title: Management of Osteoarthritis with Avocado/Soybean Unsaponifiables.
abstract: Osteoarthritis (OA) is a painful and life-altering disease that severely limits the daily activity of millions of Americans, and is one of the most common causes of disability in the world. With obesity on the rise and the world's population living longer, the prevalence of OA is expected to increase dramatically in the coming decades, generating burdensome socioeconomic costs. This review summarizes current pharmaceutical, non-pharmaceutical, and prospective new treatments for OA, with primary focus on the dietary supplement Avocado/Soybean Unsaponifiables (ASU). ASU modulates OA pathogenesis by inhibiting a number of molecules and pathways implicated in OA. Anticatabolic properties prevent cartilage degradation by inhibiting the release and activity of matrix metalloproteinases (MMP-2,3,13) and increasing tissue inhibitors of these catabolic enzymes (TIMP-1). ASU also inhibits fibrinolysis by stimulating the expression of plasminogen activator inhibitor (PAI-1). Anabolic properties promote cartilage repair by stimulating collagen and aggrecan synthesis via inhibition of inflammatory cytokines such as IL1, IL6, IL8, TNF, ERK, and PGE2. Chondroprotective effects are mediated by correcting growth factor abnormalities, increasing TGFβ while decreasing vascular endothelial growth factor (VEGF) in synovial fluid. ASU also inhibits cholesterol absorption and endogenous cholesterol biosynthesis, which mediate reactive oxygen species pathology in chondrocytes. At the clinical level, ASU reduces pain and stiffness while improving joint function, resulting in decreased dependence on analgesics.
authors.affiliation: University of California-Davis Health System, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 4635 2nd Ave, Suite 2000, Sacramento, CA 95817, .
authors.forename: Blaine A
authors.initials: BA
authors.lastname: Christiansen
authors.affiliation: Formulation Technology Inc. 571 Armstrong Way Oakdale, CA 95361 Ph: 209- 847-0331.
authors.forename: Simi
authors.initials: S
authors.lastname: Bhatti
authors.affiliation: Pharmin USA, LLC, 2375 Lindbergh Avenue San Jose, CA 95128 .
authors.forename: Ramin
authors.initials: R
authors.lastname: Goudarzi
authors.affiliation: Corresponding author: shahin.emami1@gmail.com.
authors.forename: Shahin
authors.initials: S
authors.lastname: Emami
keywords: Arthrocen; Osteoarthritis; avocado soybean unsaponifiables (ASU); cartilage; dietary supplements