CHONDROITIN

Chondroitin sulfate

GENERAL INFORMATION: Chondroitin sulfate is in a category of compounds called glycosaminoglycans (essentially a long-chain of specialized sugars). Chondroitin is used in the body as a building block for larger structures called proteoglycans (proteoglycans attract water into the joint space for lubrication of the cartilage during movement). Chondroitin is related in structure and function to another sugar derivative, Glucosamine sulfate, both of which are widely used as dietary supplements to nourish joint cartilage. Scientific studies have confirmed chondroitin's ability to alleviate joint pain associated with osteoarthritis (see research below).

OSTEOARTHRITIS: Osteoarthritis is also known as Degenerative Joint Disease and is the most common form of arthritis­affecting some 40 million Americans. The most oft-affected joints are weight-bearers like the knees, hips, and small joints of the hands. Cartilage destruction causes pain, deformity, and limitation of movement. Current treatment of this condition usually involves non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen. Though these drugs can suppress the pain symptoms, they have not been found to contribute to any long-term cartilage repair.

CHONDROITIN SCIENTIFIC SUPPORT: An Alternative Medicine Review stated that chondroitin sulfates, whether absorbed intact or broken into their constituent components, provides substrates (substance on which an enzyme acts) for the formation of a healthy joint matrix. The review further expounded that oral administration of chondroitin sulfates helps to slowly reduce symptoms and to reduce the need for non-steroidal anti-inflammatory drugs (1). The Naval Medical Department in Norfolk, Va., conducted a 16-week randomized double-blind placebo-controlled study of glucosamine (1,500 mg daily), chondroitin sulfate (1,200 mg daily), and manganese ascorbate (228 mg daily) to determine the efficacy of these substances on U.S. Navy divers and special warfare community with chronic pain and degenerative joint disease. They found the combination therapy to relieve symptoms of knee osteoarthritis (2). The Department of Rheumatology at Pitie Salpetriere Hospital in Paris, France, performed a randomized, double-blind study using 127 knee osteoarthritis patients (each received 1,200 mg chondroitin sulfate daily for three-months). The study conclusively revealed condroitin sulfate to improve overall symptoms and joint mobility (3). A randomized, double-blind, placebo controlled trial of a topical cream containing glucosamine sulfate and chondroitin sulfate was carried out at the Department of Complementary Medicine in Australia. There, sixty-three patients were randomized to receive either a topical glucosamine and chondroitin preparation or placebo to be used as required over an 8-week period. The Department concluded topical application of chondroitin and glucosamine to be effective in relieving the pain from OA of the knee and that improvement was evident in just four weeks (4). Another double-blind placebo-controlled clinical study in France set out to assess the efficacy and safety of chondroitin sulfate 1 g/day as compared to placebo in patients with osteoarthritis. The study called for three-month treatment followed by three-month post-treatment. The French group observed a trend toward the efficacy of chondroitin as compared to placebo with good tolerability after three months treatment, and persistent efficacy one month post-treatment (5). The Louisiana State University Health Sciences Center in New Orleans studied the effect of a daily dose of 1500 mg of glucosamine and 1200 mg of chondroitin sulfate taken for twelve weeks on subjects diagnosed with disk displacement, disk location, or painful osteoarthritis. Forty-five subjects were observed and those subjects taking GS-CH had overall improvements in their pain and a reduction in the number of daily over-the-counter medications needed (6). A 1-year, randomized, double-blind, controlled pilot study which included 42 patients suffering from knee osteoarthritis was undertaken at the Department of Neuclid, University Hospital of Geneva, in Switzerland. Patients were treated daily with 800 mg chondroitin sulfate and the group found that CS was well-tolerated and both significantly reduced pain and increased overall mobility capacity (7).

REFERENCES:
(1) Kelly GS. The role of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease. Altern Med Rev. 1998 Feb;3(1):27-39.
(2) Leffler CT, Phillippi AF, Leffler SG, Mosure JC, Kim PD. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Mil Med. 1999 Feb;164(2):85-91.
(3) Bourgeois P, Chales G, Dehais J, Delcambre B, Kuntz JL, Rozenberg S. Efficacy and tolerability of chondroitin sulfate 1200 mg/day vs. chondroitin sulfate 3 x 400 mg/day vs placebo. Osteoarthritis Cartilage. 1998 May; 6 Suppl A: 25-30.
(4) 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 Mar; 30(3):523-8.
(5) Mazieres B, Combe B, Phan Van A, Tondut J, Grynfeltt M. Chondroitin sulfate in osteoarthritis of the knee: a prospective, double-blind, placebo controlled multicenter clinical study. J Rheumatol. 2001 Jan;28(1):173-81.
(6) Nguyen P, Mohamed SE, Gardiner D, Salinas T. A randomized double-blind clinical trial of the effect of chondroitin sulfate and glucosamine hydrochloride on tempromandibular joint disorders: a pilot study. Cranio. 2001 Apr;19(2):130-9.
(7) Uebelhart D, Thonar EJ, Delmas PD, Chantraine A, Vignon E. Effects of oral chondroitin sulfate on the progression of knee osteoarthritis: a pilot study. Osteoarthritis Cartilage. 1998 May;6 Suppl A: 39-46.