Green-lipped (greenshell™) mussel (Perna canaliculus) extract supplementation in treatment of osteoarthritis: a systematic review

Abstract

Objectives Intervention studies using New Zealand green-lipped or greenshell™ mussel (GSM) (Perna canaliculus) extract in osteoarthritis (OA) patients have shown effective pain relief. This systematic review summarises the efficacy of GSM extracts in the treatment of OA. Methods A literature search of the three databases EMBASE, MEDLINE, and Scopus was performed to identify relevant articles published up to March 2020. Inclusion criteria were clinical trials published in English measuring the effect of supplementation of whole or a lipid extract from GSM on pain and mobility outcomes in OA patients. Results A total of nine clinical trials were included in systematic review, from which five studies were considered appropriate for inclusion in a forest plot. Pooled results showed that GSM extracts (lipid extract or whole powder) provide moderate and clinically significant treatment effects on a visual analogue scale (VAS) pain score (effect size: − 0.46; 95% CI − 0.82 to − 0.10; p = 0.01). The whole GSM extract improved gastrointestinal symptoms in OA patients taking anti-inflammatory medications. The GSM extract was considered to be generally well tolerated in most of the studies. Conclusion The overall analysis showed that GSM provided moderate and clinically meaningful treatment effects on OA pain. However, the current evidence is limited by the number and quality of studies, and further larger and high-quality studies are needed to confirm the effectiveness and to identify the optimal GSM format. Nevertheless, it is worth considering using GSM extracts especially for patients seeking alternative pain relief treatments with fewer side effects compared to conventional treatment.

WGA-M001, a Mixture of Total Extracts of Tagetes erecta and Ocimum basilicum, Synergistically Alleviates Cartilage Destruction by Inhibiting ERK and NF-κB Signaling

“…Moreover, in DMM-induced OA mice, oral administration of WGA-M001 at doses up to 100 mg/kg effectively inhibited cartilage destruction compared to that associated with a high dose (500 mg/kg) of T. erecta or O. basilicum. Recent research has shown that Boswellia and P. canaliculus are well-known OA-alleviating substances [41,55,56]. However, our study demonstrated that WGA-M001 had a stronger protective effect against OA development compared to the effect of the positive controls.…”

Effects of Greenshell™ mussel intervention on biomarkers of cartilage metabolism, inflammatory markers and joint symptoms in overweight/obese postmenopausal women: A randomized, double-blind, and placebo-controlled trial

“…In the second trial, GSM powder was compared to glucosamine sulfate in a 12 week intervention where both supplements showed equal effectiveness on the aforementioned outcome measures ( 18 ). Our recent systematic review on the existing clinical trials concluded that both GSM lipid extract or whole meat powder products provide a clinically meaningful improvement in VAS pain for OA symptoms ( 44 ). In terms of knee related symptoms, the GSM group showed a greater improvement in KOOS symptoms domain overtime, although the change was not significant and did not reach the suggested minimal clinical improvement (at least eight points improvement) ( 32 ).…”

Medical treatment of osteoarthritis: botanical pharmacologic aspect

“…Furthermore, recently, a New Zealand research group reported that the addition of oil from GSM to the diet of diet-induced metabolic OA rats resulted in both decreased plasma levels of the C telopeptide of type II collagen (CTX-II), which is known as a biomarker of cartilage degradation, and a cartilage protective effect in histology [ 41 ]. The same research group also reported that the use of GSM whole extract or lipid extract reduced the VAS pain scores of knee/hip OA patients in a systematic review [ 42 ]. They also reported that both VAS pain scores and plasma CTX-II levels decreased in postmenopausal women with obesity who received 3 g/day of whole GSM powder compared to those who received placebo [ 43 ].…”