Methods: OA patients were treated with CS (800 mg/day) or paracetamol (4 g/day) for 6 month. Clinical examination was performed at baseline, and after 1.5, 6 and 9 months of treatment, with collection of plasma and synovial fluid. The clinical examination included measurement of the overflow, hypertrophy and vascularisation of the synovia as well as functional study of the articulation (with Lequesne and EVA index). The levels of CXCL16, fractalkine/CX3CL1, MCP-1/CCL-2, RANTES/CCL5 and GRO-a/ CXCL1 were determined by ELISA in the plasma and synovial samples collected. The statistical analysis was performed with SPSS package. We performed two different analyses. In the first one, we studied the difference between the levels of the chemokine between each time and the baseline. We performed this analysis in separate with the paracetamol group and chondroitin one. For this comparison we used a non parametric test (Wilcoxon 2 related samples test). We performed a second analysis in order to analyze if there were differences in the chemokine levels over time, depending on the treatment received. For this analysis an independent sample t-test was performed. Results: Improvements in the clinical signs of inflammation were detected after 6-9 months after CS treatment of OA patients. The comparison of the levels of each chemokine at the different times studied versus the baseline, indicated us that these effects were accompanied bya significant reduction in the synovial levels of MCP-1 at 6 month (p¼0.05), whereas in the paracetamol group there was a significant increased level of RANTES (p¼0.035). In plasma, only MCP-1 concentration was significant diminished (p¼0.023) by CS administration. To study in global the answer to the treatments, we perform a comparison between the effect of each drug to the levels of each chemokine. This analysis showed us that there were significant differences between the response to the treatment in MCP-1, 6 month after treatment (p¼0.016), and in fractalkine, 9 month after treatment (p¼0.036). In both cases the treatment with chondroitin showed a diminution of the levels of the chemokines, while paracetamol didn't affect in the case of MCP-1 or even increased in the case of fractalkine. All these data show that chemokine attraction of macrophage, T-cell, eosinophil and basophil is reduced with a 6 month treatment with chondroitin. Conclusions: These results suggest that CS sulphate may represent an adequate drug to reduce the inflammation associated to the OA process.
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