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维生素E在预防和治疗骨关节炎中的作用——当前证据综述

The Role of Vitamin E in Preventing and Treating Osteoarthritis - A Review of the Current Evidence.

作者信息

Chin Kok-Yong, Ima-Nirwana Soelaiman

机构信息

Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.

出版信息

Front Pharmacol. 2018 Aug 21;9:946. doi: 10.3389/fphar.2018.00946. eCollection 2018.

Abstract

Osteoarthritis is a debilitating disease of the joint involving cartilage degeneration and chondrocytes apoptosis. Oxidative stress is one of the many proposed mechanisms underpinning joint degeneration in osteoarthritis. The current pharmacotherapies emphasize pain and symptomatic management of the patients but do not alter the biological processes underlying the cartilage degeneration. Vitamin E is a potential agent to prevent or treat osteoarthritis due to its antioxidant and anti-inflammatory effects. This review aims to summarize the current evidence on the relationship between vitamin E and osteoarthritis derived from preclinical and human studies. Cellular studies showed that vitamin E mitigated oxidative stress in cartilage explants or chondrocyte culture invoked by mechanical stress or free radicals. Animal studies suggested that vitamin E treatment prevented cartilage degeneration and improve oxidative status in animal models of osteoarthritis. Low circulating or synovial vitamin E was observed in human osteoarthritic patients compared to healthy controls. Observational studies also demonstrated that vitamin E was related to induction or progression of osteoarthritis in the general population. Vitamin E supplementation might improve the outcomes in patients with osteoarthritis, but negative results were also reported. Different isomers of vitamin E might possess distinct anti-osteoarthritic effects. As a conclusion, vitamin E may retard the progression of osteoarthritis by ameliorating oxidative stress and inflammation of the joint. Further studies are warranted to develop vitamin E as an anti-osteoarthritis agent to reduce the global burden of this disease.

摘要

骨关节炎是一种使人衰弱的关节疾病,涉及软骨退变和软骨细胞凋亡。氧化应激是众多被认为是骨关节炎关节退变基础的机制之一。目前的药物治疗主要侧重于患者的疼痛和症状管理,而不会改变软骨退变的生物学过程。维生素E因其抗氧化和抗炎作用,是预防或治疗骨关节炎的一种潜在药物。这篇综述旨在总结目前来自临床前和人体研究的关于维生素E与骨关节炎之间关系的证据。细胞研究表明,维生素E可减轻机械应激或自由基引起的软骨外植体或软骨细胞培养中的氧化应激。动物研究表明,在骨关节炎动物模型中,维生素E治疗可预防软骨退变并改善氧化状态。与健康对照相比,在人类骨关节炎患者中观察到循环或滑膜维生素E水平较低。观察性研究还表明,在普通人群中,维生素E与骨关节炎的诱导或进展有关。补充维生素E可能会改善骨关节炎患者的预后,但也有负面结果的报道。维生素E的不同异构体可能具有不同的抗骨关节炎作用。总之,维生素E可能通过减轻关节的氧化应激和炎症来延缓骨关节炎的进展。有必要进一步开展研究,将维生素E开发成一种抗骨关节炎药物,以减轻这种疾病的全球负担。

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