Efficacy of vitamin E in knee osteoarthritis management of North Indian geriatric population

Abstract

Background: Osteoarthritis (OA) is the most common cause of chronic pain and disability in the elderly. It involves progressive destruction of articular cartilage as a consequence of various factors including augmented oxidative stress with advancing age which has not yet been controlled. It is conceivable that exogenous vitamin E supplementation ameliorates the modifiable indexes via regulation of free radical production and the consumption of antioxidant reserve. The objectives of the present study were to investigate the therapeutic effect of vitamin E supplementation in ameliorating the altered activity of antioxidant enzymes (superoxide dismutase, ceruloplasmin, glutathione peroxidase and catalase), erythrocyte malondialdehyde level (MDA, i.e. marker of lipid peroxidation) and markers of systemic inflammation (plasma C-reactive protein [CRP] and synovial fluid interleukin 6 [IL-6]) in osteoarthritic elderly. Methods: Antioxidant enzymes status, MDA, IL-6 and CRP levels were estimated by using standard methods in 40 healthy individuals (control group) and in 40 osteoarthritic patients aged 50-70 years before and after 3 months of vitamin E supplementation, i.e. group I (nonsupplemented) and group II (200 mg/day vitamin E supplemented). The obtained values were compared statistically by using Student's t-test. Results: Marked alteration in antioxidant enzymes, MDA and inflammatory markers were observed in group I (p < 0.05) as compared with controls. These levels were ameliorated significantly after vitamin E supplementation (p < 0.05) in group II. However, elevated levels of serum CRP and synovial fluid IL-6 (r = 0.034; p < 0.05) were decreased insignificantly (p < 0.1) after vitamin E supplementation in knee OA patients. Conclusions: These findings confirm the protective role of vitamin E supplementation against oxidative stress mediated biomolecular deterioration in OA. However, the anti-inflammatory role of vitamin E remains to be explored.

Cumulative effect of systemic inflammation and oxidative stress in 40 known cases of active rheumatoid arthritis

“…6 In the present study, plasma CRP levels were found to be significantly high (p<0.001) in active RA patient which clarify the combined role of inflammation and oxidative stress in the etiopathogenesis of active RA and its complications. 7,14,16 On the basis of present findings and consistent findings of previous studies, it can be inferred that these antioxidant enzymes and CRP are excellent markers of oxidative stress and systemic inflammation in active RA patients. It also authenticate the fact that combined effect of inflammation and oxidative stress plays a significant role in the etiopathogenesis of RA and the patients are unable to counteract the augmented oxidative stress effectively.…”

Effects of single or combined administration of salmon calcitonin and omega-3 fatty acids vs. diclofenac sodium in sodium monoiodoacetate-induced knee osteoarthritis in male Wistar rats

“…Yet, some other researchers reported that N-3 reduce lipid peroxidation, and so improve the activities of the antioxidant system [42]. The possible generation of free radicals in OA, and the accompanying lipid peroxidation are associated with the depression of the antioxidant system [36]. The anti-lipid peroxidative effect of Sct and/ or N-3 was well-appreciated in the current study.…”

“…SOD, glutathione peroxidase (GPx), CAT, protein kinase C, and vitamins C and E] have also been reported [34,35]. The resulting imbalance between the endogenous pro-oxidants and antioxidants indices tend to cause cellular oxidative stress, which is known to play a vital role in the progression of OA [36]. In this study, there was a significant decrease in SOD activity in the OA control group, relative to the normal control group.…”

Development of a Rat Model of Knee Osteoarthritis by a Combination of Monoiodoacetate and Streptozotocin

“…In addition, proinflammatory biomarkers IL-6 and TNF-α are significant predictors of knee OA (Livshits et al, 2009;Kou & Wu, 2014) and OA cartilages from DM patients showed increased responsiveness to IL-1β-induced inflammation via oxidative stress and polyol pathway thus participate in the increased inflammation in OA (Laiguillon et al, 2015). On the other hand, chondroprotective agents such as the antioxidants have been found to promote cartilage repair by stimulating anabolic metabolism of chondrocytes and/or inhibiting catabolic processes found in OA (Altman et al, 1987;Bhattacharya et al, 2012). The aim of this work is to develop an animal model of OA induced by a combination of MIA and DM, and investigate the extent of damages to the articular cartilage of the knee joint in this model using scanning and transmission electron microscopy.…”