Glucosamine in Osteoarthritis: Effects on Articular Joint Tissues

With the ongoing aging of the population worldwide, osteoarthritis (OA) is a disease that will affect increasing numbers of people. In the last decades ‘disease-modifying osteoarthritis drugs’ have received considerable interest. Glucosamine (GlcN) is one of the compounds which is claimed to slow down OA progression and to have a beneficial effect on OA-related symptoms when compared to placebo treatment. The general aim of this thesis was to gain more insight into the working mechanism of GlcN in OA. In the first part of the thesis in vitro experiments with different OA models, using the tissue types that can be involved in OA, were performed. In osteoarthritic cartilage it was found that GlcN was able to interfere with mechanisms leading to further cartilage degradation. Restoration of already damaged cartilage by GlcN is not to be expected. It was also shown that adding GlcN to cultures with human OA synovium, led to more hyaluronic acid in vitro. In the second part of the thesis GlcN was administered orally to patients using placebo-controlled methodology, to establish its effects on OA symptoms, and to examine the effects on joint tissue in vivo after a period of GlcN ingestion. It was found that GlcN was not significantly better than placebo in reducing symptoms and progression of hip OA. Considering the effects of oral GlcN on joint tissues in vivo, it appeared that administration of GlcN may have primed the cartilage such, that its sensitivity to adding GlcN in vitro increased.

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