scholarly journals The Effects of Morus alba and Acacia catechu on Quality of Life and Overall Function in Adults with Osteoarthritis of the Knee

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Douglas S. Kalman ◽  
Susan J. Hewlings
Keyword(s):  
Cartilage Damage ◽  
Type Ii Collagen ◽  
Cartilage Degradation ◽  
Morus Alba ◽  
Osteoarthritis Of The Knee ◽  
Significant Difference ◽  
Womac Questionnaire ◽  
Acacia Catechu ◽  
Double Blinded ◽  
And Function

The purpose of this study was to determine the effects of UP1306 on discomfort and function in adults with osteoarthritis of the knee. In a randomized, double-blinded, placebo-controlled, parallel design, 135 subjects received UP1306, a standardized, proprietary extract of Morus alba and Acacia catechu, glucosamine chondroitin, or placebo for 12 weeks. Discomfort, stiffness, and activities of daily living measured by the WOMAC questionnaire and VAS (pain/discomfort) were improved within all groups. Range of motion and distance walked were improved. There were no changes in TNFα levels for any of the products. There was a significant difference in urinary C-telopeptides of type II collagen (CTX-II), a marker of cartilage degradation between UP1306, and placebo after 12 weeks (p=0.029). All efficacy measurements were improved from baseline to most time-points for UP1306, the comparator, and placebo without a significant association between the products. There was a significant difference between the changes of uCTX-II for UP1306 and placebo after 12 weeks. Early intervention with UP1306 aimed at reducing bone and cartilage degradation through reported inhibition of catabolic proinflammatory pathways may help to prevent joint cartilage damage. This study is registered with Clinical Trial ID ISRCTN15418623.

scholarly journals INTRAARTICULAR EPSILON AMINOCAPROIC ACID VERSUS TRANEXAMIC ACID IN TOTAL KNEE ARTHROPLASTY

2021 ◽  
Vol 29 (6) ◽  
pp. 312-315
Author(s):  
JOAO PAULO FERNANDES GUERREIRO ◽  
JOSE RODOLFO MARTINES BALBINO ◽  
BRUNO POSSANI RODRIGUES ◽  
MARCUS VINICIUS DANIELI ◽  
ALEXANDRE OLIVEIRA QUEIROZ ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Aminocaproic Acid ◽  
Osteoarthritis Of The Knee ◽  
Significant Difference ◽  
Total Knee ◽  
Double Blinded ◽  
Epsilon Aminocaproic Acid

ABSTRACT Objective: To examine and compare the clinical efficacy of intraarticular epsilon aminocaproic acid (EACA) and tranexamic acid (TXA) in total knee arthroplasty (TKA). Methods: This study was a prospective, single-center, double-blinded randomized controlled trial, including sixty patients with osteoarthritis of the knee divided into two groups of 30 patients. In the TXA group, 1 g of TXA (0.05 g/ml) was applied intraarticularly, and in the EACA group, 4 g of EACA (0.2 g/ml) was applied intraarticularly. Serum hemoglobin (Hgb) and hematocrit (Htb) were measured during the preoperatively and 24 and 48 hours postoperatively. The range of motion and pain were evaluated by clinical examination. To evaluate knee function before and 2 months after surgery, the Western Ontario and McMaster Universities Index (WOMAC) questionnaire was used. Results: In total, 56 (93.3%) patients were evaluated up to the second postoperative month. No significant difference between the groups (p > 0.05) was found in the decrease in Hgb or Htb at 24 or 48 hours. Regarding assessment of the pain, WOMAC score and gain in knee flexion, no significant advantages up to 60 days after surgery (p > 0.05) were found. Conclusions: The decrease in Hgb and Htb during the first 48 hours postoperatively and the risk of transfusion were similar with the intraarticular use of 1 g of TXA and 4 g of EACA in TKA. The possible benefits regarding knee pain, gain in flexion and function were also similar for the two drugs. Level of Evidence II, Randomized, Double-Blinded, Single-Centre, Prospective Clinical Trial.

scholarly journals IL-1β Damages Fibrocartilage and Upregulates MMP-13 Expression in Fibrochondrocytes in the Condyle of the Temporomandibular Joint

2019 ◽  
Vol 20 (9) ◽  
pp. 2260 ◽  
Author(s):  
Hessam Tabeian ◽  
Beatriz F. Betti ◽  
Cinthya dos Santos Cirqueira ◽  
Teun J. de Vries ◽  
Frank Lobbezoo ◽  
...  
Keyword(s):  
Gene Expression ◽  
Temporomandibular Joint ◽  
Mechanical Loading ◽  
Cartilage Damage ◽  
Cartilage Degradation ◽  
Mechanical Stimuli ◽  
Condylar Cartilage ◽  
Catabolic Enzymes ◽  
Mechanical Tensile ◽  
And Function

The temporomandibular joint (TMJ), which differs anatomically and biochemically from hyaline cartilage-covered joints, is an under-recognized joint in arthritic disease, even though TMJ damage can have deleterious effects on physical appearance, pain and function. Here, we analyzed the effect of IL-1β, a cytokine highly expressed in arthritic joints, on TMJ fibrocartilage-derived cells, and we investigated the modulatory effect of mechanical loading on IL-1β-induced expression of catabolic enzymes. TMJ cartilage degradation was analyzed in 8–11-week-old mice deficient for IL-1 receptor antagonist (IL-1RA−/−) and wild-type controls. Cells were isolated from the juvenile porcine condyle, fossa, and disc, grown in agarose gels, and subjected to IL-1β (0.1–10 ng/mL) for 6 or 24 h. Expression of catabolic enzymes (ADAMTS and MMPs) was quantified by RT-qPCR and immunohistochemistry. Porcine condylar cells were stimulated with IL-1β for 12 h with IL-1β, followed by 8 h of 6% dynamic mechanical (tensile) strain, and gene expression of MMPs was quantified. Early signs of condylar cartilage damage were apparent in IL-1RA−/− mice. In porcine cells, IL-1β strongly increased expression of the aggrecanases ADAMTS4 and ADAMTS5 by fibrochondrocytes from the fossa (13-fold and 7-fold) and enhanced the number of MMP-13 protein-expressing condylar cells (8-fold). Mechanical loading significantly lowered (3-fold) IL-1β-induced MMP-13 gene expression by condylar fibrochondrocytes. IL-1β induces TMJ condylar cartilage damage, possibly by enhancing MMP-13 production. Mechanical loading reduces IL-1β-induced MMP-13 gene expression, suggesting that mechanical stimuli may prevent cartilage damage of the TMJ in arthritic patients.

Serum Levels of Coll2-1, a Specific Biomarker of Cartilage Degradation, Are Not Affected by Sampling Conditions, Circadian Rhythm, and Seasonality

Cartilage ◽  
2019 ◽  
pp. 194760351987848 ◽  
Author(s):  
Anne-Christine Hick ◽  
Misch Fonck ◽  
Bérénice Costes ◽  
Elisabeth Cobraiville ◽  
Sébastien Pirson ◽  
...  
Keyword(s):  
Circadian Rhythm ◽  
Healthy Subjects ◽  
Type Ii Collagen ◽  
Serum Levels ◽  
Cartilage Degradation ◽  
Blood Collection ◽  
Knee Oa ◽  
Significant Difference ◽  
Collection Tube ◽  
Study Type

Objective: To assess intraindividual biological variability of serum cartilage specific biomarker Coll2-1 and define the best standardized conditions for blood sampling. Design: Blood samples were taken from 116 subjects with knee osteoarthritis (OA) at a single time point (PRODIGE study) and from 15 healthy subjects under various conditions, including fasting condition, sampling time and season, blood treatment, and type of blood collection tube (COVAR study). Type II collagen-specific biomarker Coll2-1 was directly measured in serum using an immunoassay. Results: There was no significant difference on Coll2-1 values between samples collected at any of the 5 sampling times or at any of the sampling days measured. None of the sampling parameters tested had a significant impact on Coll2-1 value (clotting time, clotting temperature and temperature of blood centrifugation, type of tube). On the contrary, differences were found in between subjects and between subjects with knee OA and healthy subjects. Conclusion: Coll2-1 measurement is not affected by sampling specific conditions, circadian rhythm or seasons but was found elevated in subject with knee OA indicating that Coll2-1 serum variation is not linked to the study environment, but to cartilage degradation in OA. Coll2-1 assay is sufficiently robust for use in OA clinical trials.

scholarly journals A COMPARATIVE CLINICAL STUDY TO EVALUATE THE EFFICACY OF ABHA GUGGULU AND YOGARAJA GUGGULU IN JANU SANDHIGATA VATA

2021 ◽  
Vol 9 (9) ◽  
pp. 1943-1950
Author(s):  
Archana B.H. Jadav ◽  
Susheel Shetty
Keyword(s):  
Clinical Trial ◽  
Statistical Difference ◽  
Structure And Function ◽  
The Body ◽  
Osteoarthritis Of The Knee ◽  
Basic Character ◽  
Significant Difference ◽  
Comparative Clinical Study ◽  
And Function ◽  
Single Blind

Mobility is the basic character of life that depends on the structural as well as the functional character of the body. As age advances, while proper nutrition is not available, the body loses its qualitative capacity for structure and function. Janu Sandhigata Vata has been explained classically by Acharyas and its lakshanas are Vata Poorna- dhrithi Sparsha, Sandhi Shotha, Sandhi Shoola and the presence of Vedana during Prasarana and Aakunchana. The lakshanas of Janu Sandhigata Vata is found to be congruent with Osteoarthritis of the Knee. Research statis- tics have shown that in India, 22% of the population shows Osteoarthritis and females slightly dominate in the incidence. Abha Guggulu and Yogaraja Guggulu are two formulations that contain the drugs of Vatahara, Shothahara, Vedanasthapaka property which will help in the management of Janu Sandhigata Vata. Methods: It was a single-blind randomized comparative clinical trial. The study was conducted on 40 subjects for 30 days. Observations were analyzed and findings were evaluated by using statistical methods. Results: The severity of symptoms markedly reduced in both the groups which is statistically significant and on comparing the effect be- tween Abha Guggulu and Yogaraja Guggulu, there was no statistical difference obtained. Conclusion: The result suggests that both Abha Guggulu and Yogaraja Guggulu had a significant effect on Janu Sandhigata Vata There was no significant difference in the effect of Abha Guggulu and Yogaraja Guggulu. Keywords: Janu Sandhigata Vata, Abha Guggulu, Yogaraja Guggulu

scholarly journals Assessment of the Response Profile to Hyaluronic Acid Plus Sorbitol Injection in Patients with Knee Osteoarthritis: Post-Hoc Analysis of a 6-Month Randomized Controlled Trial

Biomolecules ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1498
Author(s):  
Olivier Bruyère ◽  
Germain Honvo ◽  
Eduard Vidovic ◽  
Bernard Cortet
Keyword(s):  
Hyaluronic Acid ◽  
Physical Function ◽  
Response Rate ◽  
Controlled Trial ◽  
Womac Pain ◽  
Knee Oa ◽  
Intention To Treat ◽  
Womac Questionnaire ◽  
Double Blinded ◽  
And Function

In a previous randomized trial, the non-inferiority of two hyaluronic acid injections (Synolis VA versus Synvisc-One) was assessed in patients with knee OA, with a response rate of 79% for Synolis VA. To assess whether a responder profile could be established for this treatment modality, we used the Synolis VA arm of a published 6-month prospective, multicenter, comparative, randomized, double-blinded trial. At baseline and during the study, pain and function were assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Ninety-six subjects from the intention-to-treat trial were included in the analysis. The 6-month change of WOMAC Pain with Synolis VA was not associated with any baseline clinical data. However, the change in WOMAC Function was significantly associated with its baseline level, even after adjustment for potential confounding variables (p = 0.028), i.e., a poorer physical function at baseline was associated with a better response. In conclusion, in addition to the high absolute response rate to Synolis VA, the probability of success is even increased if administered in patients with more limited physical function at baseline. Further research with other potential confounding clinical variables is warranted in order to better applicate the concept of personalized medicine.

scholarly journals Discovery and Characterization of a Novel Inhibitor of Matrix Metalloprotease-13 That Reduces Cartilage Damage in Vivo without Joint Fibroplasia Side Effects

2007 ◽  
Vol 282 (38) ◽  
pp. 27781-27791 ◽  
Author(s):  
Adam R. Johnson ◽  
Alexander G. Pavlovsky ◽  
Daniel F. Ortwine ◽  
Faith Prior ◽  
Chiu-Fai Man ◽  
...  
Keyword(s):  
Side Effects ◽  
Cartilage Damage ◽  
Type Ii Collagen ◽  
Selective Inhibition ◽  
Cartilage Degradation ◽  
Zinc Ion ◽  
Structural Protein ◽  
Structure Based Drug Design ◽  
Mmp Inhibitors

Matrix metalloproteinase-13 (MMP13) is a Zn2+-dependent protease that catalyzes the cleavage of type II collagen, the main structural protein in articular cartilage. Excess MMP13 activity causes cartilage degradation in osteoarthritis, making this protease an attractive therapeutic target. However, clinically tested MMP inhibitors have been associated with a painful, joint-stiffening musculoskeletal side effect that may be due to their lack of selectivity. In our efforts to develop a disease-modifying osteoarthritis drug, we have discovered MMP13 inhibitors that differ greatly from previous MMP inhibitors; they do not bind to the catalytic zinc ion, they are noncompetitive with respect to substrate binding, and they show extreme selectivity for inhibiting MMP13. By structure-based drug design, we generated an orally active MMP13 inhibitor that effectively reduces cartilage damage in vivo and does not induce joint fibroplasias in a rat model of musculoskeletal syndrome side effects. Thus, highly selective inhibition of MMP13 in patients may overcome the major safety and efficacy challenges that have limited previously tested non-selective MMP inhibitors. MMP13 inhibitors such as the ones described here will help further define the role of this protease in arthritis and other diseases and may soon lead to drugs that safely halt cartilage damage in patients.

scholarly journals Comparison of the Efficacy between Conventional Moxibustion and Smoke-Free Moxibustion on Knee Osteoarthritis: A Randomized Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Ling Luo ◽  
Mo Liao ◽  
Jia-xi Peng ◽  
Qi Ma ◽  
Jian-ying Zhou ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Controlled Trial ◽  
Womac Score ◽  
Acupuncture Points ◽  
Osteoarthritis Of The Knee ◽  
Randomized Controlled ◽  
Parallel Group ◽  
Significant Difference ◽  
The Difference ◽  
And Function

Objective. The aim of this study was to investigate the difference of efficacy between conventional moxibustion (CM) and smoke-free moxibustion (SM) for patients with osteoarthritis of the knee (KOA). Methods. This is a multicentre, randomized, single blinded, parallel-group clinical trial. Patients with KOA were randomly allocated to CM group (69) and SM group (69) in 7 hospitals of China. Moxibustion treatment in 12 sessions over 4 weeks was administrated at 3 acupuncture points (EX-LE4, ST35, and ST36). Patients completed standard questionnaires at baseline and after 2 weeks, 4 weeks, 8 weeks, and 12 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) from the baseline to 4 weeks. The secondary outcomes include Visual Analogue Scale (VAS) and Patient Global Assessment score (PGA). Results. Analyses showed that the WOMAC score improved in pain (95% CI,-0.1[-1.2 to 0.9], p=0.76), stiffness (95% CI,-0.1 [-0.5 to 0.3], p=0.71), and function (95% CI, 2.2 [-1.3 to 5.8], p=0.22) compared between the two groups at 4 weeks, as well as the VAS score (95% CI,0.1 [-0.3 to 0.6], p=0.60). Similar results presented at 8 and 12 weeks. No statistically significant difference was observed between CM and SM groups for outcome measurements. Conclusions. It suggested that smoke generated during moxibustion treatment does not affect the efficacy of moxibustion in the treatment of KOA, which should be taken into account to be removed for the sake of reducing environmental pollution or moxa smoke exposure of acupuncturists or patients. This trial is registered with Clinical Trials.gov, NCT02772055.

scholarly journals Effect of Electro-acupuncture (EA) and Manual Acupuncture (MA) on Markers of Inflammation in knee osteoarthritis

2019 ◽  
Author(s):  
Guang-Xia Shi ◽  
Tian-Qi Wang ◽  
Jing-Wen Yang ◽  
Jian-Feng Tu ◽  
Li-Qiong Wang ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Matrix Protein ◽  
Cartilage Degradation ◽  
Inflammatory Factors ◽  
Manual Acupuncture ◽  
Markers Of Inflammation ◽  
Tnf Α ◽  
Significant Difference ◽  
And Function ◽  
And Cartilage

Abstract Background Inflammation plays a significant role in the pathogenesis of knee osteoarthritis (KOA). Although both Electro-acupuncture (EA) and Manual Acupuncture (MA) are known to influence systemic inflammation, little is known about the potential changes in inflammation as a working mechanism of EA and MA in KOA.Methods Data from the Acupuncture for Knee Osteoarthritis Trial (ATKOA) were used. Serum concentrations of inflammatory factors (tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, IL-8, IL-18, IL-4, IL-10,IL-13,IL-15, IL-17, monocyte chemotactic protein-1 (MCP-1), CC­chemokine ligand 5 (CCL5), and cartilage degradation biomarkers (matrix metalloproteinase-1 MMP-1, MMP-3, MMP-13 and cartilage oligomeric matrix protein COMP) were measured at baseline and after 8 weeks of treatment. Clinical outcomes were valid and reliable self-reported pain and function measures for osteoarthritis using the Western Ontario and McMasters osteoarthritis index questionnaire (WOMAC) and Visual Analogue Scale (VAS) at baseline and post-treatment.Results Both 8-weeks EA and MA significantly reduced pro-inflammatory cytokines (TNFα, IL-1β) and cartilage degradation biomarkers (MMP-3, MMP-13), significantly increased the anti-inflammatory cytokine IL-13 compared with pre-treatment (p<0.05). Further, the reduction of TNF-α were more significant in EA when compared to MA (p=0.046). While, there was no significant difference between groups in cytokines IL-1β (p=0.102), MMP-3(p=0.113), MMP-13(p=0.623) or IL-13(p=0.935). Moreover, in both EA and MA the effect of acupuncture on the VAS and WOMAC function scale after 8 weeks is clinically important, although no significant differences were found between groups.Conclusions 8 weeks of both EA and MA seem to provide improvement in pain relief and function among individuals with mild to moderate knee OA. This benefit is partly mediated by changes of major inflammatory factors TNF-α, IL-1β and IL-13.

scholarly journals Efficacy Comparison of Five Different Acupuncture Methods on Pain, Stiffness, and Function in Osteoarthritis of the Knee: A Network Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-19 ◽  
Author(s):  
Shaowei Li ◽  
Pingjin Xie ◽  
Zhenghui Liang ◽  
Weihan Huang ◽  
Zhanhui Huang ◽  
...  
Keyword(s):  
Physical Function ◽  
Meta Analysis ◽  
Splitting Method ◽  
Osteoarthritis Of The Knee ◽  
Womac Pain ◽  
Function Recovery ◽  
Significant Difference ◽  
Fire Needle ◽  
And Function ◽  
Physical Function Recovery

The principal objective of this present study was to compare the effects of different acupuncture methods on pain, stiffness, and physical function for osteoarthritis of the knee by the pairwise and network meta-analysis (NMA). A network meta-analysis of randomized controlled trials (RCTs) was searched from three English databases and one Chinese database until January 2018. A pairwise meta-analysis was performed with a random effects model. Then we carried out the NMA within a Bayesian framework. Mean difference (MD) and its 95% confidence interval (CI) were calculated by R 3.4.1, Stata 14.0, and RevMan 5.3 software to assess the relief of pain, the effectiveness for stiffness, and physical function recovery. Node-splitting method was used to calculate the inconsistency. Rank probabilities were assessed and clustered by the surface under the cumulative ranking curve (SUCRA). 16 trials mostly researched short-term effectiveness and showed that fire needle and electro-acupuncture were statistically significant to decrease WOMAC pain and physical function scores when compared with other treatments, but there was no significant difference in stiffness calculations. Our NMA demonstrated that acupuncture with heat pain or electrical stimulation might be suggested as the better choices in all acupuncture methods to osteoarthritis of the knee.

scholarly journals UP1306: A Composition Containing Standardized Extracts of Acacia catechu and Morus alba for Arthritis Management

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 272 ◽  
Author(s):  
Mesfin Yimam ◽  
Teresa Horm ◽  
Laura Wright ◽  
Ping Jiao ◽  
Mei Hong ◽  
...  
Keyword(s):  
Treatment Options ◽  
Cartilage Degradation ◽  
Morus Alba ◽  
Root Bark ◽  
Botanical Composition ◽  
Collagen Induced Arthritis ◽  
Arthritis Severity ◽  
Tnf Α ◽  
Acacia Catechu ◽  
Factor Α

Osteoarthritis (OA) is characterized by progressive articular cartilage degradation. Although there have been significant advances in OA management, to date, there are no effective treatment options to modify progression of the disease. We believe these unmet needs could be bridged by nutrients from natural products. Collagen induced arthritis in rats was developed and utilized to evaluate anti-inflammatory and cartilage protection activity of orally administered botanical composition, UP1306 (50 mg/kg) and Methotrexate (75 µg/kg) daily for three weeks. Objective arthritis severity markers, urine, synovial lavage, and serum were collected. At necropsy, the hock joint from each rat was collected for histopathology analysis. Urinary cartilage degradation marker (CTX-II), pro-inflammatory cytokines (tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), and IL-6), and proteases (Matrix Metallopeptidase 3 (MMP3) and 13) were measured. Rats treated with UP1306 showed statistically significant improvements in arthritis severity markers, including uCTX-II (91.4% vs. collagen-induced arthritis (CIA)), serum IL-1β, TNF-α, and IL-6 levels as well as synovial MMP-13. The histopathology data were also well aligned with the severity score of arthritis for both UP1306 and Methotrexate. UP1306, a botanical composition that contains a standardized blend of extracts from the heartwood of Acacia catechu and the root bark of Morus alba, could potentially be considered as a dietary supplement product for the management of arthritis.

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