Role of Glucosamine and Hyaluronic Duos in Joint Mobility

Role of Glucosamine and Hyaluronic Duos in Joint Mobility

Osteoarthritis (OA) is a degenerative condition of joints characterized by cartilage degradation, osteophyte formation and bone remodelling. This leads to pain, stiffness, and inflammation with reduced joint functions. Osteoarthritis can affect any joint, including the knee, hand, foot, ankle or hip1. Non-steroidal anti-inflammatory drugs (NSAIDs), viscosupplementation and joint replacement are the currently available options to manage OA. This article will focus on glucosamine (GlcN) and hyaluronic acid (HA) in osteoarthritis management.

Glucosamine is an amino monosaccharide synthesized from glucose. It is present in almost all tissues but is highly concentrated in connective tissues, particularly cartilage. Oral glucosamine sulfate has very high absorption (≈90%); it is incorporated into cartilage once absorbed. Hyaluronic acid (HA) is a polysaccharide comprising repeating disaccharide units (D-glucuronic and N-acetyl-D-glucosamine). HA is enriched in the extracellular matrix of soft connective tissues. In osteoarthritis, HA's viscosity is decreased, leading to cartilage degradation2.

A combination of GlcN and HA is effective in managing osteoarthritis. Glucosamine acts as an adjuvant for HA production inside the body. A study reported that glucosamine supplementation stimulates HA production in synovial tissues3. Hyaluronic acid is reported to inhibit the expression of MMP-3, MMP-13 and ADAMTS (A Disintegrin and Metalloproteinase with ThromboSpondin motifs) in vivo4.

Various clinical studies highlight the role of glucosamine and hyaluronic acid in managing osteoarthritis. A double-blind, randomized, placebo-controlled clinical trial involving 40 individuals observed that oral hyaluronic preparation significantly improved joint pain and function. Additionally, a significant decrease in inflammatory markers (IL-6, IL-8, IL-10, 1L-12, TNF-α, GM-CSF) was observed5. Another comparative study between viscosupplementation and oral drug (300 mg HA+100 mg Boswellia serrata extract) observed that both interventions significantly improved AKSS and VAS pain score6. Another double-blind, placebo-controlled trial reported that oral HA supplementation (200 mg, OD for 12 months) significantly improved the JKOM (Japanese Knee Osteoarthritis Measure) score compared to placebo7. In a clinical trial, the long-term effect of glucosamine sulphate was studied over 3 years. Compared to the placebo, a significant reduction in joint-space loss and WOMAC score was observed in the interventional group (1500 mg glucosamine, OD)8.

Overall, it can be concluded that oral glucosamine and hyaluronic acid supplementation can effectively manage osteoarthritis symptoms.

References

  1. Allen, K. D.; Thoma, L. M.; Golightly, Y. M. Epidemiology of Osteoarthritis. Osteoarthritis Cartilage 2022, 30 (2), 184–195. https://doi.org/10.1016/j.joca.2021.04.020.
  2. Abatangelo, G.; Vindigni, V.; Avruscio, G.; Pandis, L.; Brun, P. Hyaluronic Acid: Redefining Its Role. Cells. MDPI July 1, 2020, pp 1–19. https://doi.org/10.3390/cells9071743.
  3. Uitterlinden, E. J.; Koevoet, J. L. M.; Verkoelen, C. F.; Bierma-Zeinstra, S. M. A.; Jahr, H.; Weinans, H.; Verhaar, J. A. N.; Van Osch, G. J. V. M. Glucosamine Increases Hyaluronic Acid Production in Human Osteoarthritic Synovium Explants. BMC Musculoskelet Disord 2008, 9. https://doi.org/10.1186/1471-2474-9-120.
  4. Mladenovic, Z.; Saurel, A. S.; Berenbaum, F.; Jacques, C. Aggrecanases, and RANKL Expression Are Partially Prevented by Hyaluronic Acid in Interleukin 1-Stimulated Osteoblasts. Journal of Rheumatology 2014, 41 (5), 945–954. https://doi.org/10.3899/jrheum.130378.
  5. Nelson, F. R.; Zvirbulis, R. A.; Zonca, B.; Li, K. W.; Turner, S. M.; Pasierb, M.; Wilton, P.; Martinez-Puig, D.; Wu, W. The Effects of an Oral Preparation Containing Hyaluronic Acid (Oralvisc®) on Obese Knee Osteoarthritis Patients Determined by Pain, Function, Bradykinin, Leptin, Inflammatory Cytokines, and Heavy Water Analyses. Rheumatol Int 2015, 35 (1), 43–52. https://doi.org/10.1007/s00296-014-3047-6.
  6. Ricci, M.; Micheloni, G. M.; Berti, M.; Perusi, F.; Sambugaro, E.; Vecchini, E.; Magnan, B. Clinical Comparison of Oral Administration and Viscosupplementation of Hyaluronic Acid (HA) in Early Knee Osteoarthritis. Musculoskelet Surg 2017, 101 (1), 45–49. https://doi.org/10.1007/s12306-016-0428-x.
  7. Tashiro, T.; Seino, S.; Sato, T.; Matsuoka, R.; Masuda, Y.; Fukui, N. Oral Administration of Polymer Hyaluronic Acid Alleviates Symptoms of Knee Osteoarthritis: A Double-Blind, Placebo-Controlled Study over a 12-Month Period. The Scientific World Journal 2012, 2012. https://doi.org/10.1100/2012/167928.
  8. Reginster, J. Y.; Deroisy, R.; Rovati, L. C.; Lee, R. L.; Lejeune, E.; Bruyere, O.; Giacovelli, G.; Henrotin, Y.; Dacre, J. E.; Gossett, C. Long-Term Effects of Glucosamine Sulphate on Osteoarthritis Progression: A Randomised, Placebo-Controlled Clinical Trial. Lancet 2001, 357 (9252), 251–256. https://doi.org/10.1016/S0140-6736(00)03610-2.
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Dr. Sunny Gupta, Ph.D. Cancer Biology

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Dr. Sunny is an accomplished researcher with expertise in natural products and their therapeutic applications. He has extensive experience in designing and executing assays for the preclinical testing of natural products, both in vitro and in vivo, with a focus on diseases such as cancer and dengue. Sunny’s research integrates traditional natural compounds (Ayurveda) with modern scientific approaches to develop and validate affordable and sustainable treatments. He holds an M.Tech in Biotechnology from Maulana Abul Kalam Azad University of Technology, Kolkata, and a Ph.D. in Cancer Biology from the Indian Institute of Technology Delhi, India.