacoemulsification: Rabbit model

To evaluate the protective effect of different ophthalmic viscosurgical devices on corneal endothelial cells during phacoemulsification in a rabbit model. Harlan Biotech Israel and Ophthalmology Department, Kaplan Medical Center, Rehovot, Israel. Experimental study. Rabbit eyes were randomly assigned to 3 equally sized groups. Endothelial cell counts were performed in all eyes before initiation of the study. The aqueous humor was completely replaced by Biolon (sodium hyaluronate 1.0%) in Group A, by a combination of Viscoat (sodium chondroitin sulfate 4.0%-sodium hyaluronate 3.0%) and Provisc (sodium chondroitin sulfate 1.0%) using the soft-shell technique in Group B, and by a combination of Visiol (sodium hyaluronate 2.0%-mannitol 0.5%) and Biolon using the soft-shell technique in Group C. The eyes were exposed to alternating 10 seconds of phacoemulsification and a 10-second pause until a total exposure time of 2.5 minutes elapsed. Endothelial cell counts were repeated 3 days after surgery. The study used 18 rabbit eyes, 6 in each group. Group A had the highest endothelial cell loss (13%) followed by Group B (7%), and Group C (4%). The difference in cell loss between Group C and Group A was statistically significant (P = .037). The study showed the efficiency and advantages of the soft-shell technique using the combination of Visiol and Biolon over Biolon alone.

A Multicenter, Randomized, Double-blind, Parallel Group Pilot Evaluation of the Efficacy and Safety of Intravesical Sodium Chondroitin Sulfate Versus Vehicle Control in Patients With Interstitial Cystitis/Painful Bladder Syndrome

The goal of this pilot study was to gather information on differences between intravesical chondroitin sulfate and inactive vehicle control for treatment of interstitial cystitis/painful bladder syndrome (IC/PBS). This was a prospective, randomized, double-blind, inactive vehicle-controlled, 12-week study (6-week treatment period, followed by a 6-week follow-up period) in patients with IC/PBS. Patients were randomized to weekly intravesical treatment with 2.0% sodium chondroitin sulfate in phosphate-buffered saline or intravesical vehicle control. Primary efficacy analysis compared responders (moderately or markedly improved) according to the 7-point Global Response Assessment. Secondary endpoints include questionnaires focused on symptoms and quality of life. Sixty-five evaluable patients were randomized. At the primary endpoint analysis (week 7), 22.6% of the vehicle control group were responders compared with 39.4% of the active therapy group (P = .15). There was no statistically significant difference for any of the secondary endpoints. Overall, 76.9% of the patients in the study reported at least 1 adverse event; most were mild or moderate, the majority associated with the vehicle control treatment. Nine nonserious intervention-related adverse events were reported in 3 patients in the vehicle control group compared with 2 in 1 patient in the active treatment group. The difference in treatment effect in this small underpowered study was not statistically significant, although twice as many patients reported a clinically significant benefit with intravesical chondroitin sulfate treatment compared with vehicle control treatment. This trial provides data required to design a well-powered randomized vehicle-controlled trial to determine the true efficacy of this potentially promising therapy.

Zwei-Jahres-Follow-up nach Einsatz von 0,2 % Natrium-Chondroitinsulfat bei der Behandlung der „Überaktiven Blase“

A retrospective study was performed to investigate whether the improvement of symptoms achieved with 0.2 % sodium chondroitin sulfate in treating overactive bladder (OAB) persists after 24 months. Two years ago, a total of 82 patients with chronic OAB were randomly assigned to receive either anticholinergic treatment (Tolterodin; group A, n = 41) or 0.2 % sodium chondroitin sulfate (Gepan instill; group B, n = 41). Diagnostic assessment included a gynecological examination and history, urodynamic test-ing, introital ultrasound, and cystoscopy. Duration of treatment was 12 months. The patients underwent repeat follow-up after 24 months and the findings were compared with the results at 12 months. In group A, 15 / 35 (43 %) women reported an improvement of symptoms after 12 months as opposed to only 5 / 35 (14 %) after 24 months. In group B, there was an improvement in 23 / 32 (72 %) at 12 months and in 18 / 32 (56 %) after 24 months (p = 0.001). The subjective results were corroborated by means of urodynamic test-ing, pad counts, voiding frequency and nycturia (voiding diary). Our findings suggest that instillation treatment with 0.2 % sodium chondroitin sulfate results in a more sustained improvement or cure of the symptoms of overactive bladder due to development of a glycosaminoglycan layer. Long-term results are needed for confirmation.

Simultaneous determination of chondroitin sulfate sodium, allantoin and pyridoxine hydrochloride in pharmaceutical eye drops by an ion-pair high-performance liquid chromatography

An ion-pair high-performance liquid chromatography (HPLC) method has been developed for the simultaneous determination of chondroitin sulfate sodium (CSS), allantoin and pyridoxine hydrochloride (VB 6) in a commercial eye drops dosage form. An Alltima C 18 column (250 mm × 4.6 mm i.d., 5 μm) was used for the separation at room temperature, with 25 mM ammonium dihydrogen phosphate (containing 0.01% heptanesulfonic acid sodium salt) and acetonitrile (95:5, v/v) as the mobile phase at the flow rate of 0.5 mL min −1. The detection wavelength for CSS, allantoin and VB 6 was 195 nm, 215 nm and 291 nm, respectively. The method showed good linearity for CSS, allantoin and VB 6, with correlation coefficients greater than 0.9996, in the range of 203.96–815.84 mg L −1, 371.16–1488.64 mg L −1, and 23.32–93.28 mg L −1, respectively. The instrumental and method precisions were adequate with all relative standard deviations lower than 2.0%. The accuracy of this method, measured by the recovery of three compounds from spiked placebo solutions, was from 99.01% to 101.92%. The three components, CSS, allantoin and VB 6 were well separated from other ingredients and degradation products. This method is fast, simple, and can be used for direct and simultaneous determination of CSS, allantoin and VB 6 in the pharmaceutical preparation.

Posterior Juxtascleral Infusion of Modified Triamcinolone Acetonide Formulation for Refractory Diabetic Macular Edema: One-Year Follow-Up

To evaluate prospectively the efficacy and safety of posterior juxtascleral infusion of a new formulation of triamcinolone acetonide for refractory diffuse diabetic macular edema. This was an interventional case series. Twenty-two consecutive eyes of 18 patients with refractory diffuse diabetic macular edema were included in the study. Each patient underwent a complete ophthalmic examination, including optical coherence tomography (OCT) and digital fluorescein angiography (FA). All patients received a suspension of 40 mg triamcinolone acetonide, 20 mg sodium chondroitin sulfate, and 15 mg sodium hyaluronate (1.5 mL), delivered posteriorly through a conjunctival and Tenon's incision. All patients completed the 1-year follow-up. On average, studied eyes received 1.5 treatments. Mean preoperative foveal thickness (+/-SD) and visual acuity (+/-SD) were 474.2 +/- 136.6 microm and 0.6 +/- 0.37 logarithm of the minimum angle of resolution (logMAR), respectively. The central foveal thickness was significantly reduced from baseline at every follow-up visit (P < 0.001). Mean (+/-SD) reductions in macular thickness were 136 +/- 108 microm at 1 week and 128 +/- 122 microm after 1 year of follow-up. Mean (+/-SD) improvement in visual acuity at 12 months was 0.15 +/- 0.21 logMAR (P = 0.008). Visual acuity improvement of one or more lines and three or more lines were observed in 14 (63.6%) and 6 (27.3%) eyes, respectively. Seven eyes (31.8%) required topical treatment due to a significant intraocular pressure increase. Posterior juxtascleral infusion of a new formulation of triamcinolone acetonide is an effective treatment for diffuse diabetic macular edema unresponsive to conventional grid laser photocoagulation. A randomized, larger study is warranted.

A real‐life multicentre clinical practice study to evaluate the efficacy and safety of intravesical chondroitin sulphate for the treatment of interstitial cystitis

To report a multicentre, community based open-label study designed to assess the efficacy and safety of intravesical sodium chondroitin sulphate in the treatment of patients with the clinical diagnosis of interstitial cystitis (IC). Chondroitin sulphate is a naturally occurring glycosaminoglycan (GAG) in the bladder mucus layer and changes in this GAG have been implicated in the pathogenesis of IC, and small single-centre studies have suggested that intravesical chondroitin sulphate may have efficacy in IC. Patients with IC were treated with sodium chondroitin sulphate (Uracyst, Stellar Pharmaceuticals Inc., London ON, Canada) solution 2.0% via urinary catheter weekly for 6 weeks and then monthly for 16 weeks for a total of 10 treatments. The primary efficacy endpoint was the percentage of responders to treatment as indicated by a marked or moderate improvement on a seven-point patient Global Response Assessment (GRA) scale at week 10 (4 weeks after the initial six treatments) compared with baseline. A major secondary efficacy endpoint (durability) was the percentage of responders on the GRA scale after 10 treatments. Additional secondary efficacy objectives were differences from baseline in Patient Symptom/Problem Index scores over the course of the treatment compared with baseline. In all, 47% of the 53 enrolled patients with long standing moderately severe IC (mean [SD, range] diagnosis of IC 3.0 [3.4, 0.1-16] years; duration of symptoms 9.2 [9.2, 1-39] years; baseline symptom score 14.2 [3.2]) were responders at week 10. At 24 weeks, 60% were responders. There was a statistically and clinically significant decrease in the mean (SD) symptom and bother scores from baseline at 10 weeks and 24 weeks, at 9.0 (4.3) and 8.1 (5.0), respectively (P < 0.001). There were no significant safety issues during the study. This multicentre community based real-life clinical practice study suggests that intravesical chondroitin sulphate may have an important role in the treatment of IC and validates the rationale for a randomized placebo-controlled trial.

Interstitial cystitis: bladder pain and beyond

Background: Interstitial cystitis is characterized by over 6 months of chronic pain, pressure and discomfort felt in the lower pelvis or bladder. It is often relieved with voiding, along with daytime frequency and nocturia in the absence of a urinary tract infection. Interstitial cystitis occurs primarily in females including adolescents and its diagnosis is still one of exclusion. It is now recognized as a serious medical condition associated with significant disability. Objective: The aim of this paper was to review the pathogenesis and treatment of interstitial cystitis with emphasis on new pathogenetic trends and therapeutic modalities. Methods: About 713 mostly original papers were reviewed in Medline from 1990 to August. 2008. All authors independently reviewed the literature. Large, double-blind, placebo-controlled, clinical trials were few and the medical histories of the patients used varied considerably making conclusions difficult. Promising pilot trials turned out mostly negative on follow-up. Results: Increasing evidence of co-morbid diseases, neurogenic inflammation and the effect of stress are promising as new targets for pathophysiology. No new effective treatments have emerged. Oral pentosanpolysulfate, amitriptyline, hydroxyzine and quercetin, as well as intravesical heparin/bicarbonate/lidocaine solutions, are still used with variable success. Some pilot open-label trials presented encouraging findings. Conclusion: Interstitial cystitis contributes substantially to chronic pelvic pain and to poor quality of life. Oral or intravesical administration of solutions containing sodium hyaluronate, chondroitin sulfate and quercetin to both reduce bladder inflammation and ‘replenish’ the glycosaminoglycan layer should be tried. There is a clear need for therapeutic modalities. New potential translational research areas are suggested.

Zwei-Jahres-Follow-up nach Einsatz von Natrium-Chondroitinsulfat bei der Behandlung der „Überaktiven Blase“

AIM: A retrospective study was performed to investigate whether the improvement of symptoms achieved with sodium chondroitin sulfate in treating overactive bladder (OAB) persists after 24 months. MATERIALS AND METHODS: Two years ago, a total of 82 patients with chronic OAB were randomly assigned to receive either anticholinergic treatment (Tolterodin; group A, n = 41) or sodium chondroitin sulfate (Gepan® instill; group B, n = 41). Diagnostic assessment included a gynecological examination and history, urodynamic testing, introital ultrasound, and cystoscopy. Duration of treatment was 12 months. The patients underwent repeat follow-up after 24 months and the findings were compared with the results at 12 months. RESULTS: In group A, 15/35 (43 %) women reported an improvement of symptoms after 12 months as opposed to only 5/35 (14 %) after 24 months. In group B, there was an improvement in 23/32 (72 %) at 12 months and in 18/32 (56 %) after 24 months (p = 0.001). The subjective results were corroborated by means of urodynamic testing, pad counts, voiding frequency and nycturia (voiding diary). CONCLUSION: Our findings suggest that instillation treatment with sodium chondroitin sulfate (Gepan® instill) results in a more sustained improvement or cure of the symptoms of overactive bladder due to development of a glycosaminoglycan layer. Long-term results are needed for confirmation.

Trial Formation of Artificial Bone by Inkjet Powder-Layered Manufacturing

Artificial bone implants are in relatively simple shapes for use mainly by cutting or manually. To produce a desired bone shape, we used tribasic calcium phosphate bone ash powder as the material and aqueous sodium chondroitin sulfate solution as the binder in inkjet powder-layered manufacturing. In experiments, we reproduced a rabbit femur with a precision of 0.6 mm and a minimum longitudinal hollow shaft 2 mm in diameter based on computed tomography data. We gave the brittle artificial bone a compressive strength of 3 MPa by dipping it in water and binder through its hydrate reaction.

Comparison of the incidence of opacification of Hydroview hydrogel intraocular lenses with the ophthalmic viscosurgical device used during surgery

To determine the effect of intraoperative ophthalmic viscosurgical devices (OVDs) on late opacification of the Hydroview hydrogel intraocular lens (IOL) (Bausch & Lomb Surgical). Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada. A retrospective study of 949 cases of Hydroview IOL implantations from February 1998 to September 2000 was conducted. Of the 949 implantations, 462 were performed by 1 surgeon (J.H.S.) using Viscoat (sodium chondroitin sulfate 4.0%-sodium hyaluronate 3.0%) and 487 were performed by a second surgeon (W.A.N.) using Biolon (sodium hyaluronate 1.0%). Surgical techniques were identical with the exception of surgeon OVD preference. The number of IOLs opacifying and requiring explantation was determined in each group. Seventy-one Hydroview IOLs had surface calcification deposits that presented a mean of 39 months postoperatively. Twenty-two IOLs opacified sufficiently to warrant a recommendation of IOL explantation; 20 IOLs were explanted, and 2 surgeries were cancelled due to death or disability. In all cases of opacification, Viscoat had been used intraoperatively. This represented a 15.4% incidence of opacification in the Viscoat group, with 31.0% cases severe enough to warrant a recommendation of explantation. The results suggest that the intraoperative use of Viscoat has a facilitating role in the development of late calcification and opacification of the Hydroview IOL.

Comparison of the effect of Viscoat and DuoVisc on postoperative intraocular pressure after small-incision cataract surgery

To evaluate the effect of Viscoat (sodium chondroitin sulfate 4%-sodium hyaluronate 3%) and DuoVisc (Viscoat and Provisc [sodium hyaluronate 1%]) on postoperative intraocular pressure (IOP) after bilateral small-incision cataract surgery. Department of Ophthalmology, University of Vienna, Vienna, Austria. This prospective randomized study comprised 60 eyes of 30 consecutive patients with age-related cataract in both eyes. Each patient's eyes were randomly assigned to receive Viscoat or DuoVisc during cataract surgery. DuoVisc is a packet containing 2 ophthalmic viscosurgical devices (OVDs): the dispersive Viscoat, which was used for intraocular lens (IOL) implantation. In the Viscoat group, the Viscoat was used during the entire surgery. The intraocular pressure (IOP) was measured preoperatively as well as 1, 6, and 20 to 24 hours postoperatively. One and 6 hours postoperatively, the mean IOP was significantly higher in the Viscoat group than in the DuoVisc group (25.8 mm Hg and 20.5 mm Hg, respectively, at 1 hour and 24.7 mm Hg and 21.1 mm Hg, respectively, at 6 hours) (P<.05). At 20 to 24 hours, the mean IOP was not statistically significantly different between the 2 groups. Intraocular pressure spikes to 30 mm Hg or higher occurred in 4 eyes in the DuoVisc group and 11 eyes in the Viscoat group (P<.05). Viscoat caused significantly higher IOP increases and significantly more IOP spikes than DuoVisc in the early postoperative period. Therefore, if Viscoat is used during cataract surgery, an additional cohesive OVD should be used for IOL implantation.

A Case of Cataract Surgery without Pupillary Device in the Eye with Iridoschisis

PurposeTo introduce a case of iridoschisis patient who underwent cataract surgery successfully without pupil device.MethodsA 64-year-old female who showed iridoschisis of her both eyes underwent cataract operation at her right eye without a pupillary device. The preoperative and postoperative ophthalmologic examinations including visual acuity, intraocular pressure, reaction of anterior chamber, and degree of damage on iris was evaluated respectively.ResultsCataract surgery was performed under topical anesthesia through a clear corneal incision. Iris fibrils were held in place by ophthalmic viscosurgical device (OVD, sodium hyaluronate 3%-sodium chondroitin sulfate 4%, Viscoat®) that was injected into the anterior chamber. A small capsulorrhexis was made and the nucleus was delivered with low-power phacoemulsification, most of which was performed under the anterior capsule. The iris came into contact with the OVDs only and received no mechanical trauma. There were no intraoperative complications such as tear of the iris, hyphema, loss of mydriasis, or rupture of the posterior lens capsule. The edema of corneal stroma and inflammation of anterior chamber was shown at immediate-postoperative period, but completely subsided 2 weeks later. The visual acuity showed improvement from 20/400 to 20/30.ConclusionsIn iridoschisis patients, there is a risk of aspiration of iris fibers during cataract surgery. With adequate use of OVD and careful modulation of surgical devices, cataract surgery was successfully performed without using extra pupil-supporting device.

Effect of antiglaucoma agents on postoperative intraocular pressure after cataract surgery with Viscoat

To compare the effectiveness of brinzolamide 1%, brimonidine 0.2%, acetazolamide 250 mg, intracameral acetylcholine, and timolol 0.5% in preventing intraocular pressure (IOP) peaks during the early period after phacoemulsification in which sodium chondroitin sulfate 4%-sodium hyaluronate 3% (Viscoat) was used as the ophthalmic viscosurgical device (OVD). Department of Ophthalmology, Baskent University Medical Faculty, Ankara, Turkey. This prospective randomized study comprised 185 eyes of 185 patients with uncomplicated cataract scheduled for phacoemulsification using Viscoat as the OVD. Patients were randomly assigned to 1 of 6 groups: postoperative application of topical brinzolamide 1%, brimonidine 0.2%, oral acetazolamide 250 mg, intracameral acetylcholine, timolol 0.5%, or no ocular hypotensive agent (control group). The IOP was measured at baseline (preoperatively) as well as 6 hours, 20 to 24 hours, and 1 week after surgery. The mean preoperative IOP values were not significantly different between the groups. Six hours and 20 to 24 hours postoperatively, the mean IOP was significantly lower in all groups receiving an ocular hypotensive agent than in the control group (P<.01). Six hours after surgery, the mean IOP significantly increased in all groups but was higher in the control group. At 20 to 24 hours, the mean IOP decreased significantly in all ocular hypotensive agent groups but remained significantly high in the control group. One week after surgery, there were no significant differences between the groups. Brinzolamide, brimonidine, acetazolamide, intracameral acetylcholine, and timolol had similar effects in reducing IOP increases after phacoemulsification performed using Viscoat.

Nonheme Iron Absorption in Young Women Is Not Influenced by Purified Sulfated and Unsulfated Glycosaminoglycans

Meat is a well-known enhancer of iron absorption, yet the molecular entity mediating the effect remains obscure. Recently published data indicate that highly acidic sulfated glycosaminoglycans (GAG) from fish and chicken muscle are effective stimulants of iron uptake in Caco-2 cells. Two fully randomized stable isotope studies with crossover design were performed in a group of 16 apparently healthy young women to assess the effect of purified sulfated and unsulfated GAG on human iron absorption. Iron absorption was measured on the basis of erythrocyte incorporation of 57Fe or 58Fe 14 d after the administration of labeled semisynthetic meals (SSM) based on egg albumin, corn oil, maltodextrin, and water. The meals were consumed with or without added sodium hyaluronate (NaH, 300 mg) or chondroitin sulfate (CS, 360 mg) as representative unsulfated and sulfated GAG, respectively. The level of GAG added was 3 times (NaH) to about 10 times (CS), the amount expected to be present in 150 g beef muscle. Geometric mean iron absorption from SSM containing NaH (21.2%) or CS (19.4%) did not differ from that of SSM without GAG (19.5 and 20.3%, respectively). NaH and CS at those levels do not affect human nonheme iron absorption.

Two Dimensional and Three Dimensional Interactions between Bovine Serum Albumin and Chondroitin Sulfate

The interaction between glycosaminoglycan and protein in solution and at interface are important for the biofunctions of tissues. We previously reported that the binding behavior between sodium hyaluronate NaHA and bovine serum albumin BSA both in solution and at interface. Here, two- and three-dimensional interactions between sodium chondroitin sulfate Na 2 ChS and BSA were studied by an electrophoretic light scattering ELS and a quartz crystal microbalance QCM method. Na 2 ChS molecules bound to BSA molecules by an electrostatic force and form soluble complex in solution. Their molar ratio γ = n BSA / n Chs of the saturated complex was about 6-7. However, the value of γ was about 1 at interface when the binding between Na 2 ChS and BSA became saturated. Na 2 ChS molecules could adsorb onto a BSA monolayer by a hydrophobic force in a Langmuir type. Its adsorption layer was a double-layer structure from the results. The results of Na 2 ChS-BSA complex in solution and at interface were discussed by comparing with the binding behavior between sodium hyaluronate NaHA and BSA to elucidate the effects of the sulfate group and charee density of Na 2 ChS.

Der Einsatz von Natrium-Chondroitinsulfat bei der Behandlung der „Überaktiven Blase”

It is not always possible to clearly differentiate the symptoms of overactive bladder and interstitial cystitis. A prospective randomized study was performed to determine whether instillation of sodium chondroitin sulphate for treatment of interstitial cystitis is also effective in treating overactive bladder. The expected benefit of this therapeutic approach in overactive bladder is based on the assumption that the glycosaminoglycan layer may be damaged in overactive bladder as well. Patients with chronic overactive bladder were randomized to one of two study groups each including 41 patients. Group A was treated with an anticholinergic agent (tolterodine), group B with sodium chondroitin sulphate (Uropol S). The diagnosis was established on the basis of a gynecologic examination and history, urodynamic testing, introital ultrasound, and cystoscopy. Patients were treated for 12 months. An improvement of symptoms was reported by 15/35 (43 %) of the patients in group A (p = 0.000) as compared with 23/32 (72 %) of the patients in group B. The subjective outcome was corroborated by means of urodynamic testing, number of pads used, voiding frequency, and nycturia (voiding diary). Quality of life increased significantly in both groups in the course of treatment but there was no significant difference between both groups. The results of the study presented here suggest that restoring the glycosaminoglycan layer also improves or cures the symptoms in patients with overactive bladder. Patients clearly benefit from instillation of sodium chondroitin sulphate. These results must be confirmed in larger studies before a wider use of this therapeutic option can be recommended.