title: Glucosamine but not ibuprofen alters cartilage turnover in osteoarthritis patients in response to physical training.
abstract: OBJECTIVE
  To investigate changes in levels of serum cartilage oligomeric matrix protein (COMP) and urine c-telopeptide of type-2 collagen (CTX-II) as markers for cartilage turnover in patients with osteoarthritis (OA) of the knee, in response to muscle strength training in combination with treatment with glucosamine, ibuprofen or placebo.
  
  
  METHODS
  A 12-week double blind, placebo controlled, randomized study.
  
  
  METHODS
  Thirty-six elderly patients with bilateral tibiofemoral knee OA determined by radiography were randomly assigned to treatment with glucosamine (n=12), ibuprofen (n=12) or placebo (n=12) during 12 weeks of strength training of both legs with focus on the quadriceps muscle. Strength tests (5 repetition maximum), blood and urine sampling were performed before and after the training period. Serum COMP and urinary CTX-II were measured by enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  All three groups increased their muscle strength following 12 weeks of strength training (P<0.001). Serum COMP levels were reduced in the glucosamine-treated group after the training period (P=0.012), whereas they did not change in the two other groups. Glucosamine reduced COMP statistically significant compared to both placebo and ibuprofen; the mean reduction with glucosamine was 13% vs placebo (P=0.0378) and 17% vs ibuprofen (P=0.0122). Urinary CTX-II levels did not change significantly in any of the three experimental groups.
  
  
  CONCLUSIONS
  Serum COMP decreased significantly over the 12-week training period when treatment with glucosamine was added to the training regimen. This suggests an effect by glucosamine on the response of the OA cartilage to a period of joint loading in humans with knee OA.
authors.affiliation: Institute of Sports Medicine Copenhagen, Faculty of Health Sciences, Bispebjerg Hospital, University of Copenhagen, Denmark. sp12@bbh.regionh.dk
authors.forename: S G
authors.initials: SG
authors.lastname: Petersen
authors.forename: T
authors.initials: T
authors.lastname: Saxne
authors.forename: D
authors.initials: D
authors.lastname: Heinegard
authors.forename: M
authors.initials: M
authors.lastname: Hansen
authors.forename: L
authors.initials: L
authors.lastname: Holm
authors.forename: S
authors.initials: S
authors.lastname: Koskinen
authors.forename: C
authors.initials: C
authors.lastname: Stordal
authors.forename: H
authors.initials: H
authors.lastname: Christensen
authors.forename: P
authors.initials: P
authors.lastname: Aagaard
authors.forename: M
authors.initials: M
authors.lastname: Kjaer
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D064236:Cartilage Oligomeric Matrix Protein; D002358:Cartilage, Articular / Q000378:metabolism; D024043:Collagen Type II / Q000652:urine*; D004797:Enzyme-Linked Immunosorbent Assay; D005081:Exercise Therapy; D016326:Extracellular Matrix Proteins / Q000097:blood*; D005260:Female; D005944:Glucosamine / Q000627:therapeutic use*; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D008297:Male; D064235:Matrilin Proteins; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000378:metabolism / Q000628:therapy*; D010146:Pain / Q000188:drug therapy; D010446:Peptide Fragments / Q000652:urine*; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D064236:Cartilage Oligomeric Matrix Protein; D024043:Collagen Type II; D016326:Extracellular Matrix Proteins; D006023:Glycoproteins; D064235:Matrilin Proteins; D010446:Peptide Fragments; C577553:TSP5 protein, human; C543437:collagen II C-telopeptide; D005944:Glucosamine; D007052:Ibuprofen