title: Glucosamine supplementation demonstrates a negative effect on intervertebral disc matrix in an animal model of disc degeneration.
abstract: METHODS
  Laboratory based controlled in vivo study.
  
  
  OBJECTIVE
  To determine the in vivo effects of oral glucosamine sulfate on intervertebral disc degeneration.
  
  
  BACKGROUND
  Although glucosamine has demonstrated beneficial effect in articular cartilage, clinical benefit is uncertain. A Centers for Disease Control report from 2009 reported that many patients are using glucosamine supplementation for low back pain, without significant evidence to support its use. Because disc degeneration is a major contributor of low back pain, we explored the effects of glucosamine on disc matrix homeostasis in an animal model of disc degeneration.
  
  
  METHODS
  Eighteen skeletally mature New Zealand White rabbits were divided into 4 groups: control, annular puncture, glucosamine, and annular puncture + glucosamine. Glucosamine treated rabbits received daily oral supplementation with 107 mg/d (weight based equivalent to human 1500 mg/d). Annular puncture surgery involved puncturing the annulus fibrosus of 3 lumbar discs with a 16-gauge needle to induce degeneration. Serial magnetic resonance images were obtained at 0, 4, 8, 12, and 20 weeks. Discs were harvested at 20 weeks for determination of glycosaminoglycan content, relative gene expression measured by real time polymerase chain reaction, and histological analyses.
  
  
  RESULTS
  The magnetic resonance imaging index and nucleus pulposus area of injured discs of glucosamine treated animals with annular puncture was found to be lower than that of degenerated discs from rabbits not supplemented with glucosamine. Consistent with this, decreased glycosaminoglycan was demonstrated in glucosamine fed animals, as determined by both histological and glycosaminoglycan content. Gene expression was consistent with a detrimental effect on matrix.
  
  
  CONCLUSIONS
  These data demonstrate that the net effect on matrix in an animal model in vivo, as measured by gene expression, magnetic resonance imaging, histology, and total proteoglycan is antianabolic. This raises concern about this commonly used supplement, and future research is needed to establish the clinical relevance of these findings.
authors: *The Ferguson Laboratory for Orthopaedic and Spine Research †Department of Physical Medicine and Rehabilitation, Pittsburgh, PA ‡Department of Internal Medicine, Georgetown University School of Medicine, Washington, DC; and §Department of Obstetrics and Gynecology, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: Lloydine
authors: L
authors: Jacobs
authors: Nam
authors: N
authors: Vo
authors: Joao Paulo
authors: JP
authors: Coelho
authors: Qing
authors: Q
authors: Dong
authors: Bernard
authors: B
authors: Bechara
authors: Barrett
authors: B
authors: Woods
authors: Eric
authors: E
authors: Hempen
authors: Robert
authors: R
authors: Hartman
authors: Harry
authors: H
authors: Preuss
authors: Judith
authors: J
authors: Balk
authors: James
authors: J
authors: Kang
authors: Gwendolyn
authors: G
authors: Sowa
mesh_terms: D000284:Administration, Oral; D000818:Animals; D001682:Biological Availability; D019587:Dietary Supplements / Q000633:toxicity*; D004195:Disease Models, Animal; D005109:Extracellular Matrix / Q000378:metabolism*; D005260:Female; D005786:Gene Expression Regulation; D005944:Glucosamine / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000633:toxicity*; D006025:Glycosaminoglycans / Q000378:metabolism; D007403:Intervertebral Disc / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D055959:Intervertebral Disc Degeneration / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D008159:Lumbar Vertebrae / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D008279:Magnetic Resonance Imaging; D011817:Rabbits; D013997:Time Factors
chemical_list: D006025:Glycosaminoglycans; D005944:Glucosamine