Антирезорбтивная активность фармацевтического хондроитина сульфата у лиц старшей возрастной группы

Шавловская О.А., Золотовская И.А., Прокофьева Ю.С. Антирезорбтивная активность фармацевтического хондроитина сульфата у лиц старшей возрастной группы. Терапевтический архив. 2020; 92 (12): 75–79.
DOI: 10.26442/00403660.2020.12.200448

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Shavlovskaya O.A., Zolotovskaya I.A., Prokofyeva Yu.S. Antiresorptive activity of pharmacological chondroitin sulfate in the older age group. Therapeutic Archive. 2020; 92 (12): 75–79. DOI: 10.26442/00403660.2020.12.200448

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Аннотация

Распространенность остеоартрита (ОА) увеличивается пропорционально возрасту, так в популяции лиц старше 65 лет. В основе патогенеза ОА лежит воспаление хрящевой ткани сустава, что приводит к повреждению хряща, активированию сигнальных путей и повышению уровня цитокинов.
Цель. Изучить данные литературы в отношении ремоделирования костно-хрящевой ткани с развитием резорбтивных процессов и обсудить возможные алгоритмы и рекомендации по ведению больных ОА на фоне хондропротективной терапии.
Материалы и методы. Проведен комплексный анализ данных, представленных в открытых источниках, опубликованных и доступных на таких ресурсах, как PubMed, EMBASE, Cochrane, Еlibrary.
Результаты. Согласно имеющимся рекомендациям и мнению экспертов обязательным компонентом комплексной терапии ОА являются
препараты, содержащие фармацевтический хондроитин сульфат, который в ряде исследований также продемонстрировал высокую
антирезорбтивную эффективность.
Заключение. Применение лекарственного препарата на основе фармацевтического хондроитина сульфата (Хондрогард) не только способствует уменьшению болевого синдрома при ОА, но и оказывает положительное действие на процессы воспаления, в том числе ассоциированные с возрастными изменениями в организме.

Ключевые слова: старение, остеоартрит, инфламэйджинг, хондропротекторы, хондроитина сульфат, костная резорбция.

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The prevalence of osteoarthritis (OA) increases in proportion to age, so in the population of people over 65 years of age. The pathogenesis of OA is based on inflammation of the cartilage tissue of the joint, which leads to damage to the cartilage, activation of signaling pathways and increased levels of cytokines.
Aim. To study the literature data on bone and cartilage remodeling with the development of resorptive processes and discuss possible algorithms and recommendations for the management of patients with OA on the background of chondroprotective therapy.
Materials and methods. A comprehensive analysis of data presented in open sources, published and available on such resources as PubMed, EMBASE, Cochrane, and Library.
Results. According to the available recommendations and the opinion of experts, among the methods of OA therapy, drugs containing pharmaceutical chondroitin sulfate are currently being discussed, which in a number of studies has demonstrated high antiresorptive effectiveness.
Conclusion. The use of drugs based on pharmaceutical chondroitin sulfate (Chondroguard) contributes not only to the reduction of pain in OA, but also has a positive effect on the processes of inflammation, including those associated with age-related changes in the body.

Keywords: aging, osteoarthritis, inflammaging, chondroprotectors, chondroitin sulfate, bone resorption.

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1. [Dydykina IS, Nurbaieva KS, Kovalenko PS, et al. From knowing the mechanism of action to choosing a method for the prevention and treatment of osteoarthritis. RMJ. 2020;7:14-8 (In Russ.)].
2. [Zotkin EG, Dydykina IS, Lila AM. Inflammaging, age-related diseases and osteoarthritis. RMJ. 2020;7:33-8 (In Russ.)].
3. [Naumov AV, Khovasova NO, Moroz VI, et al. The clinical status and treatment options for osteoarthritis in patients with frailty. Therapeutic Archive. 2019;91(12):42-8 (In Russ.)]. doi: 10.26442/00403660.2019.12.000487
4. Yoshimura N, Oka H, Muraki S, et al. Reference values for hand grip strength, muscle mass, walking time, and one-leg standing time as indices for locomotive syndrome and associated disability: the second survey of the ROAD study. J Orthopaed Sci. 2011;16:768-77. doi: 10.1007/s00776-011-0160-1
5. Yoshimura N, Muraki S, Oka H, et al. Cohort profile: research on osteoarthritis/osteoporosis against disability study. Int J Epidemiol. 2010;39:988-95. doi: 10.1093/ije/dyp276
6. [Zolotovskaya IA, Davydkin IL. A antiresorptive-cytokine effects of chondroprotective therapy in patients with lower back pain. S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(4):65-71 (In Russ.)]. doi: 10.17116/jnevro202012004165
7. Domenichiello AF, Ramsden CE. The silent epidemic of chronic pain in older adults. Prog Neuropsychopharmacol Biol Psychiatry. 2019;93:284-90. doi: 10.1016/j.pnpbp.2019.04.006
8. Macfarlane GJ, Barnish MS, Jones GT. Persons with chronic widespread pain experience excess mortality: longitudinal results from UK Biobank and meta-analysis. Ann Rheum Dis. 2017;76:1815-22. doi: 10.1136/annrheumdis-2017-211476
9. Whitlock EL, et al. Association between persistent pain and memory decline and dementia in a longitudinal cohort of elders. JAMA Intern Med. 2017;177:1146-53. doi: 10.1001/jamainternmed.2017.1622
10. Franceschi C, Garagnani P, Vitale G, et al. Inflammaging and «Garb-aging». Trends Endocrinol Metab. 2017;28(3):199-212. doi: 10.1016/j.tem.2016.09.005
11. Minciullo PL, Catalano A, Mandraffino G, et al. Inflammaging and anti-inflammaging: the role of cytokines in extreme longevity. Arch Immunol Ther Exp (Warsz). 2016;64(2):111-26. doi: 10.1007/s00005-015-0377-3
12. [Gromova OA, Torshin IYu, Lila AM, et al. Molecular mechanisms of myoprotective action of chondroitin sulfate and glucosamine sulfate in sarcopenia. Neurology, Neuropsychiatry, Psychosomatics. 2019;11(1):117-24 (In Russ.)]. doi: 10.14412/2074-2711-2019-1-117-124
13. Kiguchi N, Saika F, Kobayashi Y, Kishioka S. Epigenetic regulation of CC-chemokine ligand 2 in nonresolving inflammation. BioMol Concepts. 2014;5(4):265-73. doi: 10.1515/bmc-2014-0022
14. Valero T, Moschopoulou G, Mayor-Lopez L, Kintzios S. Moderate superoxide production is an early promoter of mitochondrial biogenesis in differentiating N2a neuroblastoma cells. Neurochem Int. 2012;61(8):1333-43. doi: 10.1016/j.neuint.2012.09.010
15. [Groznova OS, Miklashevich IM, Voinova VYu, et al. Biomarkers of early cardiovascular aging. Ros. Vestn. Perinatologii i Pediatrii. 2019; 64(4):11-8 (In Russ.)]. doi: 10.21508/1027-40652019-64-4-11-18
16. Loeser RF, Yammani RR, Carlson CS, et al. Articular chondrocytes express the receptor for advanced glycation end products: potential role in osteoarthritis. Arthritis Rheum. 2005;52:2376e85. doi: 10.1002/art.21199
17. Barnes PJ. Mechanisms of development of multimorbidity in the elderly. Eur Respir J. 2015;45(3):790-806. doi: 10.1183/09031936.00229714
18. [Parcernyak AS, Khalimov YuSh. Chronic inflammation and premature aging – two parallel processes in polymorbid cardiovascular pathology. Bulletin of the Russian Military medical Academy. 2019;3(67):78-82 (In Russ.)].
19. Navarro SL, White E, Kantor ED, et al. Randomized trial of glucosamine and chondroitin supplementation on inflammation and oxidative stress biomarkers and plasma proteomics profiles in healthy humans. PLoSOne. 2015;10(2):e0117534. doi: 10.1371/journal.pone.0117534
20. Yasuda T. Cartilage destruction by matrix degradation products. Mod Rheumatol. 2006;16:197e205. doi: 10.3109/s10165-006-0490-6
21. Vallieres M, du Souich P. Modulation of inflammation by chondroitin sulfate. Osteoarthritis and Cartilage. 2010;18(1):S1-6. doi: 10.1016/j.joca.2010.02.017
22. Herrero-Beaumont G, Marcos ME, Sanchez-Pernaute O, et al. Effect of chondroitin sulphate in a rabbit model of atherosclerosis aggravated by chronic arthritis. Br J Pharmacol. 2008;154:843e51. doi: 10.1038/bjp.2008.113
23. Martel-Pelletier J, Farran A, Montell E, et al. Discrepancies in composition and biological effects of different formulations of chondroitin sulfate. Molecules. 2015;20(3):4277-89. doi: 10.3390/molecules20034277
24. [Shavlovskaya OA, Naumov AV, Romanov ID. Treating chronic pain during isolation. Doctor.Ru. Neurology Psychiatry. 2020;19(4):11-7 (In Russ.)]. doi: 10.31550/1727-2378-2020-19-4-11-17
25. Bruyere O, Honvo G, Veronese N, et al. An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin Arthritis Rheum. 2019;49(3):337-50. doi: 10.1016/j.semarthrit.2019.04.008
26. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res (Hoboken). 2020;72(2):149-62. doi: 10.1002/acr.24131
27. [Shavlovskaya OA, Naumov AV. Updated recommendations of the American College of rheumatology for the management of patients with osteoarthritis. Remedium. 2020;4-6:42-52 (In Russ.)]. doi: 10.21518/1561-5936-2020-4-5-6-42-52
28. [Alekseeva LI. Сlinical guidelines update on the treatment of patients with osteoarthritis in 2019. RMJ. 2019;(4):2-6 (In Russ.)].
29. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-89. doi: 10.1016/j.joca.2019.06.011
30. [Gromova OA, Torshin IYu, Lila AM, et al. Systematic study review on antitumor effects of glucosamine and chondroitin sulfate cartilage protectors. RMJ. Medical Review. 2019;4(I):4-10 (In Russ.)].
31. [Alekseeva LI, Taskina EA, Kashevarova NG. Osteoarthritis: epidemiology, classification, risk factors, and progression, clinical presentation, diagnosis, and treatment. Modern Rheumatology J. 2019;13(2):9-21 (In Russ.)]. doi: 10.14412/1996-7012-2019-2-9-21
32. Cecchini M, Sassi F, Lauer JA, et al. Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. Lancet. 2010;376:1775-84. doi: 10.1016/S0140-6736(10)61514-0
33. Tat SK, Pelletier J-P, Verges J, et al. Chondroitin and glucosamine sulfate in combination decrease the pro-resorptive properties of human osteoarthritis subchondral bone osteoblasts: a basic science study. Arthritis Res Ther. 2007;9(6):R117. doi: 10.1186/ar2325
34. Elgawish MH, Zakaria MA, Fahmy HS, Shalaby AA. Еffect of chondroitin sulfate on cartilage volume loss and subchondral bone marrow lesions in osteoarthritis knee. Egypt Rheumatol Rehabilitation. 2015;13(3):153-8. doi: 10.4103/1110-161x.163948
35. Wildi LM, Raynauld J-P, Martel-Pelletier J, et al. Chondroitin sulphate reduces both cartilage volume loss and bone marrow lesions in knee osteoarthritis patients starting as early as 6 months after initiation of therapy: a randomised, double-blind, placebo-controlled pilot study using MRI. Ann Rheum Dis. 2011;70(6):982-9. doi: 10.1136/ard.2010.140848
36. Pelletier J-P, Raynauld J-P, Beaulieu AD, et al. Chondroitin sulfate efficacy versus celecoxib on knee osteoarthritis structural changes using magnetic resonance imaging: a 2-year multicentre exploratory study. Arthritis Res Ther. 2016;18:256. doi: 10.1186/s13075-016-1149-0
37. Honvo G, Bruyere O, Geerinck A, et al. Efficacy of Chondroitin sulfate in patients with knee osteoarthritis: a comprehensive meta-analysis exploring inconsistencies in randomized, placebo-controlled trials. Adv Ther. 2019;36(5):1085-99. doi: 10.1007/s12325-019-00921-w

Авторы

О.А. Шавловская 1, И.А. Золотовская 2, Ю.С. Прокофьева 3,4

1 АНО ВО «Международный Университет восстановительной медицины», кафедра восстановительной медицины и реабилитации, Москва, Россия;
2 ФГБОУ ВО «Самарский государственный медицинский университет» Минздрава России, Самара, Россия;
3 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России,
Москва, Россия;
4 ГБУЗ «Городская клиническая больница им. С.И. Спасокукоцкого» Департамента здравоохранения г. Москвы, Москва, Россия

________________________________________________

O.A. Shavlovskaya 1, I.A. Zolotovskaya 2, Yu.S. Prokofyeva 3,4

1 International University of Restorative Medicine, Moscow, Russia;
2 Samara State Medical University, Samara, Russia;
3 Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia;
4 Spasokukotsky City Clinical Hospital, Moscow, Russia

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