Degenerative and Glucosamine...

The paper “Enhanced and Coordinated in Vivo Expression of Inflammatory Cytokines and Nitric Oxide Synthase by Chondrocytes from Patients with Osteoarthritis” was quite interesting because it compared the inflammatory activity at arthritic joints from two sources—the synovial membrane and the cartilage within the joint. The paper divides the four test arthritises, rheumatic, psoriatic, osteoarthritis and traumatic knee arthritis into two groups of arthritic disease—inflammatory (RA and PsA) and degenerative (traumatic and OA). One small point that caught my eye was the concluding sentence of the paper “both inflammatory and so-called degenerative arthropathies” (2173). It caught my eye because for one it seemed very out of tone with the rest of the paper. However, I decided to look into the degenerative classification. One article I found, the “International Symposium on ‘Joint Failure’: Recent Advances in Osteoarthritis and related Disorders,” commented that “the term ‘degenerative’ implied irreversible pathological changes” and the fact that cartilage used to be seen as a metabolically dead tissue gives rise to the idea that osteoarthritis is a degenerative disease. However, as we know cartilage and chrondocytes is very metabolically active and I thought it was interesting that “matrix synthesis is osteoarthritic joints is actually greater than in normal joints and increases with the severity of the disease”

On a different note, when I was surfing the net about osteoarthritis, a site with health supplements to reduce osteoarthritic symptoms came up. Glucosamine is currently classified in the US strictly as a health supplement. It is said to be affective due to its anti-inflammatory effects, stimulation of proteoglycan synthesis and by decreasing the metabolic activity of chrondocytes. However its drug trial history has given opposing and contradictory results, also it should be note initial trials were sponsored by the paten holder of the drug—interestingly enough the initial trials were all reported successful. While the drug is medically approved for use in Europe, it is still undergoing testing and trial by the National Health Institute in the US. The trial mentioned in an article online is called Glucosamine/chondroitin Arthritis Intervention Trial (GAIT). I think it is interesting that the paper we read commented that the “succession of events in the pathogenesis of OA” is elusive yet drugs are being researched and used without really knowing the ramifications since the actual pathway within the body is still relatively unknown.

”International Symposium on ‘Joint Failure’: Recent Advances in Osteoarthritis and related Disorders” British Journal of Rheumatology

http://rheumatology.oxfordjournals.org/cgi/reprint/23/3/166.pdf

Efficacy of Glucosamine and Chondroitin Sulfate May Depend on Level of Osteoarthritis Pain

http://www.nih.gov/news/pr/feb2006/nccam-22.htm