The possibilities of using chondroitin sulphate in the pain treatment in neurological practice

Shirokov V.A.; Novikova A.V.

doi:https://doi.org/10.17116/pain20222001165

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OBJECTIVE

To analyze and summarize the data of the modern literature on the mechanisms of action, pharmacological effects and the prospects for the use of chondroitin sulfate in the treatment of pain syndromes in neurological practice. Particular attention is paid to the intrinsic analgesic and anti-inflammatory effect of chondroitin sulfate, the possibility of using the drug in elderly patients with concomitant somatic pathology, the advantages of using the parenteral form of the drug are analyzed in order to increase its bioavailability and increase the rate of achieving a clinical effect.

Keywords:

chondroitin sulfate

pain syndromes

systemic inflammation

anticytokine activity

Authors:

Shirokov V.A.

Yekaterinburg Medical Scientific Center for Prevention and Health Protection of Industrial Workers

Novikova A.V.

Pirogov Russian National Research Medical University

Received:

24.12.2021

Accepted:

30.12.2021

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References:

Kahan A, Uebelhart D, De Vathaire F, Delmas PD, Reginster JY. Long-term effects of chondroitins 4 and 6 sulfate on knee osteoarthritis: The study on osteoarthritis progression prevention, a two-year, randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2009;60(2):524-533. https://doi.org/10.1002/art.24255
Kantor ED, Lampe JW, Navarro SL, Song X, Milne GL, White E. Associations between glucosamine and chondroitin supplement use and biomarkers of systemic inflammation. J Altern Complement Med. 2014;20(6):479-485. https://doi.org/10.1089/acm.2013.0323
Reginster JY, Heraud F, Zegels B, Bruyere O. Symptom and structure modifying properties of chondroitin sulfate in osteoarthritis. Mini Rev Med Chem. 2007;7(10):1051-1061. https://doi.org/10.2174/138955707782110088
Danilov AB, Grigorenko NV. An antinociceptive effect of chondroprotectors: A myth or a reality. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2015;115(9):84-89. (In Russ.). https://doi.org/10.17116/jnevro20151159184-89
Bishnoi M, Jain A, Hurkat P, Jain SK. Chondroitin sulphate: A focus on osteoarthritis. Glycoconj J. 2016;33(5):693-705. https://doi.org/10.1007/s10719-016-9665-3
Du Souich P. Absorption, distribution and mechanism of action of SYSADOAS. Pharmacol Ther. 2014;142(3):362-374. https://doi.org/10.1016/j.pharmthera.2014.01.002
Kubo M, Ando K, Mimura T, Matsusue Y, Mori K. Chondroitin sulfate for the treatment of hip and knee osteoarthritis: current status and future trends. Life Sci. 2009;85(13-14):477-483. Epub 2009 Aug 18. https://doi.org/10.1016/j.lfs.2009.08.005
David-Raoudi M, Deschrevel B, Leclercq S, Galéra P, Boumediene K, Pujol JP. Chondroitin sulfate increases hyaluronan production by human synoviocytes through differential regulation of hyaluronan synthases: Role of p38 and Akt. Arthritis Rheum. 2009;60(3):760-770. PMID: 19248106. https://doi.org/10.1002/art.24302
Imada K, Oka H, Kawasaki D, Miura N, Sato T, Ito A. Anti-arthritic action mechanisms of natural chondroitin sulfate in human articular chondrocytes and synovial fibroblasts. Biol Pharm Bull. 2010;33(3):410-414. PMID: 20190401. https://doi.org/10.1248/bpb.33.410
Campo GM, Avenoso A, Campo S, D’Ascola A, Traina P, Samà D, Calatroni A. Glycosaminoglycans modulate inflammation and apoptosis in LPS-treated chondrocytes. J Cell Biochem. 2009;106(1):83-92. PMID: 19009563. https://doi.org/10.1002/jcb.21981
Jomphe C, Gabriac M, Hale TM, Héroux L, Trudeau LE, Deblois D, Montell E, Vergés J, du Souich P. Chondroitin sulfate inhibits the nuclear translocation of nuclear factor-kappaB in interleukin-1beta-stimulated chondrocytes. Basic Clin Pharmacol Toxicol. 2008;102(1):59-65. Epub 2007 Nov 05. https://doi.org/10.1111/j.1742-7843.2007.00158.x
Ji RR, Nackley A, Huh Y, Terrando N, Maixner W. Neuroinflammation and Central Sensitization in Chronic and Widespread Pain. Anesthesiology. 2018;129(2):343-366. https://doi.org/10.1097/ALN.0000000000002130
Franceschi C, Garagnani P, Parini P, Giuliani C, Santoro A. Inflammaging: A new immune-metabolic viewpoint for age-related diseases. Nat Rev Endocrinol. 2018;14(10):576-590. https://doi.org/10.1038/s41574-018-0059-4
Kantor ED, Lampe JW, Vaughan TL, Peters U, Rehm CD, White E. Association between use of specialty dietary supplements and C-reactive protein concentrations. Am J Epidemiol. 2012;176(11):1002-1013. Epub 2012 Nov 08. https://doi.org/10.1093/aje/kws186
Cohen M, Wolfe R, Mai T, Lewis D. A randomized, double blind, placebo controlled trial of a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor for osteoarthritis of the knee. J Rheumatol. 2003;30(3):523-528. Erratum in: J Rheumatol. 2003;30(11):2512. PMID: 12610812.
Hochberg MC, Martel-Pelletier J, Monfort J, Möller I, Castillo JR, Arden N, Berenbaum F, Blanco FJ, Conaghan PG, Doménech G, Henrotin Y, Pap T, Richette P, Sawitzke A, du Souich P, Pelletier JP; MOVES Investigation Group. Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: A multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Ann Rheum Dis. 2016;75(1):37-44. https://doi.org/10.1136/annrheumdis-2014-206792
Morita M, Yamada K, Date H, Hayakawa K, Sakurai H, Yamada H. Efficacy of Chondroitin Sulfate for Painful Knee Osteoarthritis: A One-Year, Randomized, Double-Blind, Multicenter Clinical Study in Japan. Biol Pharm Bull. 2018;41(2):163-171. https://doi.org/10.1248/bpb.b17-00556
Singh JA, Noorbaloochi S, MacDonald R, Maxwell LJ. Chondroitin for osteoarthritis. Cochrane Database of Systematic Reviews. 2015;1:CD005614. https://doi.org/10.1002/14651858.CD005614.pub2
Martel-Pelletier J, Roubille C, Abram F, et al. First-line analysis of the effects of treatment on progression of structural changes in knee osteoarthritis over 24 months: data from the osteoarthritis initiative progression cohort. Annals of the Rheumatic Diseases. 2015;74:547-556.
Gabay C, Medinger-Sadowski C, Gascon D, Kolo F, Finckh A. Symptomatic effects of chondroitin 4 and chondroitin 6 sulfate on hand osteoarthritis: A randomized, double-blind, placebo-controlled clinical trial at a single center. Arthritis Rheum. 2011;63(11):3383-3391. https://doi.org/10.1002/art.30574. PMID: 21898340
Shirokov VA. Spondyloarthrosis: pathogenesis and management of pain syndrome. Effektivnaya farmakoterapiya. 2014;1:8-12. (In Russ).
Vizilo TL, Vizilo AD, Trubitsina MV, Chechenin AG, Polukarova EA. Facet syndrome at lumbar level in elderly patients: diagnostics and treatment. Lechashchij vrach. 2016;4:112-116. (In Russ).
Husky MM, Ferdous Farin F, Compagnone P, Fermanian C, Kovess-Masfety V. Chronic back pain and its association with quality of life in a large French population survey. Health Qual Life Outcomes. 2018;16(1):195. https://doi.org/10.1186/s12955-018-1018-4
Meucci RD, Fassa AG, Faria NM. Prevalence of chronic low back pain: systematic review. Rev Saude Publica. 2015;49:1. https://doi.org/10.1590/S0034-8910.2015049005874
Krämer J. Intervertebral disk diseases. Under the total ed. Prof Shirokov VA. M.: MEDpress-inform; 2015;472. (In Russ.).
Fujii K, Yamazaki M, Kang JD, Risbud MV, Cho SK, Qureshi SA, Hecht AC, Iatridis JC. Discogenic Back Pain: Literature Review of Definition, Diagnosis, and Treatment. JBMR Plus. 2019;3(5):e10180. https://doi.org/10.1002/jbm4.10180
Zolotovskaya IA, Davydkin IL. Antiresorptive-cytokine effects of the chondroprotective therapy in patients with lower back pain. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2020;120(4):65-71. (In Russ). https://doi.org/10.17116/jnevro202012004165
Lambert C, Mathy-Hartert M, Dubuc JE, Montell E, Vergés J, Munaut C, Noël A, Henrotin Y. Characterization of synovial angiogenesis in osteoarthritis patients and its modulation by chondroitin sulfate. Arthritis Res Ther. 2012;14(2):R58. https://doi.org/10.1186/ar3771
Hassanali SH, Oyoo GO. Osteoarthritis: A look at pathophysiology and approach to new treatments: A review. East African Orthopaedic Journal. 2011;5:51-57. https://doi.org/10.4314/eaoj.v5i2.72398
Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, Ferreira PH, Fritz JM, Koes BW, Peul W, Turner JA, Maher CG; Lancet Low Back Pain Series Working Group. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018;391(10137):2368-2383. https://doi.org/10.1016/S0140-6736(18)30489-6
Van Tulder M, Koes B, Bombardier C. Low back pain. Best Pract Res Clin Rheumatol. 2002;16(5):761-775. https://doi.org/10.1053/berh.2002.0267
Romereim SM, Johnston CA, Redwine AL, Wachs RA. Development of an in vitro intervertebral disc innervation model to screen neuroinhibitory biomaterials. J Orthop Res. 2020;38(5):1016-1026. https://doi.org/10.1002/jor.24557
Alekseeva LI, Alekseev VV, Barinov AN, Singkh G. Novel approaches to treating nonspecific low back pain. Rheumatology Science and Practice. 2016;54(1):16-20. (In Russ.). https://doi.org/10.14412/1995-4484-2016-16-20
Miyata S, Kitagawa H. Mechanisms for modulation of neural plasticity and axon regeneration by chondroitin sulphate. J Biochem. 2015;157(1):13-22. Epub 2014 Nov 06. https://doi.org/10.1093/jb/mvu067
Yang X. Chondroitin sulfate proteoglycans: key modulators of neuronal plasticity, long-term memory, neurodegenerative, and psychiatric disorders. Rev Neurosci. 2020;31(5):555-568. PMID: 32126020. https://doi.org/10.1515/revneuro-2019-0117
Campo GM, Avenoso A, Campo S, D’Ascola A, Traina P, Calatroni A. Chondroitin-4-sulphate inhibits NF-kB translocation and caspase activation in collagen-induced arthritis in mice. Osteoarthritis Cartilage. 2008;16(12):1474-1483. Epub 2008 May 23. PMID: 18501644. https://doi.org/10.1016/j.joca.2008.04.002
Shavlovskaya OA Chondroprotectors: spectrum of application in general practice. Terapevticheskij arkhiv. 2017;(5):98-104. (In Russ.). https://doi.org/10.17116/terarkh201789598-104
Barulin AE, Kurushina OV. Chondroprotectors in Complex Treatment for Back Pain. Difficult Patient Journal. 2014;3. (In Russ.).
Klein RG, Eek BCJ, O’Neill CW, Elin C, Mooney V, Derby RR. Biochemical injection treatment for discogenic low back pain: A pilot study. The Spine Journal. 2003;3:220-226. https://doi.org/10.1016/s1529-9430(02)00669-1
King DE, Xiang J. Glucosamine/Chondroitin and Mortality in a US NHANES Cohort. J Am Board Fam Med. 2020;33(6):842-847. https://doi.org/10.3122/jabfm.2020.06.200110
Shavlovskaya OA, Kuznetsov SL, Chondroitin sulfate injection in neurological practice. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2019;119(5):126-133. (In Russ.). https://doi.org/10.17116/jnevro2019119051126
Belyaeva EA, Avdeeva OS. The effectiveness of complex therapy using the injectable form of chondroitin sulfate and sodium hyaluronate with osteoarthritis of the knee joint. Terapevticheskij arkhiv. 2019;91(5):96-102. (In Russ.). https://doi.org/10.26442/00403660.2019.05.00021
Instructions for the medical use of the drug Iniectran. (In Russ.). https://www.rlsnet.ru/tn_index_id_95336.htm
Karateev AE, Lila AM. Russian experience of using injectable forms of chondroitin sulfate and glucosamine sulfate: A review of clinical studies. Modern Rheumatology. 2018;12(1):33-40. (In Russ.).
Istomina EV, Shikhkerimov RK. The possibilities of using chondroitin sulfate in patients with chronic back pain. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2019;119(3):12-15. (In Russ.). https://doi.org/10.17116/jnevro201911903112
Fedotova AV, Mironova OP. The chondroprotector mucosat in an integrated approach to the treatment of nonspecific back pain. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2018;118(9):133-137. (In Russ.). https://doi.org/10.17116/jnevro2018118091133