Objectives: This study investigated the anti-osteoarthritic effects of Kyejiinsam-tang (hereinafter referred to KIT) on the monosodium iodoacetate (MIA)-induced osteoarthritis rats. Methods: Anti-oxidative effects of KIT were measured by scavenging activities of DPPH, reactive oxygen species (ROS) and nitric oxide (NO). Scavenging activities of anti-oxidation in lipopolysaccharide (LPS)-treated RAW 264.7 cells were also measured for inhibitory effects against the production of inflammatory mediators (tumor necrosis factor-${\alpha}$, interleukin-$1{\beta}$, interleukin-6). Osteoarthritis was induced in rats by injecting MIA in the knee joint. Rats were divided into a total of 4 groups (n=6). The normal group were not treated at all without inducing osteoarthritis whereas the control group were induced for osteoarthritis by MIA and oral medicated physiological saline per day. The positive comparison group was injected with MIA and after 7 days, 2 mg/kg of Indomethacin. The experimental group was injected with MIA and after 7 days was medicated with 34 mg/kg of KIT. Indomethacin and KIT were orally-medicated for each substance a total of 4 weeks, once per day. Weight-bearing on hind legs was measured every week after MIA injection. At the end of the experiment (5 weeks after MIA injection), micro CT (computed tomography)-arthrography and histopathological examinations on the articular structures of knee joint were performed. The effect on inflammatory cytokines and immunological cells in synovial fluid was measured. Volume of cartilage was measured by micro CT-arthrography. Injury to synovial tissue was measured by H & E (hematoxylin and eosin), Safranin-O immunofluorescence. Results: 1. Cytotoxicity against hFCs was insignificant. 2. KIT showed the potent full term for DPPH. 1. NO was significantly reduced by KIT (at 100, $200{\mu}g/m{\ell}$) and ROS was also reduced, but not significantly, by KIT (at $200{\mu}g/m{\ell}$). 2. IL-6 and IL-$1{\beta}$ were significantly reduced by KIT (at 100, $200{\mu}g/m{\ell}$) and TNF-${\alpha}$ was also reduced, but not significantly, by KIT (at $200{\mu}g/m{\ell}$). 1. In hind legs weight-bearing measurement, level of weight increased. 2. Functions of liver and kidney were not affected. 3. IL-$1{\beta}$ was significantly reduced and TNF-${\alpha}$, IL-6 were also reduced but not significantly. 4. PGE2 (prostaglandin E2), LTB4 (leukotriene B4) were significantly reduced in the KIT group. 5. MMP-9 (matrix metalloproteinase-9), TIMP-1 (tissue inhibitor of metalloproteinases-1) and Osteocalcin were significantly reduced in the KIT group. 6. Destruction of cartilage on micro CT arthrography was reduced but had no significant differences. 7. Histopathologically, injury to synovial membrane of the KIT group was decreased and proteoglycan content of KIT group was increased. Conclusions: According to this study, Kyejiinsam-tang has inhibiting effect on the progression of arthritis in MIA-induced osteoarthritis rat. Kyejiinsam-tang has anti-oxidants and anti-inflammation effects, and is related to inhibiting the activity of inflammatory cytokine and injury of volume in cartilage.
Osteoarthritis (OA) is an age-related joint disease characterized by degradation of articular cartilage and its association with chronic pain. Purified Bee venom (PBV) has been traditionally used to the treatment for inflammatory diseases. The purpose of the current study is to examine whether PBV regulates the pro-inflammation against a mouse model of knee OA induced by papain. We studied the effect of PBV on papain-induced OA in the knee joints of mice. Mice were split into following groups: normal control, papain induced OA, OA treated with PBV, OA treated with meloxicam as positive control. Proteoglycan deposition was analyzed by safranin O-fast green staining and H&E staining. Papain injection significantly degraded the proteoglycan in OA mice at 42 days. Cartilage proteoglycan density was significantly higher in PBV treated OA group than those of the positive control groups. These results demonstrate that PBV efficiently suppresses pathological processes in an OA model. Thus, PBV could be a potential therapeutic strategy for the treatment of OA.
Objectives : This study was to investigate the effects of Clematidis Radix on Proteoglycan(PG) degradation by measuring of body weight, Glycosaminoglycan(GAG), Interleukin-$1{\beta}$($IL-1{\beta}$) in synovial fluid, and PG content of articular cartilage of femur in collagenase-induced arthritis in rats. Methods : Arthritis was induced by injection of collagenase(0.1 ml) into knee joint of rats. Arthritic rats were divided into control(n=8) and treated(n=8) group. Control group was taken normal saline for 15 days and treated group was taken extracts of Clematidis Radix for same duration. Normal group(n=8) was injected with normal saline and was taken normal saline for 15 days. Body weight was measured at 0, 10, 15 days after injection. GAG, $IL-1{\beta}$ in synovial fluid were measured with ELISA kit at 15 days after injection. PG content of articular cartilage of femur, represented by safranine O staining, was measured at 15 days after injection. Histopathological study on the articular cartilage of knee joint was investigated at 15 days after injection. Results : Body weight, PG of treated group, taken Clematidis Radix, were significantly increased, and GAG was significantly decreased compared with control group. But $IL-1{\beta}$ was not significantly decreased. Conclusions : On the basis of these results, we concluded that Clematidis Radix has inhibiting effects on the proteoglycan degradation in collagenase-induced rat osteoarthritis model.
Background: This study was conducted to analyze the effects of low skeletal muscle mass index (SMI) and obesity on aging-related osteoarthritis (OA) in the Korean population. Methods: A total of 16,601 participants who underwent a dual-energy X-ray absorptiometry and 3,976 subjects with knee X-rays according to the modified Kellgren-Lawrence (KL) system were enrolled. Knees of ≥KL grade 2 were classified as radiologic OA. The severity of joint space narrowing (JSN) was classified by X-rays as normal, mild-to-moderate, and severe JSN in radiologic OA. The subjects were grouped as normal SMI (SMI of ≥-1 standard deviation [SD] of the mean), low SMI class I (SMI of ≥-2 SDs and <-1 SD), and low SMI class II (SMI of <-2 SDs). Obesity was defined as a body mass index (BMI) of ≥27.5 kg/m2. Results: The modified KL grade and JSN severity were negatively correlated with the SMI and positively correlated with BMI and age. The SMI was negatively correlated with age. JSN severity was significantly associated with a low SMI class compared to a normal SMI, which was more prominent in low SMI class II than class I. Obesity was significantly associated with more severe JSN, only for obesity with a low SMI class. Furthermore, patients with a low SMI class, regardless of obesity, were prone to having more severe JSN. Conclusion: This study suggested that a low SMI class was associated with aging and that an age-related low SMI was more critically related to the severity of JSN in OA.
The study aimed to understand the knee condition of patients with knee joint pain who visited an Korean Medicine hospital by performing musculoskeletal ultrasound. From July 1, 2021 to October 31, 2021, information on the gender, age, diagnosis, and ultrasound findings of knee joint pain patients were retrospectively collected. To examine the condition of the knee joint, images were taken in a total of three postures. All images were analyzed by an examiner. 7 cases of osteoarthritis, 1 case of medial collateral ligament rupture, and 1 case of quadriceps tendon calcification were collected. It was able to check the condition of articular cartilage, lipoma arborescens, and the formation of osteophytes through musculoskeletal ultrasound. The implementation of musculoskeletal ultrasound can enable Korean medicine doctors to give more active treatment for patients through accurate and scientific diagnosis. Based on more evidence, it is thought that the use of medical devices by Korean medicine doctors will need to be made in the future.
The purpose of this study was to examine the physiochemical characteristics of hot water extract of Caragana sinica roots and verified its protective effect on MIA-induced osteoarthritis in rats. The contents of total polyphenol and total flavonoid used in this experiment were 0.40 mg/g and 0.22 mg/g respectively. We found that the weight of all experiment groups which ingested Caragana sinica extract for three weeks evenly increased in rats with MIA-induced osteoarthritis without toxicity in the liver or kidney. In the histopathological test through the Mankin score, the extent of damage of knee joint tissue in the experiment groups to which Caragana sinica extract was administered in 5 mL/kg or 10 mL/kg was significantly lower than that of the negative control groups statistically(p<0.05). As for the grade of osteoarthritis, the extent of tissue damage of the experiment groups to which Caragana sinica extract was administered in 5 mL/kg or 10 mL/kg was lower than that of the negative control groups as well.
Purpose: The purpose of this study was to determine if osteoarthritis patients would benefit in terms of pain, fatigue, difficulty with physical activity, joint stiffness, and flexibility of the joints from a structured self-help program. Method: This self-help program was carried out 2-3 hours once a week for 6 weeks in 2005-2006, and evaluated in one group pretest-posttest pre-experimental design. The subjects of this study who were diagnosed osteoarthritis were recruited at two different Community Health Centers in Kangwon. The subjects who agreed with the purpose of this study and participated both pretest and post-test were 55 patients. Mean age is 63.48 (9.48) years, mean duration of disease is 7.95 (7.66) years. The self-help program was consisted of weekly health contract, exercise, health education, group discussion, group counseling, and recreation. At every meeting, researcher and trained public health nurse evaluated the program, and prepared the next program. The measurement tools were pain rating scale (0-10), fatigue rating scale (0-10), Korean WOMAC (Western Ontario and McMaster University Osteoarthritis) Index, ruler, and goniometer. Results: At the completion of 6 weeks of self-help program, the subjects reported significantly less pain and difficulty with physical activity and more flexibility in both shoulder and knee joints compared to pretest. Conclusion: The self-help program would be helpful on pain, physical activity, and joint flexibility for arthritis patients.
Background: This study aimed to examine the effect of Scutellaria baicalensis extract (SBE) on ameliorating pain response and inflammation in an animal model. Methods: The effects of SBE on joint inflammation-induced rats and pain writhing response were measured. In rats with monosodium iodoacetate (MIA)-induced knee osteoarthritis (OA), the weight-bearing distribution of the hind legs was measured, the actual joint condition was visually confirmed, and serum cytokines were extracted from whole blood and measured. In addition, the acetic acid-induced pain was measured by the number of abdominal wall contractions and writhing responses. Results: 1. The weight-bearing distribution of the hind limbs of the SBE group was remarkably improved compared with that of the control group 7 days after MIA treatment, and the SBE 300 group was improved similarly to that of the indomethacin group. 2. Cartilage erosion was significantly recovered in the SBE and indomethacin groups, and the degree of healing of cartilage erosion by SBE was similar to that by indomethacin. 3. The serum levels of cytokines interleukin-1β, tumor necrosis factor-α, and interleukin-6 were significantly decreased in the SBE group compared with that in the control group, and the SBE 300 group had reduced levels of cytokines similar to the indomethacin group. 4. As regards acetic acid-induced writhing response, the number of writhes was significantly reduced in the SBE and ibuprofen groups, and the SBE 600 group had fewer writhes than the ibuprofen group. Conclusion: SBE significantly improves knee OA and pain and is expected to show similar therapeutic effects to indomethacin and ibuprofen.
Objectives : To verify pain relief effects and allergy inhibitory action for the osteoarthritis of the knee joint in Sweet Bee Venom in which allergy causing enzyme is removed. Methods : We randomly allocated 36 participants to treatment group Sweet Bee Venom and Bee Venom. Outcomes on pain reduction were measured by 100mm VAS(Visual Analog Scale). And we recorded into details allergic responses during Pharmacopuncture treatment. Results : Whole body condition and pain rate through VAS measurement were improved significantly in 2 weeks. We could get difference in pain score of two Pharmacopuncture groups significantly in 2 weeks. BV group showed superior reduction in pain compared to the Sweet BV group. But we could not get difference in whole score of two pharmacopuncture groups significantly. On the other hand other allergic responses such as edema, itchiness, pain were significantly lower in the Sweet BV group.
Objective: The rehabilitation protocols for functional recovery have been emphasized after total knee arthroplasty, and Pilates is in the spotlight as a safe and easily modified exercise method. The purpose of this study was to investigate the effects of mat Pilates exercise on lower extremity function, postural balance, and walking in the individuals with total knee arthroplasty. Design: One group pretest-posttest design. Methods: Eighteen older women with unilateral total knee arthroplasty was recruited in the study. The subjects were evaluated on lower extremity function, postural balance, and walking before and after mat Pilates exercise. All subject performed one hour mat Pilates exercise, 3 times a week for 8 weeks. Mat Pilates exercises were focused on core stability and lower extremity strengthening and, more dynamic movements were added to increase the difficulty of movements every two weeks. The lower extremity function was measured using the Western Ontario and McMaster Osteoarthritis Index (WOMAC), knee joint position sense, and five times sit-to-stand test. Postural balance was assessed by single leg stance test, functional reach test, and timed up and go test. Walking was measured by OptoGait system to temporospatial parameter. Results: The lower extremity function, postural balance, and walking were significantly improved after mat Pilates exercise, except for five times sit-to-stand test (p<0.05). Conclusions: This study demonstrated that the mat Pilates exercise was a useful method to improve lower extremity function, postural balance, and walking in the older women with unilateral total knee arthroplasty.
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