Progressive Joint Disease Research Articles

THE LARGER MRI-DETECTED MEDIAL TIBIAL OSTEOPHYTE WIDTH, THE HIGHER RISK FOR UNSTABLE MENISCUS TEAR IN KNEE OA -THE BUNKYO HEALTH STUDY (BHS)-

Purpose: Osteoarthritis of the knee (knee OA) is a slowly but progressive joint disease and is most common form of joint dysfunction and knee pain. Strong mechanical stress subjected to joint surface is one of the major risk factors for incidence and progression of knee OA: e.g. varus alignment increases risk of medial knee OA progression, valgus alignment increases risk of lateral knee OA progression, obesity is also a risk factor of knee OA, and burden of malalignment predicts decline in physical function.

STRUCTURAL CHANGES OF KNEE OSTEOARTHRITIS ARE PROGRESSED IN MIDDLE-AGED POPULATIONS WITH GRADE 0 OF KELLGREN-LAWRENCE CLASSIFICATION -THE OSTEOARTHRITIS INITIATIVE

Purpose: Osteoarthritis of the knee (knee OA) is a slowly but progressive joint disease and is most common form of joint dysfunction and knee pain. Knee OA is also a major cause of morbidity and disability as well as a burden on health-care resources, especially for the elderly. As approximately 25% of populations aged 55 years of age or older have knee pain while walking, most of them is speculated to have knee OA. When we use radiography, it is estimated that approximately 25 million middle-aged and elderly populations have knee OA in Japan.

THE EXPRESSION PATTERNS OF FERROPTOSIS - RELATED GENES IN OSTEOARTHRITIS PATIENTS AND THE ESTABLISHMENTS OF THE REGULATORY NETWORKS

Purpose: Osteoarthritis (OA) is a common clinical chronic degenerative and progressive joint disease. Biological factors and mechanical abnormalities are main pathogenic factors. Disorders of joint structure and tissue morphology caused by instability, etc. will eventually lead to degeneration or even loss of articular cartilage function. Relevant studies have shown that the incidence of OA is gradually increasing, due to the social structure of population aging, the people's living standards improvement, which seriously threatens the health of middle-aged and elderly people.

MEDIAL MENISCUS EXTRUSION (MME) IS A RISK FACTOR FOR PROGRESSION OF EARLY-STAGE KNEE OSTEOARTHRITIS IN MIDDLE-AGED POPULATIONS WITHOUT KNEE OSTEOARTHRITIS -THE DATA FROMOSTEOARTHRITIS INITIATIVE

Purpose: Osteoarthritis of the knee (knee OA) is a major cause of morbidity and disability as well as a burden on health-care resources, especially for the elderly. Knee OA is a slowly but progressive joint disease and is most common form of joint dysfunction and knee pain.The onset of knee OA is defined as having a Kellgren-Lawrence (K/L) classification grade 2 or higher, which is a severity classification of plain radiography. In recent years, attention has been focused on the pre-symptomatic pathology of early-stage knee OA.

Lipoproteins Cause Bone Resorption in a Mouse Model of Staphylococcus aureus Septic Arthritis.

Septic arthritis, most often caused by Staphylococcus aureus, is a rapidly progressive and destructive joint disease with substantial mortality and morbidity. Staphylococcus aureus lipoproteins (Lpps) are known to induce arthritis and bone destruction. Here, we aimed to investigate the bone resorptive effect of S. aureus Lpps in a murine arthritis model by intra-articular injection of purified S. aureus Lpps, synthetic lipopeptides, and live S. aureus strains. Analyses of the bone mineral density (BMD) of the distal femur bone were performed. Intra-articular injection of both live S. aureus and purified S. aureus Lpps were shown to significantly decrease total- and trabecular BMD. Liquid chromatography–mass spectrometry analyses revealed that the Lpps expressed by S. aureus SA113 strain contain both diacyl and triacyl lipid moieties. Interestingly, synthetic diacylated lipopeptide, Pam2CSK4, was more potent in inducing bone resorption than synthetic triacylated lipopeptide, Pam3CSK4. Modified lipoproteins lacking the lipid moiety were deprived of their bone resorptive abilities. Monocyte depletion by clodronate liposomes fully abrogated the bone resorptive capacity of S. aureus lipoproteins. Our data suggest that S. aureus Lpps induce bone resorption in locally-induced murine arthritis, an effect mediated by their lipid-moiety through monocytes/macrophages.

Effectiveness of intra-articular hyaluronic acid versus corticosteroids in knee osteoarthritis: a comparative study

<p class="abstract"><strong>Background:</strong> Osteoarthritis (OA) is the largest cause of disability worldwide and the most common cause of knee discomfort. OA is a chronic, progressive joint disease marked by articular cartilage deterioration and secondary hyperosteogeny. OA affects 35 percent of those over the age of 65 and produces considerable pain in the knee joint. The patient with OA not only suffers from chronic pain, stiffness, and reduced movement, physical and/or mental co-morbidity, but also has a direct impact on their quality of life.</p><p class="abstract"><strong>Methods:</strong> 72 patients with symptomatic osteoarthritis of unilateral knee joint (pain >3 months) were included in the present study. They were randomly divided into two groups; group A (n=36) included patients who were given intra-articular injection hyaluronic acid and group B (n=36) included those who were given intra-articular corticosteroid injection. All the data was compared both within the group as well as with one another at different follow up time.<strong></strong></p><p class="abstract"><strong>Results:</strong> There was no significant difference in the basic demographic distribution in both groups. Female sex predilection was seen in the present study. In patients receiving hyaluronic acid (HA), mean baseline visual analog scale (VAS) score was noted to be 7.45±1.4. Then at 2 weeks, 6 weeks, 3 months and 6 months follow up the mean VAS score was 3.4±1.3, 2.78±1.1, 3.71±1.4 and 3.90±1.2; p<0.05).</p><p class="abstract"><strong>Conclusions:</strong> Steroids provide an acute symptomatic relief but their benefits are short lasting. On the other hand, HA provides long lasting therapeutic pain relief.</p>

EDUKASI ACTIVITY DAILY LIVING PADA PENDERITA OSTEOARTHRITIS KNEE DI KELURAHAN TALANG BANJAR

ABSTRACT 
 Osteoarthritis is a progressive degenerative joint disease in which the cartilage that protects the ends of the bones begins to break down, causing pain and loss of mobility. Osteoarthritis is one of the complaints that can be treated by physiotherapy. Physiotherapy program in education activity daily living osteoarthritis aims to improve functional abilities so that they can carry out activities as usual, reduce impairment and improve function, protect joints from further damage. Activity daily living education for knee osteoarthritis includes stretching exercises, flexibility exercises, and osteoarthritis exercises. The method of community service activities is carried out using the lecture method, and asking questions about osteoarthritis, then distributing leaflets. The results of this educational activity are very useful for people with osteoarthritis of the knee, when given this exercise, mothers or the elderly feel happy because this activity is very useful for reducing their stiffness and pain complaints. The conclusion of this educational activity is that mothers who take part in the activity already understand exercises for osteoarthritis of the knee. 
 Keyword: Osteoarthritis Knee, Physiotherapy, Activity Daily Living

Itaconate attenuates osteoarthritis by inhibiting STING/NF-κB axis in chondrocytes and promoting M2 polarization in macrophages

Osteoarthritis (OA) is a progressive joint disease characterized by the degradation and destruction of articular cartilage, which is involved with pathological microenvironmental alterations induced by damaged chondrocytes and inflammatory macrophages. However, the current therapies cannot effectively alleviate the progression of OA. Our previous studies have shown that the pathological process of OA progression is accompanied by DNA damage, and inhibition of STING, a key molecule in DNA damage, may become a potential method for the treatment of OA. Itaconate, a metabolite highly expressed in macrophages under inflammatory conditions, has shown a wide range of anti-inflammatory effects, but its effect on OA and its underlying mechanism has not yet been studied. In this study, we found that exogenous supplementation of itaconate can activate Nrf2, and accordingly inhibit the STING-dependent NF-κB pathway, thereby alleviating the inflammation, ECM degeneration and senescence of chondrocytes stimulated by IL-1β. In addition, itaconate can regulate the polarization of RAW264.7 macrophages, further reducing the apoptosis of chondrocytes. In vivo, intra-articular injection of itaconate reduces the degradation of cartilage and inflammation of synovial membrane in the mouse OA model. In conclusion, the present work suggests that exogenous supplementation of itaconate inhibits the inflammation, senescence and ECM degeneration of chondrocytes through the Nrf2/STING/NF-κB axis and regulates the polarization of synovial macrophages, thereby ameliorating the progression of OA, which supports that itaconate as a potential drug for the treatment of OA.

Identification and development of the novel 7-genes diagnostic signature by integrating multi cohorts based on osteoarthritis

BackgroundA chronic progressive degenerative joint disease, such as osteoarthritis (OA) is positively related to age. The medical economy is facing a major burden, because of the high disability rate seen in patients with OA. Therefore, to prevent and treat OA, exploring the diagnostic biomarkers of OA will be of great significance.MethodsDifferentially expressed genes (DEGs) were obtained from the Gene Expression Omnibus database using the RobustRankAggreg R package, and a protein–protein interaction network was constructed. The module was obtained from Cytoscape, and the four algorithms of degree, MNC, closeness, and MCC in CytoHubba were used to identify the hub genes. A diagnostic model was constructed using Support Vector Machines (SVM), and the ability of the model to predict was evaluated by other cohorts.ResultsFrom normal and OA samples, 136 DEGs were identified, out of which 45 were downregulated in the normal group and 91 were upregulated in the OA group. These genes were associated with the extracellular matrix-receptor interactions, the PI3K-Akt signaling pathway, and the protein digestion and absorption pathway, as per a functional enrichment analysis. Finally, we identified the 7 hub genes (COL6A3, COL1A2, COL1A1, MMP2, COL3A1, POST, and FN1). These genes have important roles and are widely involved in the immune response, apoptosis, inflammation, and bone development. These 7 genes were used to construct a diagnostic model by SVM, and it performed well in different cohorts. Additionally, we verified the methylation expression of these hub genes.ConclusionsThe 7-genes signature can be used for the diagnosis of OA and can provide new ideas in the clinical decision-making for patients with OA.

Effectiveness of platelet-rich plasma in the treatment of grade 1 osteoarthritis of knee

Background: The most common cause of arthritis of the knee is degenerative osteoarthritis (OA) which is one of the leading causes of disability all over the world. Population which is at higher risk of osteoarthritis are elderly females, patients with obesity, and African Americans. This is a concerning factor for the advancement and different modalities of treatment for early diagnosis and early intervention in degenerative and progressive joint disease of the knee. As a recent advance in treatment platelet-rich plasma (PRP) infiltration has come to the limelight for its advantages over others.Purpose: To determine the effectiveness of platelet rich plasma in the treatment of grade 1 osteoarthritis of the knee.Methods: Patients at Vydehi institute of medical science and research centre, Bangalore with radiologically confirmed grade 1 osteoarthritis of the knee were included after adequate counseling and consent. They were evaluated and followed up with Visual Analogue Score (VAS) and International Knee Documentation Committee (IKDC) scores at the end of 6 months.Results: In a study of 100 patients with grade 1 osteoarthritis evaluated with Visual Analogue Score and International Knee Documentation Committee scoring at the end of 6 months with a mean score of 3.34 and 76.14 respectively. The study shows there is a positive correlation for the effectiveness of PRP in the treatment of grade 1 OA of the knee. Conclusion: PRP therapy is a simple, inexpensive, and minimally invasive intervention that is feasible to deliver in primary care to treat degenerative lesions of the articular cartilage of the knee. This therapy appears to have minimal associated adverse events and may have beneficial effects in terms of pain, health utility, patient satisfaction, and goal-orientated outcomes.

The Effect of Alcoholic Essence Satureja Sahandica Bornm L. on the Expression of Metalloproteinases 1, 2, 9 and 13 in a Model Similar to Osteoarthritis

Loss of the extracellular matrix of cartilage is one of the most important and prominent features of osteoarthritis (OA). The ECM has two important components, including the proteoglycan aggrecan and type II collagen, which are the main targets of MMPs and ADAM TSs enzymes. In this paper, the effect of ASSB Compared with dexamethasone and ibuprofen as representatives of steroidal and nonsteroidal anti-inflammatory drugs. One way to prevent irreversible joint damage in OA is to inhibit MMPs. ASSB can improve the condition of patients with osteoarthritis by reducing the expression of the MMPs 9 and 13 gene. <i>Background</i>: OA is a progressive joint disease characterized by cartilage degeneration, cartilage bone regeneration, and synovial membrane inflammation and is exacerbated with age. Given the side effects of conventional OA treatments, including nonsteroidal anti-inflammatory drugs and corticosteroids, it is important to consider new treatments for this disorder. Recently, the effect of matrix metalloproteinases on the pathogenesis of OA has been attracted attention. <i>Objective</i>: The aim of this paper was to evaluate the impact of Alcoholic Satureja Sahandica Bornem L. (ASSB) essence on inhibiting the expression of metalloproteinase gene 1, 2, 9 and 13 in bovine fibroblast-like synoviocytes stimulated by lipopolysaccharide as a model of osteoarthritis. <i>Methods</i>: Synovial cells were isolated from the articular cartilage of the radiocarpal joint of an 8-month-old Holstein cow. After determining the degree of toxicity by MTT Assay, the cells were exposed to stimulation of LPS without or in the presence of dexamethasone, ibuprofen and alcoholic Satureja Sahandica Bornem essence (ASSB). Metalloproteinase gene expression 1, 2, 9 and 13 were measured by RT-PCR and ELISA. The effect of ASSB on migration and cell invasion was investigated by Transwell chambers. <i>Results</i>: The results showed that Satureja Sahandica Bornm (SSB) essential oil significantly reduced the expression of metalloproteinases 9 and 12 in bovine fibroblast-like synovocytes stimulated by lipopolysaccharide. It also suppressed migration and invasion of these cells. However, Satureja Sahandica Bornm L. had no significant impact on the expression of MMPs 1 and 2. <i>Conclusion</i>: Based on our results, ASSB can significantly reduce the activity and inflammatory effect of MMPs 9 and 12 in OA, its potential role as a complement to NSAIDs and common corticosteroids was confirmed. However, cellular modeling does not confirm the beneficial effect of OA in patients.

Hemophilia: The Past, the Present, and the Future.

Hemophilia: The Past, the Present, and the Future.

Serum Amyloid A Correlates With the Osteonecrosis of Femoral Head by Affecting Bone Metabolism.

Osteonecrosis of femoral head (ONFH) is a progressive hip joint disease without disease-modifying treatment. Lacking understanding of the pathophysiological process of ONFH has become the humper to develop therapeutic approach. Serum amyloid A (SAA) is an acute phase lipophilic protein during inflammation and we found that SAA is increased for the first time in the serum of ONFH patients through proteomic studies and quantitatively verified by ELISA. Treating rBMSCs with SAA inhibited the osteogenic differentiation via Wnt/β-catenin signaling pathway deactivation and enhanced the adipogenic differentiation via MAPK/PPARγ signaling pathway activation. Finally, bilateral critical-sized calvarial-defect rat model which received SAA treated rBMSCs demonstrated reduction of bone formation when compared to untreated rBMSCs implantation control. Hence, SAA is a vital protein in the physiological process of ONFH and can act as a potential therapeutic target to treat ONFH.

Effect of nursing instructional guidelines on fatigue and pain associated with knee osteoarthritis

Background Knee osteoarthritis (KOA) is the most widespread type of arthritis and considered as the main health problem all over the world. It is a progressive degenerative joint disease that produces joint pain, declines the physical function, and leads to progression of disability. Therefore, nursing instructions are crucial to improve and enhance patient’s quality of life. The aim of the current study was to evaluate the effect of nursing instructional guidelines on fatigue and pain associated with KOA at a university hospital. Hypotheses H1–patients with KOA who receive nursing instructional guidelines will have significantly lower mean scores of fatigue compared with those who receive routine hospital care. H2–patients with KOA who receive nursing instructional guidelines will have significantly lower mean scores of related pain compared with those who receive routine hospital care. Design Pretest/posttest nonequivalent control group design was utilized to achieve the aim of the current study. Tools (a) Demographic and medical data form related to age, sex, level of education, family history of OA, type of KOA, BMI, etc.; (b) numerical pain rating scale; and (c) (SF-36) multidimensional assessment of fatigue scale were used for assessment. Setting The study was conducted at the medical and orthopedic departments in addition to the outpatient clinic at a university hospital in Egypt. Sample A purposive sample of 60 adult male and female patients was recruited over six consecutive months, who are diagnosed as having mild (stage 2) or moderate (stage 3) KOA and divided randomly into study and control groups; 30 patients in each group were recruited in the current study. Results It was found that 30% of the patients had an age from 50 to less than 60 years, with mean±SD of 50.83±9.97 years. Females were 90% in the study group and 83.3% in the control group. Moreover, 80% of the study group compared with 70% of the control group had grade II OA, with χ 2=3.21, P=0.91. There was no statistically significant difference regarding three pain readings in the study and control groups. However, there was marked difference in the mean±SD total related pain score between the study and control groups at the third pain reading (mean±SD=5.50±2.46 and 6.06±1.91, respectively). Moreover, there was a statistically significant difference over the three pain readings in the study group, as analysis of variance=32.56 and P=0.000, compared with an absence of a statistically significant difference over the three pain readings in the control group. There was a statistically significant difference in the third reading between study and control groups, as t test=3.9, as well as over the three fatigue readings in the study group, as analysis of variance=95.68 and P=0.000, compared with an absence of a statistically significant difference over the three fatigue readings in the control group. Conclusion Nursing instructional guidelines were effective in improving fatigue associated with KOA and reducing pain level. Recommendation Patients with KOA should be encouraged to follow nursing instructions through continuous health teaching to improve patient quality of care over the long term. Nursing implications: the instructional nursing guidelines could be applied in curriculum, nursing practice, and patients’ health.

Determination of Clinical Utility of Novel Biochemical Markers in Osteoarthritis

Introduction: Osteoarthritis is a progressive joint disease characterized by loss of articular cartilage, joint bone hypertrophy, subchondral sclerosis, and chemical and morphological alterations in the synovial membrane and joint capsule. Stiffness, soreness, and focused dislocation of the articular cartilage are changes in the disease seen at the last level of OA, as well as synovial inflammation. Pain is a common clinical symptom, especially after prolonged exercise and weight bearing, and stiffness occurs after inactivity. Biologic markers will also play an important role in the production and monitoring of new structure-modifying therapies for osteoarthritis due to their rapid changes in response to treatment.&#x0D; Aim: We conducted an observational study to estimate biochemical markers in the knee osteoarthritis patients who came to SMHRC Nagpur for a routine visit.&#x0D; Material and Methods: The study included 60 people who visited Shalinitai Meghe hospital in Nagpur for a health check-up. We were able to keep the two groups apart here. The control group is comprises of Healthy Volunteer, while the study group is made up Knee osteoarthritis patients. Each community consists of 30 patients. COMP, Endoglin, Osteopontin, Hs-CRP: all of these parameters were estimated by commercially available ELISA kit.&#x0D; Results: The levels of COMP, Endoglin, Osteopontin, and Hs-CRP in the study group were significantly higher than in the control group. In synovial fluid detection, endoglin levels in the sample group are not significantly higher than in the control group. Endoglin levels in the blood increase, as do other parameters.&#x0D; Conclusion: These findings show a significant increase in the systematic and local development of these biomarkers in the main OA of the knee, as well as the link between disease severity and its production, meaning that they may be involved in OA pathogenesis. Longitudinal studies with repetitive measurements of these biomarkers in plasma and synovial fluid and their interactions with knee pain OA are necessary to track or predict the clinical course of OA and, ultimately, determine their potential role in determining the best time to participate.

Correlation of Exercise Capacity with Functional Disability in Patients with Osteoarthritis of Knee

Introduction: Osteoarthritis of knee is a progressive joint disease which produces pain, inflammation and destruction of joint which in turn leads to range of motion limitation and walking disabilities. Affection in physical functioning is determined not only by just activities involving lower limb capacity but also by the activities which require use of upper extremities. Hence in this study, 6MWD and no. of rings moved in 6 minutes were taken as an outcome measures for determining the exercise capacity. KOOS is a self-administered questionnaire which was used in its cross culturally adapted format for determining the functional disability in patients. Objectives: 1. To study correlation of exercise capacity with functional disability in patients with osteoarthritis of knee. 2. To study correlation of upper limb exercise capacity with lower limb exercise capacity in patients with osteoarthritis of knee. Methods: Cross sectional, observational study including 30 patients of either gender having unilateral osteoarthritis of knee conducted in a tertiary care hospital. Results: No. of rings moved in 6 minutes and global KOOS score showed no statistically significant correlation. 6MWD and global KOOS score showed no statistically significant correlation. 6 minute walk distance and 6 minute peg board ring test showed no statistically significant correlation. Conclusion: The study suggests that there is no correlation of exercise capacity with functional disability in patients with osteoarthritis of knee. Also, there is no correlation found between upper limb exercise capacity and lower limb exercise capacity in patients with osteoarthritis of knee. KEY WORDS: Knee osteoarthritis, Knee pain, squat depth, functional disability, cardiorespiratory endurance, Knee Injury and Osteoarthritis Outcome Score, Quality of life.

Comparison of cooled and conventional radiofrequency applications for the treatment of osteoarthritic knee pain

Background and Aims:Osteoarthritis is a progressive degenerative joint disease that affects the joint cartilage and surrounding tissues. It has been determined that osteoarthritis-induced knee pain is the most common cause of physical disability in the elderly.Material and Methods:In this study, the genicular nerve RF treatments of patients with osteoarthritic knee pain conducted at the Sakarya University Training and Research Hospital in the algology clinic of the Anaesthesiology and Reanimation Department between January 2016 and December 2016 were retrospectively examined. The preoperative and postoperative 2nd, 6th, and 12th week visual analog scale (VAS) and Turkish validated Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were recorded. In addition, any complications after the treatment and side effects (bleeding, neurological damage, infection, etc.) were recorded in the file.Results:When the data of the patients were evaluated statistically, the preoperative VAS and WOMAC scores were found significantly decreased compared with the postoperative 2nd week, 6th week, and 12th week scores in patients who applied both conventional radiofrequency (RF) and cooled RF. However, there was no statistically significant difference between the two techniques.Conclusion:We found that both cooled and conventional RF techniques in genicular nerve ablation are similarly effective in reducing pain in patients with osteoarthritis-induced knee pain and improving patients’ physical functions. The complication rates are very low and there was no superiority to each other.

LPS induces fibroblast-like synoviocytes RSC-364 cells to pyroptosis through NF-κB mediated dual signalling pathway.

Rheumatoid arthritis (RA) is a chronic, progressive, and systemic inflammatory joint disease characterized by synovial inflammation and joint damage. Abnormal activation of fibroblast-like synoviocytes is an initial event of synovial inflammation and joint damage, which can significantly aggravate the progression of RA. Clinical studies have shown that synovitis may be associated with pyroptosis. Therefore, this study is mainly aim for exploring the underlying mechanisms of relationship between inflammation and pyroptosis during synovitis. A cell model of synovitis was constructed by stimulating synovial fibroblasts RSC-364 cells with lipopolysaccharide (LPS). In vitro, we found that LPS can induce pyroptosis of synovial fibroblasts through NOD-like receptor pyrin domain-3/caspase-1/gasdermin D and caspase-3/gasdermin E two signaling pathways, and these two signaling pathways can promote each other. In addition, NF-κB signaling pathway, as the upstream of these two pathways, is involved in regulating the pyroptosis of synovial fibroblast. These results suggest that pyroptosis may be triggered during the occurrence of RA. We hope to provide a new perspective for the study of RA and a new therapeutic target for clinical treatment of RA.

Glucosamine and Chondroitin Sulfate: Is There Any Scientific Evidence for Their Effectiveness as Disease-Modifying Drugs in Knee Osteoarthritis Preclinical Studies?-A Systematic Review from 2000 to 2021.

Simple SummaryOsteoarthritis is the most common progressive joint disease diagnosed in companion animals and its management continues to be a significant challenge. Nutraceuticals have been widely investigated over the years in the treatment of osteoarthritis and among them, glucosamine and chondroitin sulfate treatments are probably the most common therapies used in veterinary management. However, heterogeneous results were obtained among animal studies and the evidence of their efficacy is still controversial. Animal models have a crucial role in studying the histological changes and evaluating the therapy efficacy of different drugs. Consequently, we consider it may be of interest to evaluate the effectiveness of the most representative nutraceuticals in experimental animal studies of osteoarthritis. In this systematic review, we found a large inconsistency among the experimental protocols, but a positive cartilage response and biochemical modulation were observed in half of the evaluated articles, mainly associated with pre-emptive administrations and with some therapies’ combinations. Even though some of these results were promising, additional data are needed to draw solid conclusions, and further studies evaluating their efficacy in the long term and focusing on other synovial components may be needed to clarify their function.Glucosamine and chondroitin sulfate have been proposed due to their physiological and functional benefits in the management of osteoarthritis in companion animals. However, the scientific evidence for their use is still controversial. The purpose of this review was to critically elucidate the efficacy of these nutraceutical therapies in delaying the progression of osteoarthritis, evaluating their impact on the synovial knee joint tissues and biochemical markers in preclinical studies by systematically reviewing the last two decades of peer-reviewed publications on experimental osteoarthritis. Three databases (PubMed, Scopus and, Web of Science) were screened for eligible studies. Twenty-two articles were included in the review. Preclinical studies showed a great heterogeneity among the experimental designs and their outcomes. Generally, the evaluated nutraceuticals, alone or in combination, did not seem to prevent the subchondral bone changes, the synovial inflammation or the osteophyte formation. However, further experimental studies may be needed to evaluate their effect at those levels. Regarding the cartilage status and biomarkers, positive responses were identified in approximately half of the evaluated articles. Furthermore, beneficial effects were associated with the pre-emptive administrations, higher doses and, multimodality approaches with some combined therapies. However, additional studies in the long term and with good quality and systematic design are required.

Clinical efficacy of Curcuvet and Boswellic acid combined with conventional nutraceutical product: An aid to canine osteoarthritis.

IntroductionOsteoarthritis is a progressive degenerative joint disease which is high prevalent in dogs. In the late stage of the disease, it determines chronic neuropathic pain which leads to reduced quality-of-life in affected patients. To date it has not yet been identified a specific treatment, but it has been proved that nutraceutical and dietary supplements may play an important role in controlling inflammation and pain. The aim of this study was to evaluate, by the use of force plate gait analysis, the clinical efficacy of Boswellia and Curcuvet® combined with conventional nutraceutical therapy compared with conventional nutraceutical alone in dogs affected by osteoarthritis.Materials and methodsTwenty client-owned dogs, over 12 months old and 20 kg of body-weight, with a confirmed diagnosis of Osteoarthritis, were included in this randomized, double-blinded study. The dogs were randomly divided into two groups: the first group (A) received a conventional nutraceutical (consisted in a preparation of glucosamine, chondroitin sulfate, fish-oil containing 80% of omega 3-fatty acid, vitamin C and E, saccharomyces Cerevisiae) with a combination of acid boswellic and Curcuvet®, while the second group (B) received a conventional nutraceutical. All the enrolled dogs underwent a washout period before starting the treatment with nutraceuticals products which were the only admitted treatment over the study period. A full orthopaedic and neurologic examination, and force plate gait analysis were performed before starting the treatment, at 45, 90, and 60 days post-treatment. Ground reaction forces were recorded and analyzed.ResultsTwenty dogs were enrolled in the study. In both groups there was an increasing values of ground reaction forces. These results might indicate that both nutraceutical products determined a better condition in terms of pain feeling but that effect is much more visible after 60 days from the end of the administration in treated group.DiscussionIn conclusion Curcuvet in combination with Boswellic acid could be considered a valid aid in a multimodal treatment for canine osteoarthritis.