Nagaoka Isao, Nabeshima Kunihiro, Murakami Saya, Yamamoto Tetsuro, Watanabe Keita, Tomonaga Akihito, Yamaguchi Hideyo
Department of Host Defense and Biochemical Research, Juntendo University, Graduate School of Medicine, Tokyo;
Exp Ther Med. 2010 Sep;1(5):817-827. doi: 10.3892/etm.2010.114. Epub 2010 Jul 12.
We aimed to investigate whether a supplementary diet containing chicken comb extract (CCE) rich in hyaluronic acid (HA) has an effect on pain and other symptoms, as well as cartilage type II collagen (CII) metabolism in patients with knee osteoarthritis (OA). A randomized double-blind placebo-controlled study was conducted in 43 subjects with knee OA (Kellgren/Lawrence grade, mainly 1-2) comprising 22 patients receiving concurrent exercise therapy (ET) and 21 without ET (referred as ET-receivers and ET-unreceivers, respectively). Subjects were randomized to a CCE-containing diet (active diet) group administered a dose of 1,800 mg/day (containing 630 mg of CCE and approximately 60 mg of HA) and a placebo group, and the intervention was continued for 16 weeks. Symptomatic efficacy was evaluated based on the Japanese Orthopaedic Association clinical trials response criteria (JOA response criteria) and Visual analog scales (VAS) before (baseline) and during the intervention. To further examine its effect on CII metabolism, the levels of two degradation biomarkers (CTX-II and C2C) and one synthesis biomarker (CPII) were measured using urine or serum samples. Nineteen subjects (10 ET-receivers and 9 ET-unreceivers) in the active diet group and 21 subjects (10 ET-receivers and 11 ET-unreceivers) in the placebo group were finally included in the study. Compared to the baseline, subscale scores of the JOA response criteria, i.e., 'pain/walking function', 'pain/step-up and -down function' and 'aggregate total symptoms' were more intensely improved in the active diet group than in the placebo group. Moreover, subgroup analyses of ET-receivers and ET-unreceivers indicated that significant improvements were restricted to ET-receivers of the active diet group. Furthermore, VAS assessment indicated that the 'pain on pressing' subscale was significantly improved in ET-receivers of the active diet group. In addition, analysis of CII biomarkers revealed that serum C2C and CPII levels, but not the urinary CTX-II level, were increased in the active diet group. Notably, both urinary CTX-II/serum CPII and serum C2C/serum CPII ratios were reduced in the active diet group (particularly ET-unreceivers), suggesting that CII synthesis was relatively increased compared to CII degradation in the active diet group. Finally, no diet-related side effects were observed. The CCE-containing diet is likely to be effective in relieving symptoms in patients with knee OA. In addition, it has the potential to improve the balance of CII degradation/synthesis in knee OA.
我们旨在研究一种富含透明质酸（HA）的鸡冠提取物（CCE）补充饮食是否对膝关节骨关节炎（OA）患者的疼痛及其他症状，以及软骨II型胶原蛋白（CII）代谢有影响。对43例膝关节OA患者（Kellgren/Lawrence分级，主要为1 - 2级）进行了一项随机双盲安慰剂对照研究，其中22例患者接受同步运动疗法（ET），21例未接受ET（分别称为ET接受者和ET未接受者）。受试者被随机分为接受每日1800毫克剂量（含630毫克CCE和约60毫克HA）的含CCE饮食（活性饮食）组和安慰剂组，干预持续16周。根据日本骨科协会临床试验反应标准（JOA反应标准）和视觉模拟量表（VAS）在干预前（基线）和干预期间评估症状疗效。为进一步研究其对CII代谢的影响，使用尿液或血清样本测量两种降解生物标志物（CTX-II和C2C）和一种合成生物标志物（CPII）的水平。最终，活性饮食组纳入19名受试者（10名ET接受者和9名ET未接受者），安慰剂组纳入21名受试者（10名ET接受者和11名ET未接受者）。与基线相比，活性饮食组JOA反应标准的子量表评分，即“疼痛/行走功能”、“疼痛/上下台阶功能”和“总症状”，比安慰剂组改善更明显。此外，对ET接受者和ET未接受者的亚组分析表明，显著改善仅限于活性饮食组的ET接受者。此外，VAS评估表明活性饮食组的ET接受者中“压痛”子量表有显著改善。此外，对CII生物标志物的分析显示，活性饮食组血清C2C和CPII水平升高，但尿CTX-II水平未升高。值得注意的是，活性饮食组（尤其是ET未接受者）尿CTX-II/血清CPII和血清C2C/血清CPII比值均降低，表明活性饮食组中CII合成相对于CII降解有所增加。最后，未观察到与饮食相关的副作用。含CCE的饮食可能对缓解膝关节OA患者的症状有效。此外，它有可能改善膝关节OA中CII降解/合成的平衡。
