Page 10 - SMU Winter 2020

Used in traditional medicine in parts of an effect on the inflammatory process
India and regions of Asia for centuries, its typical of early arthritic joint pain.
main bioactive ingredient Curcumin, has It works by a unique mechanism from
demonstrated anti-inflammatory effects those above. One theory of causation of
supported by randomized clinical trials. It arthritis is auto-sensitivity of the immune
acts as an anti-inflammatory by inhibiting system to the breakdown products of
the arachidonic acid cascade modulating articular cartilage. UCII, which is chicken
proinflammatory cytokine signaling, cartilage, is thought to work through
production, and activity—interleukin, an immune modulating mechanism. By
phospholipase A2, Cox-2, 5-LOX, etc. exposing Peyer’s patches in the GI tract
5
A typical dose is a 1000–1500 mg daily. (a very active and important part of
our immune system) to these collagen
Avocado Soybean Unsaponifiables protein molecules, there appears to be a
de-sensitization or down regulation of the
Avocado Soybean Unsaponifiables (ASU) “auto-immune attack” systemically. This
is the residua of avocado and soybean then leads to decreased cytokine/pro-
oils that have been processed to make inflammatory mediators, reducing joint
soap products. The bioactive ingredients, pain and stiffness, and possibly stalling
while as yet not clearly characterized, progressive degradation in joints. Studies
seem to be phytosterols. Also, widely of UCII have shown significant reduction
available in oral capsules, ASU is mix of in WOMAC scores compared to placebo. 7
fat-soluble vitamins, sterols, triterpene The suggested dose is one capsule orally
alcohols, and furan fatty acids. In France
ASU is controlled as a prescription drug, at night on an empty stomach.
Like glucosamine and chondroitin
but in the U.S. it is available as an over- sulfate, however, what remains unclear is
the-counter supplement. It stimulates exactly which nutraceutical to try, and how
or inhibits the synthesis or activity of often or how long to continue taking them.
a broad range of cytokines modulating Similar questions remain regarding what
Turmeric inflammation. Also intriguing, it seems increased (or decreased) efficacy there may
to act directly on chondrocytes and may
Turmeric, long used as a food spice, is be in using products that combine several
6
what gives curries their yellow color. It is have an anti-catabolic effect. The typical of these elements into one supplement—
obtained from the root of Curcuma longa, oral dose for ASU is 300 mg daily. Google “Relief Factor” or “Instaflex.” The
a plant in the same family as ginger. best current evidence, including RCTs,
Typically taken in powdered form and Undenatured Type II Collagen supports Turmeric, ASU, and UCII as
widely available in capsules, Turmeric’s GI Undenatured Type II Collagen (UCII) is potentially beneficial in treating the
absorption (=bioavailability) is increased another nutraceutical supplement that symptoms of osteoarthritis, but a decade
when mixed with black pepper extract. has been evaluated and shown to have from now will we still be recommending it?

REFERENCES

1. Bruyere O, Reginster, J. Glucosamine and chondroitin sulfate as 5. Daily, DW, Yang M, Park S. Efficacy of turmeric extracts and
therapeutic agents for knee and hip osteoarthritis. Drugs Aging. curcumin for alleviating the symptoms of joint arthritis:
2007. 24(7) 573-580. A systemic review and meta-analysis of randomized clinical
2. Reginster JY, Kahan A, Vignon E. A two-year prospective, trials. J Med Food. 19 (8) 2016. 717-729.
randomized, double-blind, controlled study assessing the effect 6. Christiansen BA, et al. Management of osteoarthritis with avocado/
of chondroitin 4&6 sulfate (CS) on the structural progression of soybean unsaponifiables. Cartilage. 2015. Vol. 6(1) 30-44.
knee osteoarthritis: STOPP (Study on Osteoarthritis Progression 7. Lugo JP, Saiyed ZM, Lane NE. Efficacy and tolerability of an
Prevention) [Abstract]. Arthritis Rheum. 2006. 52(9 Suppl.):42. undenatured type II collagen supplement in modulating knee
3. The NIH Glucosamine/Chondroitin Arthritis Intervention Trial osteoarthritis symptoms: A multicenter randomized, double-
(GAIT). J Pain Palliat Care Pharmacother. 2008. 22(1):39-43. blind, placebo-controlled study. Nutrition Journal. (2016) 15:14.
4. American Academy Orthopaedic Surgeons OA Treatment
Guideline. 2013. PDF available online.

 8 SPORTS MEDICINE UPDATE | Winter 2020, Issue 1