Effect of ginger powder supplementation on nitric oxide and C-reactive protein in elderly knee osteoarthritis patients: A 12-week double-blind randomized placebo-controlled clinical trial

Abstract

There is limited evidence that ginger (生薑 shēng jiāng) powder consumption can relieve pain and inflammation because of its special phytochemical properties. This study is aimed at investigating the effect of ginger powder supplementation on some inflammatory markers in patients suffering from knee osteoarthritis. This is a double-blind randomized placebo-controlled clinical trial with a follow-up period of 3 months that was conducted on 120 outpatients with moderately painful knee osteoarthritis. Patients were randomly divided up into two groups: ginger group (GG) or placebo group (PG). Both groups received two identical capsules on a daily basis for 3 months. Each ginger capsule contained 500 mg of ginger powder; the placebo capsules had 500 mg of starch in them. Serum samples were collected prior to and after the intervention and were stored at −70 °C until the end of the study. Serum concentration of nitric oxide (NO) and hs-C reactive protein (hs-CRP) were measured using enzyme-linked immunosorbent assay kits. There was no significant difference between the two groups in terms of inflammatory markers (i.e., NO and hs-CRP) prior to the intervention. However, after 3 months of supplementation, serum concentration of NO and hs-CRP decreased in the GG. After 12 weeks, the concentration of these markers declined more in the GG than in the PG. Ginger powder supplementation at a dose of 1 g/d can reduce inflammatory markers in patients with knee osteoarthritis, and it thus can be recommended as a suitable supplement for these patients.

The effect of ginger supplementation on serum C-reactive protein, lipid profile and glycaemia: a systematic review and meta-analysis

“…Naderi et al conducted a 12-week clinical trial to investigate the effects of ginger supplementation on nitric oxide and CRP in elderly knee osteoarthritis patients and reported that ginger powder supplementation at a dose of 1 g/d can reduce inflammatory markers in patients with knee osteoarthritis (5), which is in line with the findings of a study by Rahimlou et al (35). However, one study reported that after oral administration of 100–1,000 mg/ml squeezed ginger extract in mice, the production of inflammatory markers increased (16).…”

“…C-reactive protein (CRP) is a plasma protein that rises in the systemic response to inflammatory conditions (3); in addition, there is a link between elevated level of this protein and major cardiovascular events (4, 5). Interleukin-6 (IL-6) is an important inflammatory cytokine that induces the hepatic production of CRP.…”

“…Regarding the effect of ginger supplementation on CRP, Naderi et al have reported that the concentration of inflammatory markers including CRP was reduced in the group treated with ginger compared with the group receiving placebo (5); moreover, Karimi et al reported that the ginger supplementation caused a reduction of hs-CRP, IL-10, blood glucose, LDL, and TG, and an increase in HDL (14). Imani et al indicated that daily administration of 1,000 mg ginger reduces serum fasting glucose (15).…”

Phytomedicine in Joint Disorders

“…A recent study found that ZO powder supplementation (1 g/day) for 3 months can reduce the serum level of nitric oxide and high-sensitivity reactive protein hs-CRP in patients with knee OA. The inflammatory markers started to decrease after 3 weeks of treatment [96]. Several other studies showed clinical improvement in OA patients with ZO extract, as evaluated by the pain score with VAS, reduction in intake of rescue medication, having mostly mild gastrointestinal adverse events, and similar or even better efficacy and satisfaction score than the standard treatment prescribed by the orthopedic specialist [97][98][99].…”

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“…Ginger powder exhibited significant reduction in arthritis index and visual analog scale scores and it is attributed to reduced production of NO and CRP. [58,59] 6-shagoal is most potent antioxidant and anti-inflammatory agent among other shagaols and gingerols. [60] Ginger essential oil, a secondary metabolite of ginger, also prevented chronic joint inflammation, and granuloma formation.…”