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Glucosamine (GS) is an amino monosaccharide and has been widely used as an alternative regimen for rheumatoid arthritis or osteoarthritis.  It has been suggested that GS exerts anti-inflammatory effect.  A recent study investigated the mechanism by which GS affects expression and activity of COX-2.

COX-2 (Cyclooxygenase-2) and its products, including PGE2, are involved in many inflammatory illnesses. NSAIDs that target COX-2 lessen major inflammatory symptoms such as fever and pain suggests COX-2’s role in inflammation. Thus, any compound that inhibits COX-2 has the potential to be clinically useful against inflammatory diseases.

In an in-vitro study, researchers evaluated the effects of different glucosamine salts (GS-HCl, GS sulfate) or a GS derivative (N-acetyl GS) and galactosamine HCl (Gal-HCl), on the expression of COX-2 and production of PGE2 in human cells.  The study found that, among GS salts or derivative tested, Glucosamien HCl specifically inhibits endogenous and cytokine-driven COX-2 expression at protein level via a mechanism associated with the down-regulation of COX-2 N-glycosylation and turnover.

The findings presented in this study may provide a potential explanation for the clinical effect of glucosamine supplements, particularly glucosamine HCl supplement, which are purported to have an anti-inflammatory activity.

Byeong-Churl Jang et al; Journal Of Biological Chemistry (2007); VOL 282(38):27622–27632

Turmeric has a long history of medicinal use, especially to treat inflammation, and many of its traditional uses have been validated in thousands of clinical investigations, demonstrating curcumin as a potent anti-inflammatory agent.

Osteoarthritis is the leading cause of physical disability and impairment in life quality for millions of elderly people, both in industrialized and in developing countries, and its dramatic influence on healthcare costs is likely worsened because of the aging population and current epidemic of obesity.

Previously researchers in Italy found that three-month supplementation with Meriva Curcumin, a patented curcumin-soy lethicin phytosome complex, decreased joint pain and improved joint function in osteoarthritis (OA) patients. Since OA is a chronic condition requiring prolonged treatment, the long-term efficacy and safety of Meriva were investigated in a longer eight months study involving 100 OA patients.

In this study, 100 OA patients were treated with either 200mg/day Meriva Curcumin (treatment
Group, n=50), or a placebo (control group, n=50).  After eight month, Meriva curcumin treatment group showed significant improvement in comparison to the control group:

  • The Karnofsky Performance Scale Index was improved from 73.3 at inclusion to 92.2 at the completion of the study;
  • WOMAC scores for pain dropped significantly (p<0.05) from 16.6 to 7.3; The scores for stiffness were reduced significantly from 7.4 to 3.2 (p<0.05);  The global WOMAC score decreased significantly from 80.6 to 33.3; while in the control group the decrease from 77.8 to 68.8 was statistically insignificant;
  • The results of the exercise (treadmill) tests (at a speed of 3 km/ hour, with a 10% inclination) indicate a 3.87-times greater improvement in physical performance;
  • Meriva induced a statistically significant reduction of all markers of inflammation;
  • 63% of the OA patients in the treatment group decreased use of NSAIDs and other painkillers compared to 12 percent in the control group (p<0.05);
  • These results was accompanied by a decrease in gastrointestinal complaints by 38% of patients in the treatment group compared to 15 percent in controls (p<0.05) (presumably, due to decreased use of NSAIDs and the reported GI-protective effect of curcumin).

In summary, the study authors observed significant improvements of both the clinical and biochemical end points for the treatment group compared to the control group.  The authors further suggest that, with its excellent tolerability, Meriva Curcumin is an effective and safe agent for the complementary management of osteoarthritis, leading to better disease control, a decreased use of NSAIDs, and an overall improvement in quality of life.

Gianni Belcaro et al; Altern Med Rev 2010;15(4):337-344

01 October 2011

Curcuma longa (turmeric) has a long traditional use as a treatment for inflammatory conditions.  Curcumin are believe to contribute to the therapeutic benefits of turmeric extract with three curcuminoids as the main constituents. Numerous clinical trials have investigated the mechanisms and therapeutic potential of curcumin

Curcumin has a high instability at physiological pH and an inherently low intestinal absorption.  It is therefore very poorly bioavailable. Because of curcumin’s rapid plasma clearance, its therapeutic usefulness has been somewhat limited, leading researchers to investigate the benefits of complexing curcumin with other substances to increase systemic bioavailability.

In a randomized, double-blind, crossover human study, researchers at USANA Health Sciences, in conjunction with Università del Piemonte Orientale and Indena SPA in Italy, investigated the absorption rate of a unique extract of turmeric – the Meriva Bioavailable Curcumin. Eight healthy people took either a high or low dose Meriva Curcumin, or a reference placebo.  Their serum levels of the three major curcuminoids were then evaluated.

The study found that the total curcuminoid absorption was about 29-fold higher for Meriva curcumin (high or low) than for the unformulated curcuminoid mixture.  The improved absorption, and possibly also a better plasma curcuminoid profile, might underlie the clinical efficacy of Meriva curcumin at doses significantly lower than unformulated curcuminoid mixtures.

The Meriva curcumin extract used in this clinical trial is a special patented combination of curcumin with soybean-derived lecithin, produced and distributed by Indena SpA of Milan, Italy, the world’s largest manufacturer of standardized botanical extracts.

Cuomo J et al; J Nat Prod. 2011 Apr 25; 74(4):664-9

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