Nutraceutical Approach to Chronic Osteoarthritis: From Molecular Research to Clinical Evidence
Abstract
:1. Introduction
2. Methods
3. Nutraceuticals Used for the Prevention of Worsening and Management of OA
3.1. Glucosamine and Chondroitin
3.1.1. Mechanisms of Action
3.1.2. Efficacy and Safety
3.2. Methylsulfonylmethane
3.2.1. Mechanism of Action
3.2.2. Efficacy and Safety
3.3. Collagen
3.3.1. Mechanism of Action
3.3.2. Efficacy and Safety
3.4. Hyaluronic Acid
3.4.1. Mechanism of Action
3.4.2. Efficacy and Safety
3.5. Vitamin C
3.5.1. Mechanism of Action
3.5.2. Efficacy and Safety
3.6. Vitamin D
3.6.1. Mechanism of Action
3.6.2. Efficacy and Safety
3.7. Other Promising Nutraceuticals
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Nutraceutical | Tested Daily Dose | Molecular Mechanism of Actions | Effect on OA and Related Behavior | Ref. |
---|---|---|---|---|
Anthocyanins from pomegranate juice | 300–600 mg | IL-1β, TNF-α, CCR2, NF-κB, JNK-MAPK, ROS, NO, COX-2, PGE2 | ↓ VAS pain, WOMAC pain | [13] |
Avocado/soybean unsaponifiables | 300 mg | IL-1, IL-6, IL-8, and PGE2 | ↓ VAS pain, WOMAC pain, ↓ Analgesic and NSAIDs use | [14] |
Acetyl-keto-β-boswellic acid (AKBA) (from Boswellia serrata) | 150–250 mg (AKBA) | iNOS, NF-κB, COX, LOX | ↓ VAS pain, WOMAC pain | [15] |
Capsaicin (from Chili pepper) | 10 mg | TRPV1 agonist | ↓ VAS pain, WOMAC pain | [16] |
Chondroitin | 500–1500 mg | IL-1, IL-6, TNF-α, IL-1β, TGF-β MMPs,NF-κB, ROS formation, improve of proteoglycans, type II collagen and GAGs expression | ↓ VAS pain, WOMAC pain, stiffness, function and total, ↓ Analgesic and NSAIDs use | [17,18,19] |
Collagen | 4000–10000 mg | Cartilage regeneration by increasing the synthesis of macromolecules in the extracellular matrix, CTXII, MMP-13, T regulatory (Treg) modulation | ↓ VAS pain, WOMAC pain, stiffness, function and total | [20] |
Curcumin (from Curcuma longa) | 1000–3000 mg | IL-1β, TNF-α, NF-κB, COX-2, PGE2 | ↓ VAS pain, WOMAC pain, stiffness, function and total, ↓ Analgesic and NSAIDs use | [21] |
Epigallocatechin 3-gallate (from green tea) | 400–1000 mg | IL-1β, TNF-α, CCR2, NF-κB, JNK-MAPK, ROS, NO, COX-2, PGE2 | ↓ VAS pain, WOMAC pain | [22] |
Gingerols (from ginger) | 250–400 mg ginger (5% gingerols) | iNOS, NF-κB, TRPV1 agonist | ↓ VAS pain, WOMAC pain | [23,24] |
Glucosamine | 500–1500 mg | IL-1, IL-6, TNF-α, IL-1β, TGF-β MMPs,NF-κB, ROS formation, improve of proteoglycans, type II collagen and GAGs expression | ↓ VAS pain, WOMAC pain, ↓ Analgesic and NSAIDs use | [17,18,19] |
Hyaluronic acid | 80–200 mg | CD44 receptors, IL-1β, -6, -9, MMPs, PGE2, TNFα, RHAMM, TLR4, ICAM-1, Nf-kB | ↓ VAS pain, WOMAC pain, stiffness, function and total | [25] |
Methylsulfonylmethane | 500–1500 mg | NF-Κb, IL-1, IL-6, IL-1β, TNF-α ROS, COX | ↓ VAS pain, WOMAC pain, stiffness, function and total, ↑ SF-36 quality of life all eight domains including pain, ↑ Global patient and physician assessments of disease status | [26] |
Omega-3 (EPA and DHA) | 500–4500 mg (EPA + DHA) | NF-κB, COX | ↓ Mean WOMAC scores for pain, stiffness, and function, ↓ Analgesic and NSAIDs use, ↓ OA symptoms including morning stiffness, pain in hips and knees | [27,28] |
Pycnogenol | 100–200 mg | MMPs, COX-1, -2, NF-κB, ROS | ↓ VAS pain, WOMAC pain | [29] |
Vitamin C | 500–2000 mg | MMPs, ROS | ↓ VAS pain | [30] |
Vitamin D | 2000–60000 UI | Bone formation and mineralization, MMPs, osteoclast and osteoblast activity, VEGF | Unclear | [31,32] |
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Colletti, A.; Cicero, A.F.G. Nutraceutical Approach to Chronic Osteoarthritis: From Molecular Research to Clinical Evidence. Int. J. Mol. Sci. 2021, 22, 12920. https://doi.org/10.3390/ijms222312920
Colletti A, Cicero AFG. Nutraceutical Approach to Chronic Osteoarthritis: From Molecular Research to Clinical Evidence. International Journal of Molecular Sciences. 2021; 22(23):12920. https://doi.org/10.3390/ijms222312920
Chicago/Turabian StyleColletti, Alessandro, and Arrigo F. G. Cicero. 2021. "Nutraceutical Approach to Chronic Osteoarthritis: From Molecular Research to Clinical Evidence" International Journal of Molecular Sciences 22, no. 23: 12920. https://doi.org/10.3390/ijms222312920