What Are Glucosamine And Chondroitin Sulfate?
Glucosamine and chondroitin sulfate are natural substances
found in and around the cells of cartilage. Researchers believe these
substances may help in the repair and maintenance of cartilage. In
addition, researchers believe that glucosamine inhibits inflammation
and stimulates cartilage cell growth, while chondroitin sulfate
provides cartilage with strength and resilience.
Chondroitin Sulfates are one of six glycosaminoglycans (GAGs),
formerly knows as mucopolysaccharides. They are composed of an amino
sugar, galactosamine (the immediate precursor of which is glucosamine),
and a sugar acid (glucuronic). CS are long chains of repeating
disaccharides that are sulfated. Two other GAGs are also sulfated,
keratan and dermatan. Sulfated GAGs have negative charges which cause
them to repel each other and attract water, which in turn fills space
in three dimensions and enables cartilage to absorb shock. The chains
of CS are much longer than the other sulfated GAGs. This is one of the
reasons some people feel that CS is the most important GAG. The second
way CS can be defined is as a dietary supplement in a new category
called chondroprotective nutraceuticals.
A systematic analysis of clinical trials on glucosamine and
chondroitin sulfate for treating osteoarthritis (OA) has shown that
these compounds may have some efficacy against the symptoms of this
most common form of arthritis, in spite of problems with trial
methodologies and possible biases. The study, by Timothy E. McAlindon,
D.M., and colleagues at the Boston University School of Medicine,
published in the March 15, 2000, issue of the Journal of the American
Medical Association (JAMA), recommends that additional, rigorous,
independent studies be done of these compounds to determine their true
efficacy and usefulness.
"About 21 million adults in the United States have OA," says Stephen
I. Katz, M.D., Ph.D., director of the National Institute of Arthritis
and Musculoskeletal and Skin Diseases (NIAMS), which funded this study
and has helped launch a major clinical trial on the compounds in OA,
along with the National Center for Complementary and Alternative
Medicine (NCCAM), both parts of the federal government's National
Institutes of Health (NIH). "Effective treatments are key to improving
the quality of life of Americans affected by this common disorder."
OA, also called degenerative joint disease, is caused by the
breakdown of cartilage, which cushions the ends of bones within the
joint. It is characterized by pain, joint damage, and limited motion.
It generally occurs later in life, and most commonly affects the hands
and large weight-bearing joints, such as the knees and hips.
The Boston researchers point out that glucosamine and chondroitin
sulfate have received significant media attention and have been used in
Europe for OA for over 10 years. The researchers say that physicians in
the United States and the United Kingdom have been skeptical about
these products, probably because of well-founded concerns about the
quality of scientific trials conducted to test them. Glucosamine and
chondroitin sulfate, which are sold in the United States as dietary
supplements, are natural substances found in and around the cells of
cartilage. Researchers believe these substances may help in the repair
and maintenance of cartilage.
In a double-blind, placebo-controlled trial of 119 patients with
osteoarthritis of the fingers, the group which received oral CS at 400
mg three times a day had no progression of osteoarthritis in their
fingers, unlike the placebo group, who had evidence of continuing
degeneration.
In a short trial, 24 patients with osteoarthritis were given CS in a
single dose of 800 mg daily for 10 days. Joint aspiration revealed an
increase in hyaluronic concentration and joint viscosity, and a
decrease in phospholipase A2, a marker of inflammation. Researchers
also stated that the CS group displayed a decrease in collagenolytic
activity. This paper demonstrated that oral administration of
chondroitin sulfate reaches target tissues (synovial fluid and
cartilage) at levels that can be objectively measured in less than two
weeks.
The effects of chondroitin sulfate-C on type II (CII) collagen -
induced arthritis in mice were evaluated. DBA/1J mice were immunized
with bovine CII emulsified in Freund's complete adjuvant, followed by a
booster injection 21 days later. Chondroitin sulfate-C at doses of 100,
300 and 1000 mg/kg was administered orally once daily beginning 14 days
before initial immunization. An arthritis index and hind paw edema were
examined from day 0 to day 49, when the mice were killed by ether
anesthesia for histopathological examination. The delayed-type
hypersensitivity (DTH) reaction, serum anti-CII antibody titer, and
histopathologic characteristics of both synovitis and destruction of
articular cartilage were analyzed. Both the arthritis index and the
serum anti-CII antibody titer were reduced by treatment with
chondroitin sulfate-C in a dose-dependent manner. Chondroitin sulfate-C
(1000 mg/kg) significantly inhibited hind paw edema, synovitis and
destruction of the articular cartilage, but not DTH reaction.
The signs and symptoms of osteoarthritis are common complaints seen
in patients suffering with chronic temporomandibular disorders (TMD),
specifically, internal derangements with a diagnosis of osteoarthritis.
With or without the complaints of pain and swelling, joint noises are
bothersome and annoying to both the patient and at times, to those
seated close to the patient during mealtime. In fact, many patients are
driven to seek care by family members because of his or her TMJ noises.
For years in veterinarian medicine, glucosamine and chondroitin
sulfates have been used to treat symptoms of osteoarthritis. Recently,
the use of these two supplements has been recommended for human beings
as well. Reports of decreased joint noises, pain and swelling after the
administration of therapeutic doses of these supplements have sparked
an interest in their possible use in the treatment of osteoarthritis.
This is an impressive set of studies which show that standing alone
CS can help patients suffering from osteoarthritis. Based on these
studies, oral ingestion of chondroitin sulfate is safe, well tolerated,
and is equally effective when taken all at once or in divided doses. It
appears that chondroitin sulfate helps patients in three ways: the
first being metabolic by increasing joint viscosity; the second is in
an antidegradative fashion by reducing collagenolytic activity; and the
third is by reducing inflammation, which was demonstrated in the Ronca
paper by showing decreased levels of phospholipase A2 in inflamed
joints. In turn, this leads to less pain, greater mobility and an
apparent retardation of joint space erosion.
Glucosamine and chondroitin sulfate are natural substances
found in and around the cells of cartilage. Researchers believe these
substances may help in the repair and maintenance of cartilage. In
addition, researchers believe that glucosamine inhibits inflammation
and stimulates cartilage cell growth, while chondroitin sulfate
provides cartilage with strength and resilience.
Chondroitin Sulfates are one of six glycosaminoglycans (GAGs),
formerly knows as mucopolysaccharides. They are composed of an amino
sugar, galactosamine (the immediate precursor of which is glucosamine),
and a sugar acid (glucuronic). CS are long chains of repeating
disaccharides that are sulfated. Two other GAGs are also sulfated,
keratan and dermatan. Sulfated GAGs have negative charges which cause
them to repel each other and attract water, which in turn fills space
in three dimensions and enables cartilage to absorb shock. The chains
of CS are much longer than the other sulfated GAGs. This is one of the
reasons some people feel that CS is the most important GAG. The second
way CS can be defined is as a dietary supplement in a new category
called chondroprotective nutraceuticals.
A systematic analysis of clinical trials on glucosamine and
chondroitin sulfate for treating osteoarthritis (OA) has shown that
these compounds may have some efficacy against the symptoms of this
most common form of arthritis, in spite of problems with trial
methodologies and possible biases. The study, by Timothy E. McAlindon,
D.M., and colleagues at the Boston University School of Medicine,
published in the March 15, 2000, issue of the Journal of the American
Medical Association (JAMA), recommends that additional, rigorous,
independent studies be done of these compounds to determine their true
efficacy and usefulness.
"About 21 million adults in the United States have OA," says Stephen
I. Katz, M.D., Ph.D., director of the National Institute of Arthritis
and Musculoskeletal and Skin Diseases (NIAMS), which funded this study
and has helped launch a major clinical trial on the compounds in OA,
along with the National Center for Complementary and Alternative
Medicine (NCCAM), both parts of the federal government's National
Institutes of Health (NIH). "Effective treatments are key to improving
the quality of life of Americans affected by this common disorder."
OA, also called degenerative joint disease, is caused by the
breakdown of cartilage, which cushions the ends of bones within the
joint. It is characterized by pain, joint damage, and limited motion.
It generally occurs later in life, and most commonly affects the hands
and large weight-bearing joints, such as the knees and hips.
The Boston researchers point out that glucosamine and chondroitin
sulfate have received significant media attention and have been used in
Europe for OA for over 10 years. The researchers say that physicians in
the United States and the United Kingdom have been skeptical about
these products, probably because of well-founded concerns about the
quality of scientific trials conducted to test them. Glucosamine and
chondroitin sulfate, which are sold in the United States as dietary
supplements, are natural substances found in and around the cells of
cartilage. Researchers believe these substances may help in the repair
and maintenance of cartilage.
In a double-blind, placebo-controlled trial of 119 patients with
osteoarthritis of the fingers, the group which received oral CS at 400
mg three times a day had no progression of osteoarthritis in their
fingers, unlike the placebo group, who had evidence of continuing
degeneration.
In a short trial, 24 patients with osteoarthritis were given CS in a
single dose of 800 mg daily for 10 days. Joint aspiration revealed an
increase in hyaluronic concentration and joint viscosity, and a
decrease in phospholipase A2, a marker of inflammation. Researchers
also stated that the CS group displayed a decrease in collagenolytic
activity. This paper demonstrated that oral administration of
chondroitin sulfate reaches target tissues (synovial fluid and
cartilage) at levels that can be objectively measured in less than two
weeks.
The effects of chondroitin sulfate-C on type II (CII) collagen -
induced arthritis in mice were evaluated. DBA/1J mice were immunized
with bovine CII emulsified in Freund's complete adjuvant, followed by a
booster injection 21 days later. Chondroitin sulfate-C at doses of 100,
300 and 1000 mg/kg was administered orally once daily beginning 14 days
before initial immunization. An arthritis index and hind paw edema were
examined from day 0 to day 49, when the mice were killed by ether
anesthesia for histopathological examination. The delayed-type
hypersensitivity (DTH) reaction, serum anti-CII antibody titer, and
histopathologic characteristics of both synovitis and destruction of
articular cartilage were analyzed. Both the arthritis index and the
serum anti-CII antibody titer were reduced by treatment with
chondroitin sulfate-C in a dose-dependent manner. Chondroitin sulfate-C
(1000 mg/kg) significantly inhibited hind paw edema, synovitis and
destruction of the articular cartilage, but not DTH reaction.
The signs and symptoms of osteoarthritis are common complaints seen
in patients suffering with chronic temporomandibular disorders (TMD),
specifically, internal derangements with a diagnosis of osteoarthritis.
With or without the complaints of pain and swelling, joint noises are
bothersome and annoying to both the patient and at times, to those
seated close to the patient during mealtime. In fact, many patients are
driven to seek care by family members because of his or her TMJ noises.
For years in veterinarian medicine, glucosamine and chondroitin
sulfates have been used to treat symptoms of osteoarthritis. Recently,
the use of these two supplements has been recommended for human beings
as well. Reports of decreased joint noises, pain and swelling after the
administration of therapeutic doses of these supplements have sparked
an interest in their possible use in the treatment of osteoarthritis.
This is an impressive set of studies which show that standing alone
CS can help patients suffering from osteoarthritis. Based on these
studies, oral ingestion of chondroitin sulfate is safe, well tolerated,
and is equally effective when taken all at once or in divided doses. It
appears that chondroitin sulfate helps patients in three ways: the
first being metabolic by increasing joint viscosity; the second is in
an antidegradative fashion by reducing collagenolytic activity; and the
third is by reducing inflammation, which was demonstrated in the Ronca
paper by showing decreased levels of phospholipase A2 in inflamed
joints. In turn, this leads to less pain, greater mobility and an
apparent retardation of joint space erosion.
- G. Douglas Andersen, Dynamic Chiropractic - Chondroitin Sulfate Research Update 1999
- McAlindon
TM, LaValley MP, Gulin JP, Felson DM. Glucosamine and Chondroitin
Sulfate for Treatment of Osteoarthritis: A Systematic Quality
Assessment and Meta-analysis. JAMA. 2000;283:1469-1475. Accompanying
editorial: Towheed TE, Tassos PA. Glucosamine and Chondroitin for
Treating Symptoms of Osteoarthritis: Evidence is Widely Touted but
Incomplete. JAMA. 2000;283:1483-4. - Vergruggen G, et al.
Chondroitin sulfate: structure/disease modifying antiarthritis drug in
the treatment of finger joint OA. Osteoarthritis and Cartilage
1998;6(A) :37-8. - Ronca F, et al. Anti-inflammatory activity of chondroitin sulfate. Osteoarthritis and Cartilage 1998;69(A):14-21.
- Omata
T, Itokazu Y, Inoue N, Segawa Y. Effects of chondroitin sulfate-C on
articular cartilage destruction in murine collagen-induced arthritis.
Arzneimittelforschung 2000 Feb;50(2):148-53 - Shankland WE
2nd - The effects of glucosamine and chondroitin sulfate on
osteoarthritis of the TMJ: a preliminary report of 50 patients. Cranio
1998 Oct;16(4) :230-5
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