Easing Joint Inflammation

One of the most common inflammatory health problems people experience is in the joints. Any injury to the joint can result in inflammation, but chronic inflammation in the joints is often associated with osteoarthritis (OA) or rheumatoid arthritis (RA).

Popular natural joint remedy glucosamine can rival drugs in anti-inflammatory action and reduced pain in arthritis research,¹ via suppression of inflammatory cell infiltration in joints.² Texas A&M University researchers speculated in a 2000 paper that glucosamine's anti-inflammatory mechanism was via inhibition of inducible NO synthase (iNOS);³ however, Sri Lankan scientists reported in 2008 a glucosamine derivative, quaternized amino glucosamine, inhibited pro-inflammatory cytokines—IL-1b, IL-6, TNFa and PGE2—released by activated macrophages, in addition to inhibiting the regulator of these cytokines, NFkappaB.⁴

Similarly, Boswellia serrata can inhibit leukotreine activity and reduce inflammation in RA patients.⁵ In order to decipher boswellia's exact anti-inflammatory mechanism of action, scientists from The Ohio State University Medical Center, Columbus, conducted the first whole genome screen for genes in human microvascular cells induced by TNFa, which resulted in 522 induced genes and 141 down-regulated genes ⁶ They reported 113 of the induced genes, which were related to inflammation, cell adhesion and proteolysis (protein breakdown), were "clearly sensitive" to boswellia extract (as 5-LOXIN, from Laila Nutraceuticals and PL Thomas). They further noted 5-LOXIN affected TNFa activities such as expression of VCAM, ICAM and MMPs (break down collagen). They confirmed these activities in a model of animal paw inflammation.

Most recently, a study led by a University of California, Davis, researcher confirmed these anti-inflammatory and anti-MMP mechanisms improved pain and function scores in OA patients.⁷ The researchers noted 5-LOXIN's anti-inflammatory properties are likely due to its 3-O-acetyl-11-keto-beta-boswellic acid (AKBA) content, which inhibits the 5-LOX pathway.

Protelytic enzymes—including papain, bromelain, pancreatin, trypsin and serrata peptidase—have also produced promising results, via systemic effects on inflammation. Czech researchers comparing conventional drugs to an enzyme combination (as Wobenzym® from Naturally Vitamins) in patients with long-bone fractures found subjects taking the enzymes experienced significantly reduced postoperative swelling and faster recovery.⁸ Additionally, bromelain and other systemic enzymes have also inhibited various inflammatory and disease markers in arthritic animal study.⁹ Researchers have reported bromelain supplementation has decreased PGE2 and substance P, a pro-inflammatory peptide.¹⁰

References on next page...

References for  "Joint Inflammation"

1. Thie NM et al. “Evaluation of glucosamine sulfate compared to ibuprofen for the treatment of temporomandibular joint osteoarthritis: a randomized double blind controlled 3 month clinical trial.” J Rheumatol. 28, 6:1347-55, 2001

2. Chou Mm et al. “Effects of chondroitin and glucosamine sulfate in a dietary bar formulation on inflammation, interleukin-1beta, matrix metalloprotease-9, and cartilage damage in arthritis.” Exp Biol Med (Maywood). 230, 4:255-62, 2005.3. Meininger CJ et al. “Glucosamine inhibits inducible nitric oxide synthesis.” Biochem Biophys Res Commun. 279, 1:234-9, 2004.4. Mendis E et al. " Suppression of cytokine production in lipopolysaccharide-stimulated mouse macrophages by novel cationic glucosamine derivative involves down-regulation of NF-kappaB and MAPK expressions." Bioorg Med Chem. 2008 Sep 15;16(18):8390-65. Ammon HP. “[Boswellic acids , components of frankincense) as the active principle in treatment of chronic inflammatory diseases]” Wien Med Wochenschr. 152:373-8, 2002.6. Roy S et al. “Human Genome Screen to Identify the Genetic Basis of the Anti-inflammatory Effects of Boswellia in Microvascular Endothelial Cells.” DNA Cell Biol. 24, 4:244-55, 2005.7. Sengupta K et al. " double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee." Arthritis Res Ther. 2008;10(4):R85.8. Kamenicek V, Holan P, Franek P. "[Systemic enzyme therapy in the treatment and prevention of post-traumatic and postoperative swelling.]" Acta Chir Orthop Traumatol Cech. 68, 1:45-9, 2001.9. Rovenska E et al. "Inhibitory effect of enzyme therapy and combination therapy with cyclosporine A on collagen-induced arthritis." Clin Exp Rheumatol. 19, 3:303-9, 2001.10. Hale LP. "Proteolytic activity and immunogenicity of oral bromelain within the gastrointestinal tract of mice." Int Immunopharmacol. 4, 2:255-64, 2004.