Glucosamine Research Articles

Pharmacotherapy of pain in musculoskeletal diseases: evolution and revolution of views

The article presents new views on the treatment of pain syndromes in musculoskeletal diseases, in particular in osteoarthritis (OA) of various localizations (gonarthrosis, coxarthrosis). New recommendations (2019–2020) of international societies for the study of symptomatic delayedacting drugs (SYSADOA) and their use in the treatment of OA are presented. We present the opinions of experts from different communities: the American College of Rheumatology (ACR, 2019), the European Alliance of Associations for Rheumatology (EULAR, 2019), the European Society for the Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO, 2020) – on the prescription of SYSADOA, which include chondroitin sulfate (CS), glucosamine sulfate (GS), avocado and soy unsaponifiable compounds, diacerein, hyaluronic acid for intraarticular administration. New domestic clinical guidelines (2020–2021) for the treatment of OA are presented. The changes that have taken place in the terminology of pain and in the classification of pain syndromes, reflected in the new International Classification of Diseases of the 11 th revision (ICD-11), are analyzed. New approaches to the stratification of OA, taking into account endo- and phenotyping, as well as new aspects in pain therapy associated with the molecular genetic mechanisms of SYSADOA are shown. According to the EULAR recommendations, there is indisputable evidence of the efficacy and safety of pharmaceutical CS, which is reflected in a meta-analysis (2019), a randomized placebo-controlled trial (2019), approved by the Russian Ministry of Health, and confirmed in Chondroguard’s meta-analysis of clinical trials (2020). New approaches in the treatment of pain syndromes provide for parenteral administration of CS and GS according to an intermittent scheme. The search and development of new molecules comparable in efficacy to SYSADOA in the treatment of pain in OA and low back pain have led to the emergence in clinical practice of biologically active compositions, including undenatured type II collagen, the effectiveness of which is associated with a neuroimmune mechanism of action.

Fabrication and Characterization of Glucosamine Hydrochloride from Chitin of Horseshoe Crab Shell (Tachypleus gigas)

Preparation of glucosamine hydrochloride from the chitin of horseshoe crab shells using the chemical hydrolysis method has been done using HCl concentration variation ratios of 7%, 9%, 11%,14 % with a ratio of 9:1 (v/w) for 4 hours at a temperature of 90ºC. Determination of glucosamine hydrochloride characteristics was characterized using Fourier transform-infra red (FT-IR) spectroscopy, in which the characteristics of glucosamine hydrochloride obtained in the OH group of glucosamine hydrochloride were 3446 cm-1 (s), 3448 cm-1 (s), 3450 cm-1 (s), 3448 cm-1 (s), respectively. For NH group of glucosamine hydrochloride were 1557 cm-1 (s), 1559 cm-1 (s), 1556 cm-1 (s), 1560 cm-1 (s), respectively. For CN group of glucosamine hydrochloride were 1379 cm-1 (m), 1379 cm-1 (m), 1379 cm-1 (m), 1379 cm-1 (m), respectively. While the glycoside bond of glucosamine hydrochloride 1073 cm-1 (w), 1074 cm-1 (w), 1074 cm-1 (w), 1074 cm-1 (w), respectively. Determination of the concentration of glucosamine hydrochloride with Ultraviolet Spectrophotometer analysis at a maximum wavelength of 197 nm with a standard solution of N-acetyl glucosamine in a solution of phosphate acid 0.005%, in which obtained the concentration of glucosamine hydrochloride 7% = 33.67 ppm, 9% = 36.35 ppm, 11% = 40.16 ppm, 14% = 43.97 ppm.

Evidence-based therapy for knee osteoarthritis: expected short-, medium-, and long-term outcomes of prescription crystalline glucosamine sulfate administration

The need for effective drugs for the treatment of knee osteoarthritis (OA) is constantly growing. Current guidelines recommend the use of symptomatic slow acting drugs for osteoarthritis (SYSADOA) such as glucosamine (GCA) in this disease. Among various drugs containing GCA, high bioavailability and clinical efficacy have been shown only for prescription crystalline GCA sulfate (pGCAS) administration. Several meta-analyses and network meta-analyses have shown that efficacy of pGCAS 1500 mg once daily is superior to other GCA-based products (such as GCA hydrochloride with or without sodium sulfate) and the combination of GCA with chondroitin sulfate (CS) in terms of reducing the intensity of pain and improving the functional state. These studies confirmed the favorable safety profile of pGCAS, which was comparable to placebo in the incidence of adverse events. Pharmacoeconomic studies have also demonstrated greater cost-effectiveness of pGCAS compared to other GCA drugs.A group of Russian experts at a meeting of the advisory committee reviewed the evidence in favor of the use of pGCAS and evidence of its effectiveness in the treatment of knee OA in comparison with other products that include GCA, and the fixed combination of GCA with CS. Taking into account the results obtained, the use of pGCAS at a dose of 1500 mg once a day is recommended as a rational choice for the treatment of knee OA.

Pharmacokinetic Comparison of Chitosan-Derived and Biofermentation-Derived Glucosamine in Nutritional Supplement for Bone Health.

Glucosamine and chondroitin sulfate have been used as nutritional supplementation for joint tissues and osteoarthritis (OA). Biofermented glucosamine is of great interest in the supplement industry as an alternative source of glucosamine. The purpose of this study is to compare the pharmacokinetics of chitosan-derived glucosamine and biofermentation-derived glucosamine as nutritional supplementation. In a randomized, double-blind and cross-over study design, we recruited subjects of healthy men and women. The pharmacokinetics of glucosamine were examined after a single dose of glucosamine sulfate 2KCl (1500 mg) with two different sources of glucosamine (chitosan-derived glucosamine and biofermentation-derived glucosamine) to male and female subjects fitted with intravenous (iv) catheters for repeated blood sampling up to 8 h. According to plasma concentration–time curve of glucosamine after an oral administration of 1500 mg of glucosamine sulfate 2KCl, AUC0–8h and AUC0–∞ values of glucosamine following oral administration of chitosan-derived and biofermentation-derived glucosamine formulations were within the bioequivalence criteria (90% CI of ratios are within 0.8–1.25). The mean Cmax ratios for these two formulations (90% CI of 0.892–1.342) did not meet bioequivalence criteria due to high within-subject variability. There were no statistically significant effects of sequence, period, origin of glucosamine on pharmacokinetic parameters of glucosamine such as AUC0–8h, AUC0–∞, Cmax. Our findings suggest that biofermentation-derived glucosamine could be a sustainable source of raw materials for glucosamine supplement.

FeNi incorporated N doped carbon nanotubes from glucosamine hydrochloride as highly efficient bifunctional catalyst for long term rechargeable zinc-air batteries

The ingenious design and synthesis of low-cost, non-precious metal bifunctional catalysts for oxygen reduction reactions (ORR) and oxygen evolution reactions (OER) is a pressing demand to solve energy crisis and to promote the development of zinc-air batteries. Herein, a simple strategy was developed to derive FeNi incorporated N-doped carbon nanotube (denoted as glu-NiFe) from glucosamine. Extensive metal-nitrogen-carbon (M-N-C) and FeNi alloys act as electrocatalytic active sites for ORR and OER, respectively, together with highly graphitized carbon nanotubes for facilitating electron transport. And the combinations endow glu-NiFe with an ORR half-wave potential of 0.85 V and an OER potential of 1.67 V at 10 mA cm−2, which exceed commercial catalysts of Pt/C and RuO2. Furthermore, the rechargeable Zn-air battery based on glu-NiFe delivers a high peak power density of 127 mW cm−2 and superior cycling stability (over 240 h). Moreover, a favorable performance is exhibited by glu-NiFe based all solid-state Zn-air battery. This work will provide some assistance in designing efficient and low-cost bifunctional catalysts for high performance rechargeable Zn-air batteries.

Defects passivation via d-glucosamine hydrochloride for highly efficient and stable perovskite solar cells

The defects existing on surface and grain boundaries in organic-inorganic halide perovskite films are detrimental to both the performance and stability of perovskite solar cells (PVSCs). Here, an additive of Glucosamine hydrochloride (D-GH) is introduced into the perovskite precursor solution to achieve high power conversion efficiency (PCE) and long-term stability. It is found that D-GH additive can significantly improve of the quality of perovskite film with enhanced crystallinity, compact and smooth surface and slightly enlarged grain size, leading to reduced grain boundaries, trap densities and thus negligible hysteresis in the resultant PVSCs. The optimized devices with 0.05 mg/ml D-GH additive show the best device performance with an enhanced PCE of 20.30%, as compared to the control devices with the highest PCE of 17.77%. In addition, the stability of PVSCs with 0.05 mg/ml D-GH modification is much better than that of the reference one. Overall, this work demonstrates a green and cheap additive to fabricate highly efficient and stable PVSCs. • Glucosamine hydrochloride (D-GH) was introduced into perovskite precursor solution to improve the performance of PVSCs. • The D-GH additive can significantly improve the quality of perovskite film and reduced trap densities. •. The device with D-GH as additive shows enhanced performance with PCE of 20.30%. •The stability of PVSCs with D-GH modification is much better than that of the reference one.

Deprescribing: What About Vitamins, Minerals, and Other Nutritional Supplements?

Deprescribing: What About Vitamins, Minerals, and Other Nutritional Supplements?

Osteoarthritis: management strategies depending on the location of lesions

Osteoarthritis (OA) is a multifactorial disease that can be caused by genetic factors, obesity, joint microtrauma, and excessive physical exercises. The key features of OA include gradual loss of articular cartilage, bone tissue remodeling, development of osteophytes, and subchondral sclerosis. The pathogenesis of OA is based on the loss of glycosaminoglycans, collagen disorganization, and inflammation mediated by a cytokine cascade. OA is a complex disease affecting not only cartilage, but also intraarticular and periarticular tissues. Together, these changes compromise joint function and cause chronic pain. Considerable attention has beer recently paid to OA phenotyping in order to introduce a tailored approach into patient management. Phenotypes are applicable to the three most common peripheral OA locations: gonarthrosis, coxarthrosis, and hand OA. An international group of experts of primary care has developed algorithms for OA patient management, including diagnostic criteria, treatment options, and criteria for referring the patient to a specialist (rheumatologist). Current guidelines recommend non-drug therapy, pharmacotherapy, and surgery. There is a growing interest in phytopharmaceuticals, a heterogeneous group of molecules with a high capacity of suppressing inflammation, oxidative stress, and pain, as well as improving joint function. Mucosate® in capsules (DIAMED-pharma, Russia) is one of currently available complex products with phytocompounds. It contains the NEM® complex (natural eggshell membrane), Harpagophytum root extract, glucosamine sulfate, chondroitin sulfate, and manganese sulfate monohydrate.

A method for tracing the six geographical indication (GI) jujube species by crude polysaccharide characterization

BackgroundJujube resources are abundant in China, and Shanxi Province in particular is one of the places where they originated. The most famous 6 geographical indication (GI) jujube species in Shanxi are often masqueraded by nonoriginal jujube species, which seriously undermines the brand image. However, the current national quality standards, which have simple indicators, cannot completely trace the botanical and geographical origin of GI jujubes. Compared with small biomolecules and genes, polysaccharides possess a complicated structure and are sensitive to their geographical location and botanical origin, and these characteristics are important for botanical and geographical traceability. Therefore, we selected the 6 most famous GI jujube species in Shanxi Province, measured and analyzed their crude polysaccharide characterizations, and then selected efficient tracing indicators.ResultsThe crude polysaccharides from 6 GI jujube species of Shanxi Province were tested with several parameters, including their purity (the content of polysaccharides), uronic acid content, Mw distribution, monosaccharide composition, functional groups and bonds. In the assays that measured purity and uronic acid content, the purity varied within a very narrow band (96–99%) and presented no negative or positive correlation with uronic acid content. In the experiment that measured the Mw distribution by HPGPC, five peaks (RT1, RT2, RT3, RT4, RT5) were almost observed in 6 jujube species, and the RT3 content (240–250 Da), which showed a significant correlation to the content of RT4 and RT5, exhibited significant differences among 6 jujube species (RSD = 1.28 > 1.00). The monosaccharide composition indicated that the polysaccharides from 6 jujube species were rich in glucose (55–75%), arabinose (10–15%) and galactose acid (10–20%), with small amounts of rhamnose, glucosamine hydrochloride, galactose, xylose, and mannose (less than 5%). The FT-IR spectrum showed that crude polysaccharides from six jujube species shared similar functional groups and chemical bonds.ConclusionsThe results above indicated that in the 6 GI jujube species, both homogeneity and differences were observed in the Mw distribution of crude polysaccharides. First, five peaks (RT1, RT2, RT3, RT4, RT5), which represent the Mw of 186,646–285,262 Da (RT1), 4634–17,296 Da (RT2), 240–250 Da (RT3), 98–103 Da (RT4) and 57–64 Da (RT5), respectively, could be detected in all 6 jujube species. Second, the RT3 contents exhibited significant differences among the 6 jujube species (RSD = 1.28 > 1.00) and showed a significant correlation with RT4 and RT5. Therefore, the Mw distribution may be treated as a potential distinguishing indicator among the 6 jujube species.Graphical

A personalized approach to the management of patients with chronic nonspecific back pain

Back pain is one of the most common causes of a doctor visit and occupy the first place among all non-infectious diseases in terms of the number of years of life, lost due to persistent deterioration in health. Nonspecific (musculoskeletal) pain represents the most common cause of pain and can be caused by the intervertebral disc extrusion, the lesion of the facet joints, the sacroiliac joints pain (SJP), the myofascial syndrome. A comprehensive (interdisciplinary) approach to the treatment of chronic back pain is aimed not only at reducing pain, but also at increasing physical, social and domestic activity, improving the emotional state, and developing effective stereotypes of behavior. The personalized approach is based on the patient clarifying both anatomical causes of pain and social and psychological, including erroneous ideas about the causes of back pain and its forecast, depression, increased anxiety and insomnia. Kinesitherapy represents the most effective direction when conducting patients with chronic back pain and should be combined with avoiding excessive static and physical exertion. In addition to therapeutic exercises, regular walks are of great importance, the intensity and volume of which can gradually increase. Psychological methods of therapy, mainly cognitive-behavioral therapy (CBT), are effective for chronic nonspecific back pain, they also use in the presence of emotional disorders and insomnia. In case of damage to the facet joints, the SJP, combined osteoarthritis of the knee and hip joints for chronic back pain as additional therapy, combined drugs of chondroitin sulfate and glucosamine sulfate are used. Unfortunately, in our country, a personalized approach is rarely used, including the CBT, but its use can help many patients with chronic back pain.

Therapeutic Value of Traditional Chinese Massage plus Moxibustion for Degenerative Knee Osteoarthritis.

Objective To evaluate the therapeutic value of traditional Chinese massage plus moxibustion for degenerative knee osteoarthritis (DKOA). Methods From January 2019 to October 2021, 152 patients with DKOA were enrolled. All patients were randomly divided into the treatment group and the control group. The control group was treated with oral glucosamine hydrochloride capsules. The treatment group was treated with traditional Chinese massage and moxibustion on the basis of the control group. The duration of treatment in the two groups was 8 weeks. The effectiveness, visual analog scale (VAS) score, the hospital for special surgery (HSS) score, World Health Organization Quality of Life Scale (WHOQOL-BREF) score, serum high-sensitivity C-reactive protein (CRP), and interleukin-6 (IL-6) levels were compared between the two groups before and after treatment. Results There were no significant differences in age, sex, and the duration of disease between the two groups (P > 0.05). The overall response rate in the treatment group was significantly higher than that of the control group after treatment (92.1% vs 78.9%; P=0.038); the VAS score of both two groups were significantly decreased, and the VAS score in the treatment group was significantly lower than that of the control group (3.5 ± 1.4 vs 4.8 ± 1.1; P < 0.001); the HSS score and WHOQOL-BREF score significantly improved in both groups, and the HSS score and WHOQOL-BREF score improved more in the treatment group than those of the control group (P < 0.05). The high-sensitivity CRP level significantly decreased in both groups, and the high-sensitivity CRP level in treatment group is lower than that of the control group (2.79 ± 1.65 vs 4.37 ± 1.54; P < 0.001); the IL-6 level was significantly decreased in the treatment group than in the control group (7.22 ± 3.41 vs 4.59 ± 2.98; P < 0.001). Conclusion Traditional Chinese massage plus moxibustion is worthy of clinical application, which has a significant clinical effect on DKOA, reducing pain and improving knee joint function and quality of life.

Comprehensive Rehabilitation Therapy Plus Glucosamine Hydrochloride for Exercise-Induced Knee Injuries and the Effect on Knee Function of Patients.

Objective To assess the application value of comprehensive rehabilitation therapy plus glucosamine hydrochloride for exercise-induced knee injuries and its effect on knee function. Methods A total of 96 patients with an exercise-induced knee injury who were admitted to our hospital from February 2019 to February 202 were recruited and assigned at a ratio of 1 : 1 with matched general information to a control group (n = 45) or an experimental group (n = 51). Both groups of patients received comprehensive rehabilitation therapy, and the patients in the experimental group were daily given additional glucosamine hydrochloride tablets for 8 weeks. Results The experimental group showed a higher treatment efficacy than the control group (P < 0.001). After the treatment, the VAS scores and C-reactive protein of the two groups showed a decline, with a lower result in the experimental group than in the control group (P < 0.001). The Lysholm knee scores were increased in the two groups after the treatment, and the experimental group had a higher score (P < 0.001). After the treatment, patients of both groups showed reduced five-times-sit-to-stand-test (FTSST) results, with a better outcome obtained in the experimental group (P < 0.001). Conclusion Comprehensive rehabilitation therapy plus glucosamine hydrochloride effectively improves the clinical efficacy of exercise-induced knee joint injuries and enhances the knee joint rehabilitation of the patients.

Diet and lifestyle modifications: An update on non‐pharmacological approach in the management of osteoarthritis

Osteoarthritis (OA) is a degenerative joint disease, a leading cause of bone-related disabilities affecting the quality of life of a huge segment of the global population. To eradicate this problem, non-pharmacological treatments like diet and lifestyle modification (weight loss, Tai chi, cupping therapy, kinesio taping, ultrasound and whole-body vibration, low-level laser therapy, manual therapy, electrotherapy, mudpack therapy, and moxibustion) are effective along with medical treatments. Nowadays, these preventive and therapeutic remedies are getting more attention as adjuvant measures due to enhanced awareness among the common people. In most OA management guidelines, dietary modifications along with effective exercises and therapies are preferred over other existing treatments owing to their safe nature and significant positive effects on reverting the OA symptoms. Scientific evidence has shown that food components such as phytochemicals, polyphenols, flavonoids, epigallocatechin 3-gallate, ellagic acid (EA), vitamins, minerals, extracellular vesicles, glucosamine, and chondroitin sulfate have a promising effect on relieving the OA symptoms and slowing down its progression due to their antioxidant and anti-inflammatory activities. This review summarizes the evidence-based dietary and lifestyle modifications for improved bone health with special reference to OA. Novelty impact statement This review summarizes the evidence-based non-pharmacological approach with reference to diet (phytochemicals, antioxidants, nutrients), lifestyle modification (exercises, other therapies), and comments on the effect of food processing on bioactive compounds in the management of OA. This data can serve as a benchmark or guideline for clinicians, practitioners, researchers, and patients to manage the OA.

Efficacy of Duhuo Jisheng Decoction for Treating Cold-Dampness Obstruction Syndrome-Type Knee Osteoarthritis: A Pooled Analysis.

Aim The aim of this study is to provide evidence of the effect of Duhuo Jisheng decoction (DHJSD) on knee osteoarthritis (KOA) of the cold-dampness obstruction syndrome type. Methods We searched PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure, the Wanfang database, and the China Biology Medicine for randomized controlled trials (RCTs) evaluating DHJSD or DHJSD combined with other conventional therapies (DHJSD group) compared to conventional therapy (control group) for cold-dampness obstruction syndrome-type KOA. We calculated the pooled odds ratio (OR), mean difference (MD), and 95% confidence interval (CI) using fixed- or random-effects models. Results Eleven RCTs, with a total of 895 patients, were included. The results showed that DHJSD could significantly improve the effective rate (OR = 3.13, 95%CI = 2.07 to 4.72, P < 0.001), reduce both the WOMAC (MD = −12.06, 95%CI = -16.34 to -7.79, P < 0.001) and VAS (MD = −1.02, 95%CI = -1.54 to -0.50, P = 0.0001) scores, and reduce the serum IL-6 (MD = −0.80, 95%CI = -0.90 to -0.69, P < 0.001) and TNF-α (MD = −2.49, 95%CI = -2.77 to -2.21, P < 0.001) levels during the treatment of cold-dampness obstruction syndrome-type KOA. The subgroup analysis showed that compared with glucosamine sulfate (GS) alone, DHJSD combined with GS significantly improved the effective rate (OR = 2.59, 95%CI = 1.19 to 5.65, P = 0.02) and reduced the WOMAC (MD = −13.83, 95%CI = -16.14 to -11.51, P < 0.001) and VAS (MD = −0.91, 95%CI = -1.27 to -0.55, P < 0.001) scores. DHJSD + warm-needle acupuncture (WA) lowered the VAS score more than WA alone. There was no significant difference in the decrease in serum IL-1β between the DHJSD and control groups. Conclusion This study shows that DHJSD can improve the clinical efficacy and reduce the VAS and WOMAC scores in the treatment of cold-dampness obstruction syndrome-type KOA. Compared with GS or WA alone, the combined application of DHJSD with GS or WA could better reduce both the VAS and WOMAC scores.

Dietary supplements do not improve bone morphology or mechanical properties in young female C57BL/6 mice

Bone is a hierarchical material formed by an organic extracellular matrix and mineral where each component and their physical relationship with each other contribute to fracture resistance. Bone quality can be affected by nutrition, and dietary supplements that are marketed to improve overall health may improve the fracture resistance of bone. To test this, 11 week old female C57BL/6 mice were fed either collagen, chondroitin sulfate, glucosamine sulfate, or fish oil 5 times a week for 8 weeks. Femurs, tibiae, and vertebrae were scanned with micro-computed tomography and then mechanically tested. Glucosamine and fish oil lowered elastic modulus, but did not alter the overall strength of the femur. There were no differences in bone mechanics of the tibiae or vertebrae. Overall, the data suggest that dietary supplements did little to improve bone quality in young, healthy mice. These supplements may be more effective in diseased or aged mice.

A self-assembly strategy to synthesize carbon doped carbon nitride microtubes with a large π-electron conjugated system for efficient H2 evolution

The combination of element doping into carbon nitride and developing a novel structure is charming in realizing outstanding photocatalytic performance. Herein, carbon-doped carbon nitride microtubes with a large π-electron conjugated system were developed via a facile self-assembly strategy. Glucosamine hydrochloride, a substance with abundant hydroxyl and amino, and melamine were applied as precursors based on the self-assembly behavior via hydrogen bonds. The glucosamine hydrochloride content and the formation of hydrogen bond have impacts on self-assembly behavior to fabricate a rod-shaped precursor. Afterwards, carbon-doped carbon nitride microtubes are synthesized after calcination. The effective π delocalization induced by C doping and unique tubular morphology facilitate charge carrier transfer, offer plentiful active sites as well as the improved visible light capture efficiency. Therefore, carbon-doped carbon nitride microtubes display an outstanding H2 generation rate of 3888.9 μmol h−1 g−1 under λ > 400 nm, far beyond that of pure carbon nitride (886.3 μmol h−1 g−1). Experimental and density functional theory calculation demonstrate that carbon doping endows adjustable band structure, narrow band gap, enhanced π electron density and fast charge transfer rate, finally boosts photocatalytic activity. Our work gives a facial way for fabricating C doped carbon nitride with optimized structure and catalytic performance, which offers an efficient method to develop heteroatoms-doped carbon nitride.

ANALYSIS OF METHODS OF DRUG ADMINISTRATION IN LABORATORY ANIMALS

Pharmaceutical forms containing glycosamines and chondroitins in their composition stimulate the synthesis of articular proteoglycans. In addition, glucosamine exhibits anti-inflammatory properties, slows down the degradation of articular cartilage, mainly due to its metabolic activity, the ability to inhibit the activity of interleukin (IL)-1, lysosomal enzymes, collagenase and phospholipase A2. The effect of treatment with glucosamine sulfate is noticeable after 2 weeks from the start of treatment. The question remains how and in what sequence to use chondroprotective drugs to normalize the work of joint structures.

HPLC Quantification of Glucosamine Sulfate in Eggshell membranes from White and Brown Chicken Eggs

HPLC Quantification of Glucosamine Sulfate in Eggshell membranes from White and Brown Chicken Eggs

Improved Joint Health Following Oral Administration of Glycosaminoglycans with Native Type II Collagen in a Rabbit Model of Osteoarthritis.

Simple SummaryOsteoarthritis is an incurable chronic disease. For this reason, new therapies are constantly emerging to improve clinical signs and the quality of life of our pets. Chondroitin sulfate, glucosamine and hyaluronic acid have been proven effective and are the most widely used in many formulations. In the present study, adding native type II collagen to the combination of chondroitin sulfate, glucosamine and hyaluronic acid showed improvements on osteoarthritis progression in an experimental model of osteoarthritis induced by transection of the cranial cruciate ligament of the knee in New Zealand white rabbits. Disease progression was monitored at different time points using magnetic resonance imaging biomarkers, measurement of hyaluronic acid in synovial fluid, and macroscopic and microscopic evaluations of cartilage, synovial membrane and subchondral bone. Overall, our results showed that adding native type II collagen to a combination of glycosaminoglycans allows a significantly slower osteoarthritis progression, compared to glycosaminoglycans alone.A prospective, experimental, randomized, double blinded study was designed to evaluate the effects of glycosaminoglycans, with or without native type II collagen (NC), in an osteoarthritis model induced by cranial cruciate ligament transection. The following compounds were tested: chondroitin sulfate (CS), glucosamine hydrochloride (GlHCl), hyaluronic acid (HA) and NC. Fifty-four female 12-week-old New Zealand rabbits were classified into three groups: CTR (control–no treatment), CGH (CS + GlHCl + HA) and CGH-NC (CS + GlHCl + HA + NC). Each group was subdivided into three subgroups according to survival times of 24, 56 and 84 days. Over time, all rabbits developed degenerative changes associated with osteoarthritis. CGH-NC showed significantly improved values on macroscopic evaluation, compared to CTR and CGH. Microscopically, significantly better results were seen with CGH and CGH-NC, compared to CTR, and synovial membrane values were significantly better with CGH-NC compared to CGH. A significant improvement in magnetic resonance imaging biomarkers was also observed with CGH-NC in cartilage transversal relaxation time (T2) and subchondral bone D2D fractal dimension in the lateral condyle. In conclusion, our results show beneficial effects on joint health of CGH and CGH-NC and also supports that adding NC to CGH results in even greater efficacy.

Prescription-grade crystalline glucosamine sulfate as an add-on therapy to conventional treatments in erosive osteoarthritis of the hand: results from a 6-month observational retrospective study

ObjectiveTo evaluate the efficacy of prescription-grade Crystalline Glucosamine Sulfate (pCGS) as an add-on treatment to conventional therapy, compared to usual therapy alone, in patients with erosive osteoarthritis of the hand (EHOA).MethodsThis 6-month retrospective case–control study included patients with concomitant knee osteoarthritis and symptomatic EHOA. Participants were stratified into two groups based on whether or not pCGS (1500 mg/day) was added to the conventional therapy (education and training in ergonomic principles, exercise and use on-demand of symptomatic drugs) for hand osteoarthritis. Patients were evaluated at baseline, after 3 and 6 months. Primary outcomes were the change from baseline to month 6 in Visual Analogue Scale (VAS) hand pain and in Functional Index for Hand Osteoarthritis (FIHOA) score. A set of secondary parameters was also evaluated.Results123 patients were included as follows: 67 treated with pCGS in addition to conventional therapy (pCGS Group) and 56 with conventional therapy alone (Control Group). After 6 months a significant difference in VAS and in FIHOA score (p < 0.01 and p < 0.001, respectively) was observed in favor of pCGS Group. Similar results were found for morning stiffness duration (p < 0.05), health assessment questionnaire (p < 0.01) and physical and mental component score of 36-item short form (p < 0.05 and p < 0.001, respectively). A significant reduction of symptomatic drug consumption at 3 and 6 months was reported in the pCGS Group (p < 0.001). No serious adverse event was recorded in both groups.ConclusionsDespite all the limitations inherent to an observational study, our results suggest the potential effectiveness of pCGS, when used in combination with conventional therapy in EHOA. Further randomized placebo-controlled trials are needed to confirm these positive findings.Trial RegistrationClinicalTrials.gov, http://www.clinicaltrials.gov, date of registration: February 2, 2022, NCT05237596. The present trial was retrospectively registered.