All forms of arthritis involve cartilage degradation, causing pain, swelling and limited mobility. It therefore makes sense to treat arthritis and joint pain by promoting cartilage production and limiting its deterioration. This is where supplementing with glucosamine can help.
Keywords: glucosamine, chondroitin, osteoarthritis, arthritis, joint pain, swelling, inflammation
No matter whether you suffer from osteoarthritis, rheumatoid arthritis or simply feel the effects of painful, overworked joints, protecting your cartilage is of paramount importance. Cartilage helps to cushion bones at articulating joints to prevent them rubbing against one another, thereby limiting pain and inflammation while also acting as a kind of shock absorber for the body. All forms of arthritis involve cartilage degradation, causing pain, swelling and limited mobility. It therefore makes sense to treat arthritis and joint pain by promoting cartilage production and limiting its deterioration. This is where supplementing with glucosamine can help.
Cartilage and other connective tissues are heavily steeped in extracellular matrix – the ‘filler’ substance in between cells in animal organisms. As time goes on and people age, the water content in bone cartilage tends to decrease due to a gradual reduction in proteoglycan levels in the extracellular matrix, leaving the collagen fibres within the cartilage more open to degradation. Alternatively, those suffering the effects of rheumatism may have their cartilage attacked more directly, as inflammatory mediators hasten the degradation process. Regardless of how it occurs, once the water and collagen within cartilage deteriorates, the cartilage itself becomes less resilient, losing its elastic properties and allowing bone to grind against bone, causing considerable pain, swelling, inflammation and loss of mobility.
The Importance of Glucosamine
Glucosamine plays an important role in cartilage health and resilience. As a naturally occurring long chain amino-sugar molecule, glucosamine is used in the formation of glycosaminoglycans (GAGs), which bind water within the structure of cartilage and are a key structural component of proteoglycans, the building blocks of cartilage which invest it with its flexibility and cushion-like protective properties.[1]
Glucosamine may be taken as a supplement in any of several forms – as a sulfate, hydrochloride, N-acetyl or chlorohydrate salt. However, the weight of clinical evidence strongly suggests that supplementation with glucosamine sulfate will provide the greatest benefit for the sufferers of arthritis and joint pain, possibly because the sulfate moiety may enhance the effectiveness of the synovial fluid by strengthening cartilage and aiding GAG synthesis. [2]
Mechanisms of Action
The mechanisms of action of glucosamine are still not entirely understood, although it is known that glucosamine not only promotes cartilage formation – it also inhibits its degradation. In vitro studies [3, 4] have indicated that supplementing with glucosamine increases the synthesis of proteoglycans, thereby promoting cartilage formation and repair, as well as mediating improvements in cartilage strength and elasticity. In this sense, glucosamine may be viewed as food for your cartilage.
Studies have also shown glucosamine to be an effective inhibitor of several key proteolytic enzymes (such as MMP-13 and Aggrecanases-1 and -2) and other substances that contribute to cartilage degradation.[5-8] Further, supplementation with glucosamine sulfate has been shown to mediate mild anti-inflammatory effects.[9, 10]
Clinical Effects
There is compelling evidence from numerous randomized placebo-controlled clinical to support the use of oral glucosamine sulfate in the treatment of mild to moderate osteoarthritis and joint conditions.[1, 11-13] Glucosamine has been proven to be at least equal to conventional Non-Steroidal Anti-Inflammatory Drug (NSAID) therapy for osteoarthritis, with over 20 controlled clinical trials with more than 6000 participants judging it to be effective as a treatment for the relief of pain and functional impairment resulting from decreased mobility.[1] It can work synergistically with chondroitin to further improve results. Glucosamine may be also used effectively in conjunction with conventional anti-inflammatory and analgesic treatments, making it an attractive adjuvant therapy option for the management of arthritis and general joint pain.
Bonlutin is a novel treatment formula combining fish oil, glucosamine and chondroitin for the management of osteo- and rheumatoid arthritis. Preliminary clinical studies have proven Bonlutin to be effective in alleviating joint inflammation, swelling and pain associated with arthritis, while increasing joint mobility.
Bonlutin may also assist in the prevention of muscular aches, pains and cramps and the management of soft tissue trauma, providing relief from the symptoms of tenosynovitis and fibromyalgia.
1. Towheed TE, Maxwell L, Anastassiades TP, Shea B, Houpt J, Robinson V, Hochberg MC, Wells G: Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev 2005(2):CD002946.
2. Hoffer LJ, Kaplan LN, Hamadeh MJ, Grigoriu AC, Baron M: Sulfate could mediate the therapeutic effect of glucosamine sulfate. Metabolism 2001, 50(7):767-770.
3. Vacha J, Pesakova V, Krajickova J, Adam M: Effect of glycosaminoglycan polysulphate on the metabolism of cartilage ribonucleic acid. Arzneimittelforschung 1984, 34(5):607-609.
4. Bassleer C, Henrotin Y, Franchimont P: In-vitro evaluation of drugs proposed as chondroprotective agents. Int J Tissue React 1992, 14(5):231-241.
5. Dodge GR, Jimenez SA: Glucosamine sulfate modulates the levels of aggrecan and matrix metalloproteinase-3 synthesized by cultured human osteoarthritis articular chondrocytes. Osteoarthritis Cartilage 2003, 11(6):424-432.
6. Chan PS, Caron JP, Orth MW: Effect of glucosamine and chondroitin sulfate on regulation of gene expression of proteolytic enzymes and their inhibitors in interleukin-1-challenged bovine articular cartilage explants. Am J Vet Res 2005, 66(11):1870-1876.
7. Uitterlinden EJ, Jahr H, Koevoet JL, Jenniskens YM, Bierma-Zeinstra SM, Degroot J, Verhaar JA, Weinans H, van Osch GJ: Glucosamine decreases expression of anabolic and catabolic genes in human osteoarthritic cartilage explants. Osteoarthritis Cartilage 2006, 14(3):250-257.
8. Chu SC, Yang SF, Lue KH, Hsieh YS, Lee CY, Chou MC, Lu KH: Glucosamine sulfate suppresses the expressions of urokinase plasminogen activator and inhibitor and gelatinases during the early stage of osteoarthritis. Clin Chim Acta 2006, 372(1-2):167-172.
9. Largo R, Alvarez-Soria MA, Diez-Ortego I, Calvo E, Sanchez-Pernaute O, Egido J, Herrero-Beaumont G: Glucosamine inhibits IL-1beta-induced NFkappaB activation in human osteoarthritic chondrocytes. Osteoarthritis Cartilage 2003, 11(4):290-298.
10. Chan PS, Caron JP, Orth MW: Short-term gene expression changes in cartilage explants stimulated with interleukin beta plus glucosamine and chondroitin sulfate. J Rheumatol 2006, 33(7):1329-1340.
11. Richy F, Bruyere O, Ethgen O, Cucherat M, Henrotin Y, Reginster JY: Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis. Arch Intern Med 2003, 163(13):1514-1522.
12. Pujalte JM, Llavore EP, Ylescupidez FR: Double-blind clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis. Curr Med Res Opin 1980, 7(2):110-114.
13. Drovanti A, Bignamini AA, Rovati AL: Therapeutic activity of oral glucosamine sulfate in osteoarthrosis: a placebo-controlled double-blind investigation. Clin Ther 1980, 3(4):260-272.
