Новые терапевтические возможности для ведения пациентов с синдромом гипермобильности суставов и синовитом. Клинический пример

Филатова Ю.С., Груздев А.М., Гауэрт В.Р. Новые терапевтические возможности для ведения пациентов с синдромом гипермобильности суставов и синовитом. Клинический пример. Consilium Medicum. 2023;25(2):113–118. DOI: 10.26442/20751753.2023.2.202211

© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.

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Filatova YuS, Gruzdev AM, Gauert VR. New therapeutic opportunities in management of patients with joint hypermobility syndrome and synovitis. Clinical example: A review. Consilium Medicum. 2023;25(2):113–118.
DOI: 10.26442/20751753.2023.2.202211

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Аннотация

В статье описываются вопросы диагностики и лечения синдрома гипермобильности суставов начиная с его исторических аспектов и заканчивая современными возможностями терапии. В статье обсуждаются риски развития раннего остеоартрита на фоне синдрома гипермобильности суставов. На клиническом примере разобраны вопросы диагностики согласно шкале Бейтона и Брайтоновским критериям и обоснованы возможности терапии и профилактики раннего остеоартрита согласно клиническим рекомендациям по дисплазии соединительной ткани, в рамках которых рассматривается данный синдром.

Ключевые слова: синдром гипермобильности суставов, синовит, ранний остеоартрит

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The article describes the issues of diagnosis and treatment of joint hypermobility syndrome. Starting from its historical aspects, ending with the modern possibilities of therapy. The article discusses the risks of developing early osteoarthritis against the background of joint hypermobility syndrome. On a clinical example, the issues of diagnosis according to the Beighton scale and the Brighton criteria are analyzed, and the possibilities of therapy and prevention of early osteoarthritis are presented, according to the clinical recommendations for connective tissue dysplasia, within which this syndrome is considered.

Keywords: joint hypermobility syndrome, synovitis, early osteoarthritis

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Список литературы

1. Grahame R. The hypermobility syndrome. Ann Rheum Dis. 1990;49(3):199-200. DOI:10.1136/ard.49.3.199
2. Kirk JA, Ansell BM, Bywaters EG. The hypermobility syndrome. Musculoskeletal complaints associated with generalized joint hypermobility. Ann Rheum Dis. 1967;26(5):419-25. DOI:10.1136/ard.26.5.419
3. Grahame R. Joint hypermobility syndrome pain. Curr Pain Headache Rep. 2009;13(6):427-33. DOI:10.1007/s11916-009-0070-5
4. Grahame R. Joint hypermobility: emerging disease or illness behaviour? Clin Med (Lond). 2013;13 Suppl. 6:s50-2. DOI:10.7861/clinmedicine.13-6-s50
5. Bird HA. Joint hypermobility in children. Rheumatology (Oxford). 2005;44(6):703-4. DOI:10.1093/rheumatology/keh639
6. Seçkin U, Tur BS, Yilmaz O, Yağci I, et al. The prevalence of joint hypermobility among high school students. Rheumatol Int. 2005;25(4):260-3. DOI:10.1007/s00296-003-0434-9
7. Schilling F. Das Hypermobilitätssyndrom – eine polysymptomatische Erkrankung. Arthritis u Rheuma. 2004;24:43-7. DOI:10.1055/s-0037-1618453
8. Skoumal M, Haberhauer G, Mayr H. Begleitkrankheiten bei primärer Gelenkhypermobilität. Med Klin. 2004;99:585-90.
9. Zweers MC, Hakim AJ, Grahame R, Schalkwijk J. Joint hypermobility syndromes: the pathophysiologic role of tenascin-X gene defects. Arthritis Rheum. 2004;50(9):2742-9. DOI:10.1002/art.20488
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16. Murray KJ. Hypermobility disorders in children and adolescents. Best Pract Res Clin Rheumatol. 2006;20:329-51.
17. Golightly YM, Nelson AE, Kraus VB, et al. General joint hypermobility and hip osteoarthritis: the Johnston county osteoarthritis project. Osteoarthritis Cartilage. 2012;20:182.
18. Hunter DJ, Zhang Y, Sokolove J, et al. Trapeziometacarpal subluxation predisposes to incident trapeziometacarpal osteoarthritis (OA): the Framingham Study. Osteoarthritis Cartilage. 2005;13:953-7. DOI:10.1016/j.joca.2005.06.007
19. Shakulashvili NA, Chikhladze HE, Akhvlediani RP. Osteoarthritis and hypermobility syndrome in cross – examinations. Osteoarthritis Cartilage. 2001;30(2):48.
20. Клинические рекомендации Российского научного медицинского общества терапевтов по диагностике, лечению и реабилитации пациентов с дисплазиями соединительной ткани (первый пересмотр) утверждены на XII Национальном конгрессе терапевтов 22–24 ноября 2017 года. Медицинский вестник Северного Кавказа. 2018;13(1):137-209 [Clinical guidelines of the Russian Scientific Medical Society of Internal Medicine on the diagnosis, treatment and rehabilitation of patients with the connective tissue dysplasia (first edition) approved by the XII National Congress of Internists on 22–24 November 2017. Meditsinskii vestnik Severnogo Kavkaza. 2018;13(1):137-209 (in Russian)]. DOI:10.14300/mnnc.2018.13037
21. Thorbecke GJ. Suppression of type II collagen-induced arthritis by intragastric administration of soluble type II collagen. Proc Natl Acad Sci USA. 1986;83(19):7443-6.
22. Bagchi D, Misner B, Bagchi M, et al. Effects of orally administered undenatured type II collagen against arthritic inflammatory diseases: a mechanistic exploration. Int J Clin Pharmacol Res. 2002;22(3-4):101-10.
23. Collagenase and rheumatoid arthritis. N Engl J Med. 1968;279(17):942-3. DOI:10.1056/NEJM196810242791710
24. Tong T, Zhao W, Wu YQ, et al. Chicken type II collagen induced immune balance of main subtype of helper T cells in mesenteric lymph node lymphocytes in rats with collagen-induced arthritis. Inflamm Res. 2010;59(5):369-77. DOI:10.1007/s00011-009-0109-4
25. Bagi CM, Berryman ER, Teo S, Lane NE. Oral administration of undenatured native chicken type II collagen (UC-II) diminished deterioration of articular cartilage in a rat model of osteoarthritis (OA). Osteoarthritis Cartilage. 2017;25(12):2080-90. DOI:10.1016/j.joca.2017.08.013
26. Fan R, Hao Y, Liu X, et al. Native Collagen II Relieves Bone Impairment through Improving Inflammation and Oxidative Stress in Ageing db/db Mice. Molecules. 2021;26(16):4942. DOI:10.3390/molecules26164942
27. Crowley DC, Lau FC, Sharma P, et al. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int J Med Sci. 2009;6(6):312-21. DOI:10.7150/ijms.6.312
28. Lugo JP, Saiyed ZM, Lane NE. Efficacy and tolerability of an undenatured type II collagen supplement in modulating knee osteoarthritis symptoms: a multicenter randomized, double-blind, placebo-controlled study. Nutr J. 2016;15:14. DOI:10.1186/s12937-016-0130-8
29. Schön C, Knaub K, Alt W, et al. UC-II Undenatured Type II Collagen for Knee Joint Flexibility: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Study. J Integr Complement Med. 2022;28(6):540-8. DOI:10.1089/jicm.2021.0365
30. Shiojima Y, Takahashi M, Takahashi R, et al. Efficacy and Safety of Dietary Undenatured Type II Collagen on Joint and Motor Function in Healthy Volunteers: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study. J Am Nutr Assoc. 2023;42(3):224-41. DOI:10.1080/07315724.2021.2024466
31. Lugo JP, Saiyed ZM, Lau FC, et al. Undenatured type II collagen (UC-II) for joint support: A randomized, double-blind, placebo-controlled study in healthy volunteers. J Int Soc Sports Nutr. 2013;10:48.
32. Majeed M, Nagabhushanam K, Lawrence L, et al. Boswellia serrata Extract Containing 30% 3-Acetyl-11-Keto-Boswellic Acid Attenuates Inflammatory Mediators and Preserves Extracellular Matrix in Collagen-Induced Arthritis. Front Physiol. 2021;12:735247. DOI:10.3389/fphys.2021.735247
33. Yu G, Xiang W, Zhang T, et al. Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis. BMC Complement Med Ther. 2020;20(1):225. DOI:10.1186/s12906-020-02985-6
34. Ernst E. Frankincense: systematic review. BMJ. 2008;337:a2813. DOI:10.1136/bmj.a2813
35. Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee – a randomized double blind placebo controlled trial. Phytomedicine. 2003;10(1):3-7. DOI:10.1078/094471103321648593
36. Majeed M, Majeed S, Narayanan NK, Nagabhushanam K. A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee. Phytother Res. 2019;33(5):1457-68. DOI:10.1002/ptr.6338
37. Kulkarni PD, Damle ND, Singh S, et al. Double-blind trial of solid lipid Boswellia serrata particles (SLBSP) vs. standardized Boswellia serrata gum extract (BSE) for osteoarthritis of knee. Drug Metab Pers Ther. 2020;35(2). DOI:10.1515/dmpt-2020-0104
38. Kim LS, Axelrod LJ, Howard P, et al. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osteoarthritis Cartilage. 2006;14(3):286-94. DOI:10.1016/j.joca.2005.10.003
39. Debbi EM, Agar G, Fichman G, et al. Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study. BMC Complement Altern Med. 2011;11:50. DOI:10.1186/1472-6882-11-50
40. Garfinkel RJ, Dilisio MF, Agrawal DK. Vitamin D and Its Effects on Articular Cartilage and Osteoarthritis. Orthop J Sports Med. 2017;5(6):2325967117711376. DOI:10.1177/2325967117711376
41. Wang X, Cicuttini F, Jin X, et al. Knee effusion-synovitis volume measurement and effects of vitamin D supplementation in patients with knee osteoarthritis. Osteoarthritis Cartilage. 2017;25(8):1304-12. DOI:10.1016/j.joca.2017.02.804
42. Ameye LG, Chee WS. Osteoarthritis and nutrition. From nutraceuticals to functional foods: a systematic review of the scientific evidence. Arthritis Res Ther. 2006;8(4):R127. DOI:10.1186/ar2016
43. Филатова Ю.С., Ильин М.В., Соловьев И.Н. Остеоартрит: современные возможности терапии. Амбулаторная хирургия. 2022;19(1):60-7 [Filatova YuS, Ilyin MV, Soloviev IN. Osteoarthritis: modern possibilities of therapy. Ambulatory Surgery (Russia). 2022;19(1):60-7 (in Russian)]. DOI:10.21518/1995-1477-2022-19-1-60-67

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1. Grahame R. The hypermobility syndrome. Ann Rheum Dis. 1990;49(3):199-200. DOI:10.1136/ard.49.3.199
2. Kirk JA, Ansell BM, Bywaters EG. The hypermobility syndrome. Musculoskeletal complaints associated with generalized joint hypermobility. Ann Rheum Dis. 1967;26(5):419-25. DOI:10.1136/ard.26.5.419
3. Grahame R. Joint hypermobility syndrome pain. Curr Pain Headache Rep. 2009;13(6):427-33. DOI:10.1007/s11916-009-0070-5
4. Grahame R. Joint hypermobility: emerging disease or illness behaviour? Clin Med (Lond). 2013;13 Suppl. 6:s50-2. DOI:10.7861/clinmedicine.13-6-s50
5. Bird HA. Joint hypermobility in children. Rheumatology (Oxford). 2005;44(6):703-4. DOI:10.1093/rheumatology/keh639
6. Seçkin U, Tur BS, Yilmaz O, Yağci I, et al. The prevalence of joint hypermobility among high school students. Rheumatol Int. 2005;25(4):260-3. DOI:10.1007/s00296-003-0434-9
7. Schilling F. Das Hypermobilitätssyndrom – eine polysymptomatische Erkrankung. Arthritis u Rheuma. 2004;24:43-7. DOI:10.1055/s-0037-1618453
8. Skoumal M, Haberhauer G, Mayr H. Begleitkrankheiten bei primärer Gelenkhypermobilität. Med Klin. 2004;99:585-90.
9. Zweers MC, Hakim AJ, Grahame R, Schalkwijk J. Joint hypermobility syndromes: the pathophysiologic role of tenascin-X gene defects. Arthritis Rheum. 2004;50(9):2742-9. DOI:10.1002/art.20488
10. Beighton P, Solomon L, Soskolne CL. Articular mobility in an African population. Ann Rheum Dis. 1973;32(5):413-8.
11. Beighton P, De Paepe A, Steinmann B, et al. Ehlers-Danlos syndromes: Revised nosology, Villefranche, 1997. AmJ Med Genet. 1998;77(1):31-7.
12. Schilling F, Stofft E. Das Hypermobilität –Syndrom – Übersicht, großfamiliäre Kasuistik und Pathologie der Kollagentextur. Osteologie. 2003;12:205-32.
13. Lebets IS, Matvienko IeV, Kostiurina NA, et al. Osteoartroz i gipermobil'nost' sustavov. Travma. 2005;3(6):262-6 (in Russian).
14. Maslova ES. Vozrastnyie osobennosti klinicheskikh proiavlenii sindroma gipermobil'nosti sustavov: avtoref. dis. … kand. med. nauk. Irkutsk, 2002 (in Russian).
15. Jónsson H, Elíasson GJ, Jónsson A, et al. High hand joint mobility is associated with radiological CMC1 osteoarthritis: the AGES-Reykjavik study. Osteoarthritis Cartilage. 2009;17(5):592-5. DOI:10.1016/j.joca.2008.10.002
16. Murray KJ. Hypermobility disorders in children and adolescents. Best Pract Res Clin Rheumatol. 2006;20:329-51.
17. Golightly YM, Nelson AE, Kraus VB, et al. General joint hypermobility and hip osteoarthritis: the Johnston county osteoarthritis project. Osteoarthritis Cartilage. 2012;20:182.
18. Hunter DJ, Zhang Y, Sokolove J, et al. Trapeziometacarpal subluxation predisposes to incident trapeziometacarpal osteoarthritis (OA): the Framingham Study. Osteoarthritis Cartilage. 2005;13:953-7. DOI:10.1016/j.joca.2005.06.007
19. Shakulashvili NA, Chikhladze HE, Akhvlediani RP. Osteoarthritis and hypermobility syndrome in cross – examinations. Osteoarthritis Cartilage. 2001;30(2):48.
20. Clinical guidelines of the Russian Scientific Medical Society of Internal Medicine on the diagnosis, treatment and rehabilitation of patients with the connective tissue dysplasia (first edition) approved by the XII National Congress of Internists on 22–24 November 2017. Meditsinskii vestnik Severnogo Kavkaza. 2018;13(1):137-209 (in Russian). DOI:10.14300/mnnc.2018.13037
21. Thorbecke GJ. Suppression of type II collagen-induced arthritis by intragastric administration of soluble type II collagen. Proc Natl Acad Sci USA. 1986;83(19):7443-6.
22. Bagchi D, Misner B, Bagchi M, et al. Effects of orally administered undenatured type II collagen against arthritic inflammatory diseases: a mechanistic exploration. Int J Clin Pharmacol Res. 2002;22(3-4):101-10.
23. Collagenase and rheumatoid arthritis. N Engl J Med. 1968;279(17):942-3. DOI:10.1056/NEJM196810242791710
24. Tong T, Zhao W, Wu YQ, et al. Chicken type II collagen induced immune balance of main subtype of helper T cells in mesenteric lymph node lymphocytes in rats with collagen-induced arthritis. Inflamm Res. 2010;59(5):369-77. DOI:10.1007/s00011-009-0109-4
25. Bagi CM, Berryman ER, Teo S, Lane NE. Oral administration of undenatured native chicken type II collagen (UC-II) diminished deterioration of articular cartilage in a rat model of osteoarthritis (OA). Osteoarthritis Cartilage. 2017;25(12):2080-90. DOI:10.1016/j.joca.2017.08.013
26. Fan R, Hao Y, Liu X, et al. Native Collagen II Relieves Bone Impairment through Improving Inflammation and Oxidative Stress in Ageing db/db Mice. Molecules. 2021;26(16):4942. DOI:10.3390/molecules26164942
27. Crowley DC, Lau FC, Sharma P, et al. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int J Med Sci. 2009;6(6):312-21. DOI:10.7150/ijms.6.312
28. Lugo JP, Saiyed ZM, Lane NE. Efficacy and tolerability of an undenatured type II collagen supplement in modulating knee osteoarthritis symptoms: a multicenter randomized, double-blind, placebo-controlled study. Nutr J. 2016;15:14. DOI:10.1186/s12937-016-0130-8
29. Schön C, Knaub K, Alt W, et al. UC-II Undenatured Type II Collagen for Knee Joint Flexibility: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Study. J Integr Complement Med. 2022;28(6):540-8. DOI:10.1089/jicm.2021.0365
30. Shiojima Y, Takahashi M, Takahashi R, et al. Efficacy and Safety of Dietary Undenatured Type II Collagen on Joint and Motor Function in Healthy Volunteers: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study. J Am Nutr Assoc. 2023;42(3):224-41. DOI:10.1080/07315724.2021.2024466
31. Lugo JP, Saiyed ZM, Lau FC, et al. Undenatured type II collagen (UC-II) for joint support: A randomized, double-blind, placebo-controlled study in healthy volunteers. J Int Soc Sports Nutr. 2013;10:48.
32. Majeed M, Nagabhushanam K, Lawrence L, et al. Boswellia serrata Extract Containing 30% 3-Acetyl-11-Keto-Boswellic Acid Attenuates Inflammatory Mediators and Preserves Extracellular Matrix in Collagen-Induced Arthritis. Front Physiol. 2021;12:735247. DOI:10.3389/fphys.2021.735247
33. Yu G, Xiang W, Zhang T, et al. Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis. BMC Complement Med Ther. 2020;20(1):225. DOI:10.1186/s12906-020-02985-6
34. Ernst E. Frankincense: systematic review. BMJ. 2008;337:a2813. DOI:10.1136/bmj.a2813
35. Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee – a randomized double blind placebo controlled trial. Phytomedicine. 2003;10(1):3-7. DOI:10.1078/094471103321648593
36. Majeed M, Majeed S, Narayanan NK, Nagabhushanam K. A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee. Phytother Res. 2019;33(5):1457-68. DOI:10.1002/ptr.6338
37. Kulkarni PD, Damle ND, Singh S, et al. Double-blind trial of solid lipid Boswellia serrata particles (SLBSP) vs. standardized Boswellia serrata gum extract (BSE) for osteoarthritis of knee. Drug Metab Pers Ther. 2020;35(2). DOI:10.1515/dmpt-2020-0104
38. Kim LS, Axelrod LJ, Howard P, et al. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osteoarthritis Cartilage. 2006;14(3):286-94. DOI:10.1016/j.joca.2005.10.003
39. Debbi EM, Agar G, Fichman G, et al. Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study. BMC Complement Altern Med. 2011;11:50. DOI:10.1186/1472-6882-11-50
40. Garfinkel RJ, Dilisio MF, Agrawal DK. Vitamin D and Its Effects on Articular Cartilage and Osteoarthritis. Orthop J Sports Med. 2017;5(6):2325967117711376. DOI:10.1177/2325967117711376
41. Wang X, Cicuttini F, Jin X, et al. Knee effusion-synovitis volume measurement and effects of vitamin D supplementation in patients with knee osteoarthritis. Osteoarthritis Cartilage. 2017;25(8):1304-12. DOI:10.1016/j.joca.2017.02.804
42. Ameye LG, Chee WS. Osteoarthritis and nutrition. From nutraceuticals to functional foods: a systematic review of the scientific evidence. Arthritis Res Ther. 2006;8(4):R127. DOI:10.1186/ar2016
43. Filatova YuS, Ilyin MV, Soloviev IN. Osteoarthritis: modern possibilities of therapy. Ambulatory Surgery (Russia). 2022;19(1):60-7 (in Russian).
DOI:10.21518/1995-1477-2022-19-1-60-67

Авторы

Ю.С. Филатова*1,2, А.М. Груздев2, В.Р. Гауэрт1

1 ФГБОУ ВО «Ярославский государственный медицинский университет» Минздрава России, Ярославль, Россия;
2 ООО «Центр диагностики и профилактики плюс», Ярославль, Россия
*y.s.filatova@mail.ru

________________________________________________

Yulia S. Filatova*1,2, Alexey M. Gruzdev2, Veronika R. Gauert1

1 Yaroslavl State Medical University, Yaroslavl, Russia;
2 Center for Diagnostics and Prevention Plus, Yaroslavl, Russia
*y.s.filatova@mail.ru

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