Nutraceutical therapies for degenerative joint diseases: a critical review.
There is growing recognition of the importance of nutritional factors in the maintenance of bone and joint health, and that nutritional imbalance combined with endocrine abnormalities may be involved in the pathogenesis of osteoarthritis (OA) and osteochondritis dissecans (OCD). Despite this, dietary programs have played a secondary role in the management of these connective tissue disorders. Articular cartilage is critically dependent upon the regular provision of nutrients (glucose and amino acids), vitamins (particularly vitamin C), and essential trace elements (zinc, magnesium, and copper). Therefore, dietary supplementation programs and nutraceuticals used in conjunction with non-steroidal, anti-inflammatory drugs (NSAIDs) may offer significant benefits to patients with joint disorders, such as OA and OCD. This article examines the available clinical evidence for the efficacy of nutraceuticals, antioxidant vitamin C, polyphenols, essential fatty acids, and mineral cofactors in the treatment of OA and related joint disorders in humans and veterinary species. This article also attempts to clarify the current state of knowledge. It also highlights the need for additional targeted research to elucidate the changes in nutritional status and potential alterations to the expression of plasma membrane transport systems in synovial structures in pathophysiological states, so that current therapy and future treatments may be better focused.
Goggs
Robert
R
Connective Tissue Research Group, Faculty of Veterinary Science, University of Liverpool, Liverpool, United Kingdom.
Vaughan-Thomas
Anne
A
Clegg
Peter D
PD
Carter
Stuart D
SD
Innes
John F
JF
Mobasheri
Ali
A
Shakibaei
Mehdi
M
Schwab
Wolfgang
W
Bondy
Carolyn A
CA
D000596:Amino Acids / Q000008:administration & dosage; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D049872:Bivalvia; D028241:Camellia sinensis / Q000737:chemistry; D002356:Cartilage / Q000737:chemistry / Q000502:physiology; D002809:Chondroitin Sulfates / Q000008:administration & dosage; D005228:Fatty Acids, Essential / Q000008:administration & dosage; D005419:Flavonoids / Q000008:administration & dosage; D005944:Glucosamine / Q000008:administration & dosage; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D009752:Nutritional Status; D009765:Obesity / Q000150:complications; D010003:Osteoarthritis / Q000178:diet therapy* / Q000188:drug therapy* / Q000209:etiology; D010008:Osteochondritis Dissecans / Q000178:diet therapy* / Q000188:drug therapy* / Q000209:etiology; D010636:Phenols / Q000008:administration & dosage; D059808:Polyphenols; D014131:Trace Elements / Q000008:administration & dosage; D014815:Vitamins / Q000008:administration & dosage
D000596:Amino Acids; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005228:Fatty Acids, Essential; D005419:Flavonoids; D010636:Phenols; D059808:Polyphenols; D014131:Trace Elements; D014815:Vitamins; D002809:Chondroitin Sulfates; D005947:Glucose; D005944:Glucosamine