Chondroitin sulfate in the treatment of osteoarthritis: from in vitro studies to clinical recommendations

Abstract

Chondroitin sulfate (CS) is recommended as a therapeutic intervention in the multimodal approach of osteoarthritis (OA) management. CS has been studied extensively to describe its pharmacology (pharmacokinetic, in vitro and in vivo effects) and its clinical efficacy. Various results have been reported depending on the system of evaluation (model, dosage and duration) and the source of CS (origin and quality). The purpose of this review was to gather most of the available information about CS and to discuss its potency in OA management.

Targeting the synovial angiogenesis as a novel treatment approach to osteoarthritis

“…With the exception of acetominophen, all these agents have been demonstrated to reduce the production of pro-inflammatory and catabolic mediators (cytokines, prostanoids, MMPs or ROS) by joint cells. These aspects have been well documented in some recent reviews [Henrotin et al 2010[Henrotin et al , 2011[Henrotin et al , 2012. Herein, we overview the potential anti-angiogenic properties of these compounds.…”

Evaluation of the injection route of an anionic polymer for small interfering RNA delivery into the liver by sequential injection of anionic polymer and cationic lipoplex of small interfering RNA

“…CS-C is a compound available for the treatment of OA [21], and it attenuates inflammatory responses in murine macrophages via the suppression of NF-κB nuclear translocation [22], indicating that CS-C might be able to suppress the inflammatory responses induced by the injection of cationic lipoplexes. These results suggested that sequential injection of CS-C plus cationic lipoplexes had no side-effects with regard to hepatoxicity regardless of the injection route of CS-C.…”

Progress in the development of Lipoplex and Polyplex modified with Anionic Polymer for efficient Gene Delivery

“…CS is an anionic linear polysaccharide, which consists of alternating disaccharide units of β-glucuronic acid-(1-3)-N-acetyl-β-galactosamine-6-sulfate (Figure 1), and it can bind to CD44. CS is currently applied as a symptomatic slow-acting drug for osteoarthritis (SYSADOA) agent in the treatment of osteoarthritis (OA) [52]. Uchida et al reported that the addition of CS to pDNA/poly(ethylene glycol) (PEG)-block-poly N-[N-(2-aminoethyl)-2-aminoethyl]aspartamide (PEG-PAsp(DET)) polyplexes markedly reduced damage of cellular membrane after in vitro and in vivo gene transfections [53].…”

“…Regarding the side effects, sequential injection of αPGA plus siRNA lipoplexes exhibited hepatic damage and resulted in the induction of in lammatory cytokines such as TNFα and interleukin-10 in serum, but sequential injection of CS plus siRNA lipoplexes did not [55]. CS is a compound with an anti-in lammatory activity and available for the treatment of OA patients [52]. CS attenuates in lammatory responses in macrophages via the suppression of NF-κB nuclear translocation [89,90].…”