Management of Osteoarthritis with Avocado/Soybean Unsaponifiables

Abstract

Osteoarthritis (OA) is a painful and life-altering disease that severely limits the daily activities of millions of Americans, and it is one of the most common causes of disability in the world. With obesity on the rise and the world’s population living longer, the prevalence of OA is expected to increase dramatically in the coming decades, generating burdensome socioeconomic costs. This review summarizes current pharmaceutical, nonpharmaceutical, and prospective new treatments for OA, with primary focus on the dietary supplement avocado/soybean unsaponifiables (ASU). ASU modulates OA pathogenesis by inhibiting a number of molecules and pathways implicated in OA. Anticatabolic properties prevent cartilage degradation by inhibiting the release and activity of matrix metalloproteinases and increasing tissue inhibitors of these catabolic enzymes. ASU also inhibits fibrinolysis by stimulating the expression of plasminogen activator inhibitor. Anabolic properties promote cartilage repair by stimulating collagen and aggrecan synthesis via inhibition of inflammatory cytokines such as interleukin (IL)-1, IL-6, IL-8, tumor necrosis factor, ERK, and prostaglandin E2. Chondroprotective effects are mediated by correcting growth factor abnormalities, increasing TGF-β, and decreasing vascular endothelial growth factor (VEGF) in synovial fluid. ASU also inhibits cholesterol absorption and endogenous cholesterol biosynthesis, which mediate reactive oxygen species pathology in chondrocytes. At the clinical level, ASU reduces pain and stiffness while improving joint function, resulting in decreased dependence on analgesics.

Effects of Avocado (Persea americana)on Metabolic Syndrome: A Comprehensive Systematic Review

“…Avocado is consumed, not only for its flavor, but also for its high nutritional value and beneficial health effects (Meyer and Terry, ) including hypoglycaemic (Ezejiofor et al , ), antihypertensive (Dzeufiet et al , ), antioxidant (Nagaraj et al , ), anti‐obesity (Monika and Geetha, ), hypolipidemic (Pahua‐Ramos et al , ) (Fig. ), antilithiasis (Wientarsih et al , ), anticonvulsant (Ojewole and Amabeoku, ), antimicrobial (Pradeep et al , ), antiprotozoal and antimycobacterial (Jiménez‐Arellanes et al , ), hepatoprotective (Mahmoed and Rezq, ), antiosteoarthritis (Christiansen et al , ) and chemo‐protective (Paul et al , ).…”

Molecular mechanisms of pain regulation in patients with osteoarthritis

“…Хотя, по данным некоторых исследований на хондроцитах животных и человека in vitro [34], ТРФβ1 мо-жет участвовать в активации ФРН и усиливать боль, дру-гие исследования, напротив, связывают повышенную экспрессию ТРФβ1 с подавлением боли, ассоциирован-ным с усилением процессов регенерации ткани [35][36][37][38]. При этом отмечалась отрицательная корреляция между уровнями ТРФβ1 и рентгенологической стадией ОА [56].…”

“…В этом случае боль может быть связана с разрушением матрикса суставного хряща и высвобождением локализованного в матриксе TРФβ1. Однако другие исследования показывают, что повышение экспрессии TРФβ1 может также приводить к снижению болевых ощущений за счет активации регенеративных процессов [35][36][37][38].…”

Efficacy and safety of avocado‐soybean unsaponifiables for the treatment of hip and knee osteoarthritis: A systematic review and meta‐analysis of randomized placebo‐controlled trials

“…In early stages of OA, paracetamol and topical or oral non‐steroidal anti‐inflammatory drugs (NSAIDs) are the first‐line pharmacological treatment. Other therapeutic options include topical capsaicin and synthetic opioids tramadol or codeine; however, a large number of patients have turned to the use of dietary supplements or nutraceuticals due to their potential beneficial effects …”

“…Other therapeutic options include topical capsaicin and synthetic opioids tramadol or codeine; however, a large number of patients have turned to the use of dietary supplements or nutraceuticals due to their potential beneficial effects. 10,11 Avocado/soybean unsaponifiables (ASU) is a nutraceutical composed of natural vegetable extracts from avocado and soybean oils.…”