Алфлутоп – в современной симптом-модифицирующей терапии остеоартрита - Журнал Терапевтический архив №5 Вопросы ревматологии 2019

Алфлутоп – в современной симптом-модифицирующей терапии остеоартрита

Дроздов В.Н., Ших Е.В., Сереброва С.Ю. и др. Алфлутоп – в современной симптом-модифицирующей терапии остеоартрита. Терапевтический архив. 2019; 91 (5): 134–140. DOI: 10.26442/00403660.2019.05.000169

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Drozdov V.N., Shikh E.V., Serebrova S.Y., et al. Alflutop – in modern symptom-modifying osteoarthritis therapy. Therapeutic Archive. 2019; 91 (5): 134–140. DOI: 10.26442/00403660.2019.05.000169

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Аннотация

Одной из серьезных проблем лечения остеоартрита (ОА) является развитие нежелательных явлений при назначении медикаментозной терапии, и первое место по частоте и тяжести нежелательных лекарственных реакций принадлежит нестероидным противовоспалительным препаратам (НПВП). В статье представлены подходы к лечению ОА с использованием комплексного препарата Алфлутоп, который имеет состав, аналогичный матриксу гиалинового хряща. Препарат обладает противовоспалительным и обезболивающим действием, нормализует функцию пораженных суставов, улучшает качество жизни пациентов, а также обладает структурно-модифицирующим эффектом. Такая терапия является безопасной, хорошо переносится пациентами и снижает ежедневную потребность в НПВП и может быть использована в стартовой комплексной терапии ОА.

Ключевые слова: остеоартрит, терапия, потребность в нестероидных противовоспалительных препаратах, комплексная терапия.

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One of the serious problems during the treatment of osteoarthritis (OA) is the developing of adverse drug events during therapy. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first drugs with the high incidence and severity of adverse events. This article describes OA treatment strategies approaches for OA are presented using the complex drug Alflutop, which has a composition similar to the human hyaline cartilage. The drug has anti-inflammatory and analgesic effects, normalizes the function of the affected joints, improves the quality of patients’ life, also has a structure-modifying effect. Such therapy is safe, well tolerable for patients, and can be used used as a starting complex OA treatment.

Keywords: osteoarthritis, therapy, daily consumption of nonsteroidal anti-inflammatory drugs, complex therapy.

Список литературы

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1. Noyszewski EA, Wroblewski K, Dodge GR, Kudchodkar S, Beers J, Sarma AV, et al. Preferential incorporation of glucosamine into the galactosamine moieties of chondroitin sulfate in articular cartilage explants. Arthritis Rheum. 2001;44:1089-95. https://doi.org/10.1002/1529-0131(200105)44:5<1089::AID-ANR189>3.0.CO;2-9
2. Bassleer C, Rovati LC, Franchimont P. Glucosamine sulfate stimulates proteoglycan production in human chondrocytes in vitro. Osteoarthritis Cartilage. 1998;6:427-34. https://doi.org/10.1053/joca.1998.0146
3. Piperno M, Reboul P, Helio Le, Graverand MP, Peschard MJ, Annefeld M, Richard M, et al. Glucosamine sulfate modulates dysregulated activities of human osteoarthritic chondrocytes in vitro. Osteoarthritis Cartilage. 2000;8:207-12. https://doi.org/10.1053/joca.1999.0291
4. Dodge GR, Jimenez SA. Glucosamine sulfate modulates the levels of aggrecan and matrix metalloproteinase-3 synthesized by cultured human osteoarthritis articular chondrocytes. Osteoarthritis Cartilage. 2003;11:424-32. https://doi.org/10.1016/s1063-4584(03)00052-9
5. Mroz PJ, Silbert JE. Use of 3H-glucosamine and 35S-sulfate with cultured human chondrocytes to determine the effect of glucosamine concentration on formation of chondroitin sulfate. Arthritis Rheum. 2004;50:3574-9. https://doi.org/10.1002/art.20609
6. Biggee BA, Blinn CM, McAlindon TE, Nuite M, Silbert JE. Low levels of human serum glucosamine after ingestion of glucosamine sulfate relative to capability for peripheral effectiveness. Ann Rheum Dis. 2006;65:222-6. https://doi.org/10.1136/ard.2005.036368
7. Varghese S, Theprungsirikul P, Sahani S, Hwang N, Yarema KJ, Elisseeff JH. Glucosamine modulates chondrocyte proliferation, matrix synthesis, and gene expression. Osteoarthritis Cartilage. 2007;15:59-68. https://doi.org/10.1016/ j.joca.2006.06.008
8. Gouze JN, Bordji K, Gulberti S, Terlain B, Netter P, Magdalou J, et al. Interleukin-1beta down-regulates the expression of glucuronosyltransferase I, a key enzyme priming glycosaminoglycan biosynthesis: influence of glucosamine on interleukin-1beta-mediated effects in rat chondrocytes. Arthritis Rheum. 2001;44:351-60. https://doi.org/10.1002/1529-0131(200102)44:2%3C351:: aid-anr53%3E3.0.co;2-m
9. Chiusaroli R, Piepoli T, Zanelli T, Ballanti P, Lanza M, Rovati LC, et al. Experimental pharmacology of glucosamine sulfate. Int J Rheumatol. 2011: 939265 [Epub]. https://doi.org/10.1155/2011/939265
10. Imagawa K, deAndrés MC, Hashimoto K, Pitt D, Itoi E, Goldring MB, et al. The epigenetic effect of glucosamine and a nuclear factor-kappa B (NF-kB) inhibitor on primary human chondrocytes – implications for osteoarthritis. Biochem Biophys Res Commun. 2011;405:362-7. https://doi.org/10.1016/j.bbrc. 2011.01.007
11. Maneiro E, Fernández Sueiro J, Lema D, de Toro F, Galdo F, Blanco F. Efecto del condroitín sulfato sobre la producción de óxido nítrico por los condrocitos humanos artrósicos. Rev Esp Reumatol. 2001;28:12-7. https://doi.org/10.39 89/mc.1961.v11.i103.1883
12. Vergés J, Montell E, Martinez G, Heroux L, du Souich P. Chon- droitin sulfate reduces nuclear translocation factor NF-kappaB and does not modify the activation state of activating protein-1 (AP-1) (Abstract). Osteoarthritis Cartilage. 2004;12:194. https://doi.org/10.1016/s1063-4584(08)60572-5
13. Jomphe C, Gabriac M, Hale TM, Heroux L, Trudeau LE, Deblois D, et al. Chondroitin sulfate inhibits the nuclear translocation of nuclear factor-kappaB in interleukin-1beta- stimulated chondrocytes. Basic Clin Pharmacol Toxicol. 2008;102:59-65. https://doi.org/10.1111/j.1742-7843.2007.00158.x
14. Caraglia M, Beninati S, Giuberti G, D’Alessandro AM, Lentini A, Abbruzzese A, et al. Alternative therapy of earth elements increases the chondroprotective effects of chondroitin sulfate in mice. Exp Mol Med. 2005;37:476-81. https://doi.org/10.1038/emm.2005.58
15. Bassleer CT, Combal JP, Bougaret S, Malaise M. Effects of chondroitin sulfate and interleukin-1 beta on human articular chondrocytes cultivated in clusters. Osteoarthritis Cartilage. 1998;6:196e204. https://doi.org/10.1053/joca.199 8.0112
16. Uebelhart D, Thonar EJ, Zhang J, Williams JM. Protective effect of exogenous chondroitin 4,6-sulfate in the acute degradation of articular cartilage in the rabbit. Osteoarthritis Cartilage. 1998;6(Suppl A):6-13. https://doi.org/10.1016/ s1063-4584(98)80005-8
17. Wang L, Wang J, Almqvist KF, Veys EM, Verbruggen G. Influ- ence of polysulphated polysaccharides and hydrocortisone on the extracellular matrix metabolism of human articular chondrocytes in vitro. Clin Exp Rheumatol. 2002;20:669-76. https://doi.org/10.1016/s1063-4584(03)00168-7
18. Orth MW, Peters TL, Hawkins JN. Inhibition of articular cartilage degradation by glucosamine HCl and chondroitin sulphate. Equine Vet J Suppl. 2010;34:224-9. https://doi.org/10.1111/j.2042-3306.2002.tb05423.x
19. Chan PS, Caron JP, Orth MW. Effect of glucosamine and chondroitin sulfate on regulation of gene expression of proteolytic enzymes and their inhibitors in interleukin-1- challenged bovine articular cartilage explants. Am J Vet Res. 2005;66:1870-6. https://doi.org/10.2460/ajvr.2005.66.1870
20. Chou MM, Vergnolle N, McDougall JJ, Wallace JL, Marty S, Teskey V, et al. Effects of chondroitin and glucosamine sulfate in a dietary bar formulation on inflammation, interleukin- 1beta, matrix metalloprotease-9, and cartilage damage in arthritis. Exp Biol Med. 2005;230:255-62. https://doi.org/10.1177/153 537020523000405
21. Monfort J, Nacher M, Montell E, Vila J, Verges J, Benito P. Chondroitin sulfate and hyaluronic acid (500e730 kDa) inhibit stromelysin-1 synthesis in human osteoarthritic chondrocytes. Drugs Exp Clin Res. 2005;31:71-6. https:// doi.org/10.1016/s1699-258x(05)72734-0
22. Baici A, Bradamante P. Interaction between human leukocyte elastase and chondroitin sulfate. Chem Biol Interact. 1984;51:1-11. https://doi.org/10.10 16/0009-2797(84)90015-2
23. Baici A, Lang A. Cathepsin B secretion by rabbit articular chondrocytes: modulation by cycloheximide and glycosami- noglycans. Cell Tissue Res. 1990;259:567-73. https://doi.org/10.1007/bf01740785
24. Verbruggen G, Veys EM. Influence of sulphated glycosamino- glycans upon proteoglycan metabolism of the synovial lining cells. Acta Rhumatol Belg. 1977;1:75-92.
25. Nishikawa H, Mori I, Umemoto J. Influences of sulfated glycosaminoglycans on biosynthesis of hyaluronic acid in rabbit knee synovial membrane. Arch Biochem Biophys. 1985;240:146-53. https://doi.org/10.1016/0003-9861(85) 90017-7
26. Nishikawa H, Mori I, Umemoto J. Glycosaminoglycan polysulfate- induced stimulation of hyaluronic acid synthesis in rabbit knee synovial membrane: involvement of binding protein and calcium ion. Arch Biochem Biophys. 1988;266:201-9. https://doi.org/10.1016/0003-9861(88)90251-2
27. Chan PS, Caron JP, Rosa GJ, Orth MW. Glucosamine and chondroitin sulfate regulate gene expression and synthesis of nitric oxide and prostaglandin E(2) in articular cartilage explants. Osteoarthritis Cartilage. 2005;13:387-94. https://doi.org/10.1016/j.joca.2005.01.003
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Авторы

В.Н. Дроздов, Е.В. Ших, С.Ю. Сереброва, А.Г. Абросимов, А.К. Стародубцев

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), кафедра клинической фармакологии и пропедевтики внутренних болезней лечебного факультета, Москва, Россия

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V.N. Drozdov, E.V. Shikh, S.Y. Serebrova, A.G. Abrosimov, A.K. Starodubtsev

Сlinical pharmacology and internal medicine propaedeutics of I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Department of general medicine, Moscow, Russia

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