Supplements That Help Cartilage Repair

Courtesy of Chiromanis

Of note: NSAID’s block GAG prodcution and destroy cartilage and Steroids cause bone loss.  I might stop the NSAID’s for good and just deal with the pain.  I’m already consuming glucosamine, chondroitin and MSM.

Full Article:
Cartilage Building Supplements
 
Damaging Contributions to Cartilage and Glycosaminoglycan Processing

ANTIDEPRESSANTS  ENDANGER BONE and JOINTS
Ray: Cyclic antidepressants may increase hip fracture risk. J of Manip Med (12/91):46
STEROIDS  CAUSE BONE LOSS, INCREASE FRACTURE RISK

Bockman RS et al: Steroid induced osteoporosis. Ortho Clin of N Amer 21(1):97

Fries: Prednisone greatly increases fracture risk. J of Musculoskeletal Med (6/92):16

Mitchell: [Steroid use causes osteo-degenerative arthritic hips]. Radiology 1987; 62(3):709

Fessler: [Chronic steroid use leads to epidural lipomatosis.] Spine 1992; 17(2)
NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)  DEPRESS GAG PRODUCTION and SYNTHESIS, DESTROY CARTILAGE

Yoo: Suppression of proteoglycan synthesis in chondrocyte cultures derived from canine intervertebral disc. Spine 17(2):221-224

Newman: Lancet 1985; pgs. 11-14

VanDerKraan et al: High susceptibility of human articular cartilage glycosaminoglycan synthesis to changes in inorganic sulfate availability. J of Ortho Research 1990; 8(4):565-71

Whittaker: Arthritis drugs actually cause cartilage destruction! Health & Healing 3(6):1-4
SALICYLATES (aspirin) DEPLETE GAG SYNTHESIS in DISC, LEAD to OSTEOARTHRITIS, WEAKEN BONE

Palmoski: Arthritis and Rheumatism 1985; 28:548;   DeVries: Arthritis and Rheumatism 1985; 28:922-9;   Laan: Arthritis and sciatica drug weakens vertebrae. Backletter 1994;9(2):22
Possible Help in Healing Damaged or Degenerated Discs/Cartilage

Glucosamine Sulfate

Perna Canaliculus  (pure chondroitin sulfate)
Glucosamine sulfate and chondroitin sulfate [a form of glycosaminoglycan] are naturally occurring substances that are essential for cartilage maintenance, as well as necessary for cartilage regeneration. Together, they help chondrocytes within cartilage form new cartilage. The amount of proteoglycans formed depends upon the amount of glucosamine present. The more glucosamine available, the more proteoglycans can be made. 11

“The amount of proteoglycans formed depends upon the amount of glucosamine present.”

Glucosamine  forms proteoglycans that are found within the joints while chondroitin sulfates act like “magnets” that attract fluid into the proteoglycan molecules. This is important because the fluid acts as a shock absorber and sweeps nutrients into the cartilage. 8  They are both tied to the sulfate compound. In a dog study, it was found that sulfate and glycosaminoglycan act as chondroprotective agents. 30 Sulfur is an essential nutrient for joint tissue as it stabilizes the connective tissue matrix of cartilage, tendons, and ligaments. It inhibits the enzymes that lead to cartilage destruction in osteoarthritis. Healthy people have low serum sulfate levels; osteoarthritic people have even lower levels. Arthritic persons are commonly deficient in sulfur. 29 In the posterior anulus and nucleus in degenerative disc disease, chondroitin is undersulfated. 31

Perna Canaliculus                         

from green lipped mussel (shellfish); those allergic to shellfish should be cautious

Perna Canaliculus is pure chondroitin sulfate which is one form of glycosaminoglycan — GAG for short — in Discat and Discat Plus. It is reportedly the “single most effective” item for relief of joint pain and inflammation as occurs with disc herniations, osteoarthritis, and rheumatoid arthritis.
– may decrease (or eliminate) pain of rheumatiod and osteoarthritis
– may help restore mobility to degenerated joints/cartilage
– may decrease joint distortion from degeneration of joint tissue
Further, one of the most popular and effective substances used by doctors in Europe for arthritis is chondroitin sulfate A (CSA). CSA is naturally found in bones, cartilage, tendons, ligaments, vertebral discs as well as in many plants.  17 In one study, 77% of those taking CSA reported reduced inflammation — over 42% higher than those receiving NSAIDs. It repairs degraded bones, increases the absorption and replacement of calcium and diminishes the disease and begins rebuilding the damaged area with none of the health risks of NSAIDs.

 
Perna canaliculus extract has proven to be the single most effective preparation ever encountered for the treatment of osteo- and rheumatoid arthritis. Perna canaliculus extract did have genuine anti-inflammatory effects. 17
Glucosamine Sulfate                  
may prevent degeneration & promote regeneration of cartilage
– improves mobility and relieves pain with significantly less side effects than NSAIDs
– has good tolerability
– maintains its good benefits even if there is an interruption in taking them compared with drug therapy which relieves pain only while taking the drug

Glucosamine sulfate (GS) is a naturally occurring part of joint cartilage and forerunner for and stimulant of proteoglycan synthesis and the making of GAG which is necessary for development of the white fibrocartilage of the disc. Unlike NSAIDs which relieve symptoms of and, over time, accelerate the destruction of, degenerative joint and disc disease, glucosamine has been shown in experiments to slow the progression of the degenerative disease and promote repair of affected cartilage:

Two similar yet separate experiments6,7 were conducted and gained similar results: patients receiving GS improved by 71% compared to a placebo group.6 

A comparison8 of 2 groups –one receiving ibuprofen and one GS three times per day (total of 1500 mg) for 30 days–showed that the GS group reported less pain on rest, standing, and exercise. The GS group’s improvement was more pronounced, lasting for a period of 6 to 12 wks after the treatment ended.

In a double-blind study9 of people suffering from osteoarthritis of the knees compared a placebo group to a GS group. The GS group showed significant reduction in pain, joint tenderness, and swelling  treated with 1500 mg GS daily.

Findings by electron micrographs of cartilage of persons receiving GS compared to a placebo10 show:

Placebo results – typical of osteoarthritis;             GS results – more similar to healthy cartilage.

GS is able to stimulate proteoglycan synthesis by chondrocytes and has mild anti-inflammatory properties. In a clinical trial, GS was tested against ibuprofen. 35% of the ibuprofen group complained of adverse effects throughout the treatment, with seven dropping out of the study. Only six of the 100 patients in the GS group experienced adverse effects. Therefore, GS was as effective as ibuprofen.18

GS is the preferred form of glucosamine (over GS HCl, for example) and the only form of glucosamine subjected to over 300 scientific investigations & 20 double-blind studies. 29

The absorption rate for GS is about 98%. 24,25

GS is extremely non-toxic, and its therapeutic margin is 10-30 times better than NSAIDs 26 When taken orally, it is more effective than placebo and at least as effective as NSAIDs in relieving the symptoms of osteoarthritis. 28

2% of 1500 patients were unable to tolerate GS: peptic ulcer and diuretic use were associated with increased risk of side effects, most commonly: gastric upset (3.5%), heartburn (2.7%), diarrhea and nausea (1%). 27
Glycosaminoglycan (GAG)                      
may stop destruction of and even enhance regeneration of cartilage

Supplemented chondroitin sulfates work like naturally occurring chondroitins found in cartilage:

– stop enzyme starvation of cartilage and build proteoglycans, glycosaminoglycans, and collagen, the building blocks for healthy new cartilage. 13
– protect existing cartilage from premature breakdown by inhibiting the action of certain “cartilage chewing” enzymes. 12
– work synergistically with glucosamine.14

The central event in osteoarthritis and degenerative disc disease is the loss of the proteoglycans from the disc. 32

Low GAG precedes degenerative disc disease; injured and adjacent discs show less GAG and increased collagen. 33

osteodegenerative arthritis shows increased release of GAG. 34

Arthrosis shows a loss of glycosaminoglycan. 35

Bucci reports that OSTEOARTHRITIS CAN BE REVERSED by chondroprotective agents – GAGs – if use of analgesics (aspirin, non-steroidal drugs) is minimal.1 Further, he states that oral administration of GAGs is better than injection because constant higher levels can be maintained in the bloodstream instead of short periods of elevation by shots.

Cole, Ghosh & Taylor wrote that mature beagle dogs, when given GAG over a 26 wk period, showed cartilage improvement.2 These  findings  were  the  first  to suggest that GAG administration might  be  of value in management  of  degenerative disc disease.A 50% loss of GAG from rabbit articular cartilage when arthritis of the joint was reported in one study. This caused the cartilage matrix to be less capable of restoring the proteoglycan content of the cartilage and resulted in loss of joint stiffness and resistance to the compression.3

In rabbits with osteoarthritis of the knee, injection of sulfated GAG inhibited enzymes that destroy cartilage and promoted repair of the defects. GAG had been found to increase proliferation of the hyaline cartilage of the hip joint in mice and the femoral condyles, femur and tibia of rabbits. Furthermore, Puhl and Dustmann induced regeneration of damaged cartilage in rabbits. 5

120 patients suffering from osteoarthritis of the knees and hips were either given oral chondroitin sulfates or a placebo. After three months, the group given the oral chondroitin in the morning and the evening reported a reduction in pain and pain movement. There were no reported side effects. In addition, there was a 60-day carry-over effect when administration was stopped. Results appeared within 2 to 8 weeks. 16

50 patients suffering from osteoarthritis of the knee were given oral chondroitin sulfate or a pain medication. Cartilage tissue samples were taken after three months of therapy. Results showed that the chondroitin group had repaired the cartilage to a significant degree. 15

Eismont showed circulation into the disc when he reported that antibiotics reach the nucleus pulposus following 8 hours of intramuscular administration.4

Dogs given GAG showed less osteophyte formation, less disc space narrowing, better disc injury repair, and prevention of experimental disc degeneration. 36

Trentham et al 19 (of Harvard University) report in Science on a new way to help rheumatoid arthritis (RA) sufferers: oral tolerization. This procedure involved a liquid solution of cartilage/collagen and orange juice. Dr. Trentham states that this seems to “teach” the body’s immune system to stop inflaming the tissue around the joints. This appears to arrest the progress of RA. In a three month trial, 28 patients — all of whom were taken off all other drugs — got relief from RA; 4 went into remission. Thirty-one patients on a placebo became worse.

The Holy Grail of DDD

This will help SO MANY people, if it ever gets off the ground.  Fingers are crossed.

Mesoblast:

The intervertebral disc is a cartilage that cushions the stress forces on the spine and enables the normal rotation of the spine. With advancing age, there is progressive loss of the proteoglycan material that gives the disc its properties, and a consequent increased risk of damage to the spine. This process, termed degenerative disc disease (DDD), affects between 15 and 45% of the population.

Preclinical trials showed that a single, low dose of Mesoblast’s allogeneic adult stem cells into severely damaged intervertebral discs resulted in dramatic reversal of the degenerative process, regrowth of disc cartilage and sustained normalization of disc pathology, anatomy and function.

Since spinal surgery is advocated only in severe cases of DDD, out of the 4.5 million people only 500,000 would be considered candidates for surgery. This creates a gap of about 4 million people who are currently left untreated. These patients experiencing mild to moderate DDD are normally treated with conservative procedures with significant associated morbidity and reduced productivity, until the condition worsens to a degree that warrants spinal surgery.

Since MPCs produce the proteoglycan materials found in discs, Mesoblast envisages that the injection of MPCs into a degenerated intervertebral disc will lead to replacement of the proteoglycan of cartilage. This approach, with its anticipated ease of application and lack of side-effects, should offer a relatively non-invasive and cost-effective therapy for patients with moderate or severe degenerative disc disease.