title: Discrepancies in composition and biological effects of different formulations of chondroitin sulfate.
abstract: Osteoarthritis is a common, progressive joint disease, and treatments generally aim for symptomatic improvement. However, SYmptomatic Slow-Acting Drugs in Osteoarthritis (SYSADOAs) not only reduce joint pain, but slow structural disease progression. One such agent is chondroitin sulfate-a complex, heterogeneous polysaccharide. It is extracted from various animal cartilages, thus has a wide range of molecular weights and different amounts and patterns of sulfation. Chondroitin sulfate has an excellent safety profile, and although various meta-analyses have concluded that it has a beneficial effect on symptoms and structure, others have concluded little or no benefit. This may be due, at least partly, to variations in the quality of the chondroitin sulfate used for a particular study. Chondroitin sulfate is available as pharmaceutical- and nutraceutical-grade products, and the latter have great variations in preparation, composition, purity and effects. Moreover, some products contain a negligible amount of chondroitin sulfate and among samples with reasonable amounts, in vitro testing showed widely varying effects. Of importance, although some showed anti-inflammatory effects, others demonstrated weak effects, and some instances were even pro-inflammatory. This could be related to contaminants, which depend on the origin, production and purification process. It is therefore vitally important that only pharmaceutical-grade chondroitin sulfate be used for treating osteoarthritis patients.
authors.affiliation: Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC H2X 0A9, Canada. jm@martelpelletier.ca.
authors.forename: Johanne
authors.initials: J
authors.lastname: Martel-Pelletier
authors.affiliation: Unitat de Recerca en Inflamació i Cartílag, Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona 08003, Spain. ainafdc@gmail.com.
authors.forename: Aina
authors.initials: A
authors.lastname: Farran
authors.affiliation: Pre-Clinical R&D Area, Pharmascience Division, Bioibérica, Barcelona 08029, Spain. lmontell@bioiberica.com.
authors.forename: Eulàlia
authors.initials: E
authors.lastname: Montell
authors.affiliation: Pre-Clinical R&D Area, Pharmascience Division, Bioibérica, Barcelona 08029, Spain. jverges@bioiberica.com.
authors.forename: Josep
authors.initials: J
authors.lastname: Vergés
authors.affiliation: Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC H2X 0A9, Canada. dr@jppelletier.ca.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pelletier
mesh_terms: D000818:Animals; D002626:Chemistry, Pharmaceutical / Q000379:methods*; D002809:Chondroitin Sulfates / Q000737:chemistry* / Q000627:therapeutic use; D019587:Dietary Supplements / Q000592:standards*; D010003:Osteoarthritis / Q000188:drug therapy; D011786:Quality Control
chemical_list: D002809:Chondroitin Sulfates