Clinical and immunological features of metabolic phenotype of osteoarthritis

Ширинский, В. С.; Калиновская, Н. Ю.; Филатова, К. Ю.; Ширинский, И. В.

doi:10.15789/1563-0625-cai-1881

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…Each of the five scores was calculated as the sum of the items included. The scores were transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems [7].…”

Section: Methodsmentioning

confidence: 99%

Efficacy and safety of curcumin in patients with metabolic phenotype of osteoarthritis: A pilot study

Shirinsky

Филатова

2023

Med. immunol.

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The aim of this study was to assess efficacy and safety of curcumin in metabolic syndrome- associated osteoarthritis (MetS-OA). All patients provided written informed consent. Knee OA was diagnosed according to American College of Rheumatology criteria; MetS was diagnosed according to Russian Scientific Society of Cardiology Guidelines. The study had before-and-after design. The main inclusion criteria were presence of knee OA and MetS, levels of global health assessment and pain assessment more than 50 mm using 0-100 visual analogue scale (VAS). The main outcome was VAS global. The other outcomes were VAS pain, Knee injury and Osteoarthritis Outcome Score (KOOS) consisting of five subscales: pain (KOOS pain), other symptoms (KOOS symptoms), activities in daily living (KOOS ADL), function in sport and recreation (KOOS Sport/Rec) and knee related Quality of life (KOOS QoL). The level of depression was measured using PHQ- 9. For pain, proportion of patients achieving minimal clinically important improvement (MCII) was assessed using the cut-offs of (a) 15 of 100 for absolute improvement and 20% for relative improvement.The treatment consisted of C. longa extract 1000 mg/day for 4 weeks. The assessments were performed on baseline and 4 weeks thereafter. Eighteen women with MetS-OA of the knee were included in the study.At the end of treatment, there were significant improvements in the VAS global scale by an average 33.9 mm (p = 0.001), VAS pain by 25 mm (p = 0.001). There was a trend towards improvement in PHQ-9 by 2.9 (p = 0.05). The mean improvement in KOOS pain was 11 (p = 0.001). KOOS symptoms improved by 9 (p = 0.025), KOOS ADL - by 12.4 (p = 0.001), KOOS Sport/Rec by 10.3 (p = 0.044), and KOOS QOL by 14.4 (p = 0.009). The proportion of patients achieving clinically significant improvement (MCII) were nine (56%) for both global health and pain. There were no adverse events during the study. The findings of this study suggest clinical efficacy and safety of C. Longa in MetS-associated knee OA. There is a need for large controlled studies to confirm these results.

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Section: Methodsmentioning

confidence: 99%

Efficacy and safety of curcumin in patients with metabolic phenotype of osteoarthritis: A pilot study

Shirinsky

Филатова

2023

Med. immunol.

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Combination treatment of patients with metabolic phenotype of osteoarthritis: an exploratory study

et al. 2020

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Treatment of osteoarthritis (OA) patients with comorbidities can be challenging due to adverse events and non-sufficient efficacy of modern drugs. A safe and effective alternative could be the methods of traditional medicine and their combinations. The aim of this study was to evaluate efficacy and safety of combination of curcuma-based parapharmaceutical preparation and acupuncture in metabolic phenotype of OA (MPOA). The trial design was pilot open-label “before – after” study with the duration of 12 weeks. The patients with MPOA received parapharmaceutical preparation Epigenorm Antivir in a daily dose of 1000 mg and underwent 15-20 sessions of classical acupuncture. We enrolled twenty three women with metabolic syndrome (MS), clinical and radiographic signs of gonarthrosis, mean age 66.5 years, mean body mass index 34.5. At the end of treatment there was a decrease in pain levels according to visual analogue scale (VAS) (before 65 (12.7), after 24.6 (21.0), р=0.001), WOMAC pain scale (before 210.6 (102.2), after 103 (80.8), p = 0.014), KOOS (before 47.8 (12.1), after 66.7 (16.2), р = 0.001). The treatment resulted in statistically significant improvement of daily and social activities, role functioning, and quality of life. The results were clinically significant as evidenced by the moderate (Cohen d > 0.5) and large (Cohen d > 0.8) effect sizes of most outcome changes in accordance with the Cohen classification. The clinical improvement was accompanied by the decrease in MS components – LDL cholesterol (before 3.26 (0.26) mmol/l, after 2.43 (0.2) mmol/l, р = 0.001), triglycerides (before 2.02 (0.16) mmol/l, after 1.31 (0.1) mmol/l, р = 0.005). The treatment resulted in the reduction of systemic inflammation as evidenced by the decrease in the concentrations of TNFα (before 15.9 (1.2) pg/ml, after 12.4 (0.8), р = 0.002), histamine (before 1.6 (0.2) ng/ml, after 0.7 (0.2) pg/ml, р = 0.034), IL-18 (before 208.8 (32.6 ) pg/ml, after 160.0 (26.0) pg/ml, р = 0.002) and CRP (before 6.05 (1.3) mg/l, after 3.2 (0.7) mg/l, р = 0.022). At the same time there was an increase of concentration of IL-10 (before 1.5 (0.7) pg/ml, after 3.8 (1.2), р = 0,006) and adiponectin (before 34.0 (5.6) pg/ml, after 40.0 (6.9), р = 0.034). The treatment was well tolerated, no serious adverse events were registered. The pleiotropic actions of combination treatment occured probably due to synergistic effects of herbal therapies and acupunctures. The results provide a rationale for larger scale, randomized controlled double-blind clinical trials.

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Research Institute of Internal and Preventive Medicine, Branch of the Institute of Cytology and Genetics, Siberian Branch, Russian Academy of Sciences

Shirinsky,

Filatova,

Shirinsky

2024

Med. immunol.

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The purpose of the study was to evaluate the clinical manifestations of osteoarthritis (OA) in combination with MS (OAMS) and their relationship with concentration of several circulating proinflammatory cytokines, the level of lipids in peripheral blood serum. Forty women patients with knee OA were examined: 19 patients from the experimental group in whom OA was combined with metabolic syndrome (MS), 21 patients with OA without MetS. All patients were elderly and overweight. In the first subgroup of patients, the absolute majority of people were obese, while in the second subgroup, overweight patients predominated. Patients in the experimental subgroup showed a statistically significant increase in waist circumference compared to patients without MS. The duration of OA did not differ in both subgroups. It has been established that the metabolic phenotype of gonarthrosis – OA in combination with metabolic syndrome – differs from patients with OA without MS in greater severity of pain, a decrease in the level of daily activity, an increase in the burden of the disease and other symptoms of OA. These core characteristics are associated with poor quality of life and clinically significant symptoms of depression. The metabolic type of gonarthrosis is characterized by more pronounced laboratory signs of systemic low-grade inflammation in comparison with patients without MS, as evidenced by a threefold increase in CRP content and an increase in the level of IL-6, IL-18 in PC serum. In addition, in patients with the metabolic phenotype of OA, a fivefold increase in the level of a specific humoral immune response to type 2 collagen (Col2Ab) and dyslipidemia – an increase in the content of LDL cholesterol and triglycerides, with a comparable reduced level of HDL cholesterol – were revealed. It is concluded that the phenotype of OA in combination with MS is probably due to the pathogenetic similarity of OA and MS (syntropy), which is based on low-grade inflammation. Studying the pathogenesis of the OAMS phenotype and developing new principles for the treatment of multimorbidity should be based on patient-oriented approaches.

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Clinical and immunological features of metabolic phenotype of osteoarthritis

Cited by 3 publications

References 22 publications

Efficacy and safety of curcumin in patients with metabolic phenotype of osteoarthritis: A pilot study

Efficacy and safety of curcumin in patients with metabolic phenotype of osteoarthritis: A pilot study

Combination treatment of patients with metabolic phenotype of osteoarthritis: an exploratory study

Research Institute of Internal and Preventive Medicine, Branch of the Institute of Cytology and Genetics, Siberian Branch, Russian Academy of Sciences

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