Why extra glucosamine sulphate is needed when things
go wrong
Articular cartilage is one of the first tissues to age and has relatively
poor powers of regeneration because of the poor blood supply to the area,
even in a healthy animal/human. The delicate balance between wear
and renewal can be easily upset - a strain, a slip or fall, repeated heavy
use, poor nutrition, even bad conformation or (in the horse) hoof imbalance
through bad or irregular shoeing can start a cycle of events that will
lead to progressive degeneration of the joint.
The natural reaction of joints to a strain, injury or wear
and tear is to become inflamed, whether visibly so or not - a greater
amount of synovial fluid is produced (which is often of poorer quality)
and enzymes can be produced which actually degrade the cartilage and synovial
fluid (Stashak - 1995). This causes sustained, if not greater,
inflammation... a self perpetuating cycle leading to DJD in any animal
(and human) as the body cannot produce enough glucosamine to keep up to
the rate of repair and renewal that would be necessary. This is especially
true of an older animal with the slowing down of body systems that comes
with age.
How is Glucosamine sulphate used?
Glucosamine sulphate and chondroitin sulphate are used to relieve the
symptoms and help in the healing of Degenerative Joint Disease (DJD) -
osteoarthritis
This form of arthritis used to be thought of as a permanent,
gradually worsening condition affecting many animals (and people) as they
get older - an inevitable result of the ageing process coupled with wear
and tear on joints. In many ways this is true but many animal owners have
reported greatly improved mobility in their animals when fed Glucosamine
& Chondroitin. Human patients taking glucosamine report relief of
pain as well as improvements in mobility.
Glucosamine & Chondroitin how do they help?
Providing additional Glucosamine speeds up the repair and renewal of
damaged or worn articulating cartilage whilst additional Chondroitin helps
to neutralise the destructive enzymes and improve the quality of the synovial
fluid.
Supplementation of a combination of glucosamine and chondroitin - two
naturally occurring and essential substances - has been shown to be most
effective.
Since DJD, once started, is a permanent condition, the treatment is long
term - the animal (or human) must stay on the maintenance dose for the
rest of its life - the joint will revert back to its degenerative condition
if supplementation stops.
Many veterinary surgeons routinely inject Polysulfated Glycosaminoglycan
(chondroitin) directly into a DJD joint or one that has been operated
on and therefore will inevitably become degenerative. However, it can
also be given by intramuscular injection and, more importantly for the
average animal owner, orally - you can add glucosamine and chondroitin
to their food! The advantage of the latter being that all joints are treated,
not just the one injected (William
E Jones).
NEWS!
Recent UK field study scientifically proves the effectiveness of one particular
glucosamine supplement...
Cortaflex... in maintaining original stride
length and mobility.
Cortaflex can help maintain healthy joints and good joint mobility.
There have been other studies which have shown that, while injecting
locally into an affected joint gives the quickest improvement (almost
immediate!), there is no significant difference in the benefits gained
over oral administration of glucosamine and chondroitin after about 30
days. Giving a supplement by adding it daily to feed is, perhaps, more
reasonable than having an injection every month or so.
There is at least one major dog food manufacturer which
now produces a special dog food for older animals which contains Chondroitin
and Glucosamine and there are several brands of supplement on the market
which are designed to be added to normal food - these are available for
human, as well as equine and canine treatment.
Scientific evidence for glucosamine sulphate
Evidence there is that glucosamine is an effective treatment
for arthritis from the University of Oxford Clinical School Infomation
Management Services Unit
Conclusion/summary
"The bottom line is that there is a body of evidence supporting the
efficacy of oral and intramuscular glucosamine in arthritis."
A search of PubMed at the National Library of Medicine reveals
hundereds of scientific trials... here is a random selection...
Glucosamine
and chondroitin sulfates in the treatment of osteoarthritis: a survey
de los Reyes GC, Koda RT, Lien EJ.
Department of Pharmaceutical Sciences, School of Pharmacy, University
of Southern California, Los Angeles, CA 90089, USA.
For more than 30 years, non-steroidal anti-inflammatory drugs (NSAIDs)
have been used as standards in the treatment of osteoarthritis (OA). Serious
and often life-threatening adverse effects due to these agents are common.
Clinical findings have revealed that glucosamine sulfate and chondroitin
sulfate are effective and safer alternatives to alleviate symptoms of
OA. Experimental evidence indicates that these compounds and their
low molecular weight derivatives have a particular tropism for cartilage
where they serve as substrates in the biosynthesis of component building
blocks. This paper is a literature review of the chemistry, mechanism
of action, pharmacokinetics, clinical efficacy and safety of these two
nutraceuticals.
Publication Types:
Review
Review, Tutorial
PMID: 11127967 [PubMed - indexed for MEDLINE]
Effect
of glucosamine on interleukin-1-conditioned articular cartilage
Fenton JI, Chlebek-Brown KA, Caron JP, Orth MW.
Department of Animal Science, Michigan State University, East Lansing
48824, USA.
Glucosamine inhibits recombinant human interleukin-1 stimulated cartilage
degradation in equine cartilage explants. Recently, recombinant equine
interleukin-1 has been cloned and purified. Therefore, the objective of
this study was to characterise the effects of glucosamine on indices of
cartilage degradation in recombinant equine IL-1beta-stimulated equine
articular cartilage explants. Cartilage discs were harvested from the
weight-bearing region of the articular surface of the antebrachiocarpal
and middle carpal joints of horses (age 2-8 years) and cultured under
standard conditions. Explants were exposed to recombinant equine interleukin-1beta
(reIL-1beta) on Days 1-4 in the presence or absence of glucosamine (0.25,
2.5 or 25 mg/ml), with appropriate controls. Nitric oxide, prostaglandin
E2, sulphated proteoglycan, stromelysin and gelatinase/collagenase activity
released into conditioned media and total tissue proteoglycan content
were measured as indicators of cartilage catabolism. Glucosamine inhibited
cartilage catabolic responses in a dose dependent manner that was statistically
significant at a dose of 0.25 mg/ml for stromelysin activity and 2.5 mg/ml
for collagenase/gelatinase activity. At 25 mg/ml glucosamine also prevented
IL-1beta-induced increases in nitric oxide production, prostaglandin E2
and proteoglycan release to media. Glucosamine prevents equine articular
cartilage degradation experimentally induced by reIL-1beta in vitro. These
data provide further support for the use of glucosamine in treatment or
prevention of cartilage loss in athletic horses.
PMID: 12405690 [PubMed - indexed for MEDLINE]
Glucosamine
sulfate use and delay of progression of knee osteoarthritis: a 3-year,
randomized, placebo-controlled, double-blind study
Pavelka K, Gatterova J, Olejarova M, Machacek S, Giacovelli
G, Rovati LC.
Department of Medicine and Rheumatology, Charles University, Prague,
Czech Republic. pavelka@revma.cz
Over a three year period... 200 patients, 100 were given a supplement
containing glucosamine the other 100 were given a placeboand the results
monitored. Conclusion: Long-term treatment with glucosamine sulfate
retarded the progression of knee osteoarthritis, possibly determining
disease modification.
Glucosamine.
A nutraceutical in osteoarthritis
Phoon S, Manolios N.
Westmead Hospital, New South Wales.
BACKGROUND: Glucosamine is an amine-sugar that has been marketed as a
natural product for the treatment of osteoarthritis. It has been popularized
in the complementary section of pharmacies as a safe over-the-counter
treatment for osteoarthritic pain. OBJECTIVE: We review the literature
on the efficacy and safety of glucosamine in osteoarthritis. DISCUSSION:
Recent research suggests that it may not only provide symptomatic pain
relief, but may have a role in chondroprotection.
Publication Types:
Review
Review Literature
PMID: 12154601 [PubMed - indexed for MEDLINE]
Glucosamine
therapy compared to ibuprofen for joint pain
Ruane R, Griffiths P.
Primary Care and Community Pharmacy, King's College London.
To determine the effectiveness of oral glucosamine with ibuprofen for
the relief of joint pain in osteoarthritis a mini-review (Griffiths, 2002)
of double-blind randomized controlled trials comparing the two was undertaken.
The population was adult patients diagnosed with osteoarthritis at any
site. The outcome was arthritic pain reduction. Searches on Medline, Embase,
AMED, the Cochrane Library and the Merck index identified four trials.
Of these, two studies were obtainable and were included in the review.
Both compared 1.2 g ibuprofen daily with 1.5 g glucosamine sulphate daily,
in three divided doses. The combined number of participants in the studies
was 218. The results of these studies showed glucosamine to be of similar
efficacy to ibuprofen. The conclusion is that glucosamine is effective
in relieving joint pain associated with osteoarthritis. Glucosamine's
pain-relieving effects may be due to its cartilage-rebuilding properties;
these disease-modifying effects are not seen with simple analgesics and
are of particular benefit. In practice glucosamine can be used as an alternative
to anti-inflammatory drugs and analgesics or as a useful adjunct to standard
analgesic therapy.
Publication Types:
Review
Review Literature
PMID: 11904551 [PubMed - indexed for MEDLINE]
Glucosamine
sulfate in osteoarthritis of the knee
Noack W, Fischer M, Forster KK, Rovati LC, Setnikar I.
Department of Orthopedics-Evangelisches Waldkrankenhaus, Berlin, Germany.
Glucosamine sulfate is a drug used for the treatment of osteoarthritis
(OA), based on its pharmacological and metabolic activities on the cartilage
and chondrocytes, complemented by mild anti-inflammatory properties and
a favorable pharmacokinetic profile. The aim of this study was to define
the activity and safety of glucosamine sulfate on the symptoms of patients
with OA, using a multicenter, randomized, placebo-controlled, double-blind,
parallel-group study design. The study included 252 outpatients with OA
of the knee (Lequesne's criteria), radiological stage between I and III,
and Lequesne's severity index of at least 4 points and symptoms for at
least 6 months. Patients were treated with either placebo or oral glucosamine
sulfate 500 mg t.i.d. for 4 weeks, with weekly, with weekly clinic visits.
Responders to treatment were defined as patients with a reduction of at
least 3 points in the Lequesne's index with a positive overall assessment
by the investigator. The Lequesne's index was 10.6 +/- 0.45 S.E.M. points
in both groups at the start of the study. This decreased to 7.45 +/- 0.5
points in the treatment group (average 3.2) and 8.4 +/- 0.4 points in
the placebo group (average 2.2) (P < 0.05, Student's t-test). The responder
rate in the evaluable patients was 55% with glucosamine (N = 120) vs 38%
with placebo (N = 121). These proportions were 52% vs 37% in an intention-to-treat
analysis (P = 0.014 and 0.016, respectively; Fisher's Exact Test). The
medications were well tolerated throughout the study, with no difference
between the glucosamine and placebo treated groups. It is concluded
that glucosamine sulfate may be a safe and effective symptomatic Slow
Acting Drug for OA.
Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial
PMID: 11548224 [PubMed - indexed for MEDLINE]
Glucosamine
sulfate
Thorne Research
Glucosamine sulfate's role in halting or reversing joint degeneration
appears to be directly due to its ability to act as an essential substrate
for, and to stimulate the biosynthesis of, the glycosaminoglycans and
the hyaluronic acid backbone needed for the formation of the proteoglycans
found in the structural matrix of joints. Successful treatment of osteoarthritis
must effectively control pain and should slow down or reverse the progression
of the degeneration. Biochemical and pharmacological data combined
with animal and human studies demonstrate that glucosamine sulfate is
capable of satisfying both of these criteria.
PMID: 10383484 [PubMed - indexed for MEDLINE]
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The
articulating surfaces of the bones (the ends of the bones that come/rub
together forming the joint) are covered in articular cartilage and are
bathed in Synovial Fluid - "joint oil". In a normal healthy
joint the articular cartilage is smooth and the synovial fluid is of
sufficient high quality to provide adequate lubrication.