ORIGINAL ARTICLE
Hyelim Kim1, Jaeeun Jung1, Minhee Lee1,2, Minha Kim3, Namgil Kang3, Ok-Kyung Kim4* and Jeongmin Lee1,2*
1Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea; 2Department of Food Innovation and Health, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea; 3Nutrione Co., Ltd, Seoul 05510, Republic of Korea; 4Division of Food and Nutrition and Human Ecology Research Institute, Chonnam National University, Gwangju, 61186, Republic of Korea
Background: Osteoarthritis (OA), the most prevalent form of arthritis, is a degenerative joint disease marked by the progressive deterioration of articular cartilage, leading to clinical manifestations such as joint pain.
Objective: This study investigated the effects of Curcuma longa L. extract (CL) containing curcumin, demethoxycurcumin, and bisdemethoxycurcumin on monosodium iodoacetate (MIA)-induced OA rats.
Design: Sprague–Dawley rats with MIA-induced OA received CL supplementation at doses of 5, 25, and 40 mg/kg body weight.
Results: CL extract administration suppressed mineralisation parameters and morphological modifications and decreased arachidonate5-lipoxygenase and leukotriene B4 levels in articular cartilage. Additionally, it decreased serum prostaglandin E2, NO, and glycosaminoglycanlevels as well as the protein expression of phosphorylated inhibitor kappa B-alpha, phosphorylated p65, cyclooxygenase-2, and inducible nitric oxide synthase in the cartilage of MIA-injected rats. Furthermore, it also reduced matrix metalloproteinases and elevated SMAD family member 3 phosphorylation, tissue inhibitor of metalloproteinases, aggrecan, collagen type I, and collagen type II levels in the articular cartilage of MIA-induced OA rats.
Conclusions: This study’s findings suggest that CL supplementation helps prevent OA development and is an effective therapy for OA.
Keywords: osteoarthritis; Curcuma longa L.; MMPs; chondrocytes
Citation: Food & Nutrition Research 2024, 68: 10402 - http://dx.doi.org/10.29219/fnr.v68.10402
Copyright: © 2024 Hyelim Kim et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.
Received: 30 November 2023; Revised: 23 January 2024; Accepted: 1 February 2024; Published: 19 March 2024
*Ok-Kyung Kim, Division of Food and Nutrition and Human Ecology, Research Institute, Chonnam National University, Gwangju 61186, Republic of Korea. Email: 20woskxm@jnu.ac.kr
*Jeongmin Lee, Department of Medical Nutrition, Kyung Hee University, Yongin 17104, Republic of Korea. Email: jlee2007@khu.ac.kr
Competing interests and funding: The authors have no conflicts of interest to declare. No funding was received.
Osteoarthritis (OA) is a degenerative joint disorder characterised by the progressive breakdown of cartilage in the joints, leading to pain, stiffness, and impaired mobility. It is the most prevalent form of arthritis and a major cause of disability, particularly among older adults (1, 2). The primary cause of OA is often attributed to the wear and tear of joints over time, although various contributing factors exist, including genetic predisposition, joint injuries, and obesity. In OA, the protective cartilage that cushions the ends of bones within joints gradually deteriorates, causing bones to rub against each other, resulting in pain and reduced joint function. Common OA symptoms include joint pain, swelling, and a diminished range of motion. While OA can affect any joint, it predominantly impacts weight-bearing joints, such as the knees, hips, and spine (1–3).
OA development involves intricate pathways related to the synthesis and degradation of articular cartilage. In a healthy joint, chondrocytes, the specialised cells residing in cartilage, maintain a delicate balance between the synthesis and degradation of extracellular matrix (ECM) components, primarily collagen and proteoglycans (4–6). However, in OA, this equilibrium is disrupted. The increased mechanical stress on the joint, along with factors such as aging and genetic predisposition, triggers a cascade of events. In response to these stimuli, the chondrocytes undergo phenotypic modifications, producing an altered matrix that is more susceptible to degradation. Matrix metalloproteinases (MMPs) and aggrecanases, enzymes upregulated in OA, contribute to collagen and proteoglycan breakdown, leading to the loss of cartilage integrity. Consequently, the cartilage undergoes progressive deterioration, exposing the underlying bone and causing pain, inflammation, and functional impairment characteristic of OA (7, 8).
Previous studies, including animal and human trials, have demonstrated promising results suggesting that Curcuma longa L. (CL), commonly known as turmeric, possesses anti-inflammatory and anti-arthritic properties for arthritis prevention and treatment (9, 10). The active compound in CL, curcumin, has been the focus of various studies exploring its potential therapeutic effects on arthritis. Curcumin is recognised for its ability to modulate inflammatory pathways, inhibit the activity of inflammatory enzymes, and reduce oxidative stress (11, 12). Here, we explored the effect of CL. extract containing curcumin, demethoxycurcumin, and bisdemethoxycurcumin on alterations in bone mass, bone microstructure, and exercise performance in rats with monosodium iodoacetate (MIA)-induced OA to validate its efficacy. Moreover, we determined the factors involved in the synthesis and degradation of articular cartilage and inflammation.
Water-dispersible Curcuma longa L. extract (CL; TurmXTRA 60N®) containing 60% curcuminoids (Fig. 1) was provided by Nutrione (Seoul, Korea). Sprague–Dawley rats (4-week-old males) were obtained from SaeRon Bio (Uiwang, Korea) and housed in cages with an automatically controlled environment (temperature: 22 ± 2°C; humidity: approximately 50%; lighting: 12-h light–dark cycle). The rats were randomly categorised into six groups of eight mice each as follows: normal control (AIN93G diet), control (C; AIN93G diet and MIA injection), positive control (PC; AIN93G diet containing ibuprofen at 20 mg/kg body weight [bw] and MIA injection), and three experimental groups receiving MIA injection and an AIN93G diet containing CL at different concentrations: CL5 (5 mg/kg/bw), CL25 (25 mg/kg/bw), and CL40 (40 mg/kg/bw). Three days after dietary supplementation, the rats were anesthetised with isoflurane and administered MIA (50 μL, 60 mg/mL) (Sigma–Aldrich) via a single injection into the right knee joint. The normal group was administered 0.9% saline via injection. The rats were sacrificed via cervical dislocation 31 days after MIA injection and dietary supplementation. The experimental protocol for this animal study was approved by the Institutional Animal Care and Use Committee of Kyung Hee University (KHGASP-23-098).
Fig. 1. High-performance liquid chromatography analysis of the curcumin, demethoxycurcumin, and bisdemethoxycurcumin levels in CL. CL = Curcuma longa L. extract.
Knee joints from the rats were fixed with 10% neutral buffered formaldehyde solution to preserve their structure. The fixed sample was subsequently dehydrated with graded ethanol (decreasing concentrations of 100–70%) and embedded in paraffin wax. The paraffin blocks were sliced into 7-μm sections, stained with Hematoxylin and eosin (H&E), washed with distilled H2O, and observed using an optical microscope to visualise knee joints.
Micro-computed tomography (CT) imaging of the formalin-fixed articular cartilage from the rats was used to measure the roughness of the bone surface. Micro-CT image scanning was conducted using the Skyscan 1172® X-ray μCT Scanning System (Bruker, Belgium). After standardised reconstruction of the scanned images, each sample’s data were generated using micro-CT software to orient each sample in the same manner.
Four weeks post-MIA injection, we used a rat-specific treadmill (Jeollanamdo Institute of Natural Resources Research, Korea) to measure rear pressure, rear propulsion, and running speed.
The levels of arachidonate 5-lipoxygenase (5-LOX) were measured using the Lipoxygenase Inhibitor Screening Assay kit (Cayman chemical, Ann Arbor, MI, USA). The levels of glycosaminoglycan (GAG) were measured using an enzyme-linked immunosorbent assay (ELISA) kit (Mybiosource, San Diego, CA, USA). The levels of leukotriene B4 (LTB4), prostaglandin E2 (PGE2), and nitric oxide (NO) were measured using an ELISA kit (R&D Systems, Minneapolis, MN, USA). The assays were conducted according to the manufacturer’s instructions.
Total protein was extracted from chondrocytes and cartilage tissue using 4X NuPAGE™ LDS Sample Buffer (Life Technologies, Gaithersburg, MD, USA). Protein samples containing 20–100 μg of protein from cells were separated using gel electrophoresis and transferred to membranes. The membranes were blocked and subsequently incubated with primary antibodies (SMAD family member 3 [Smad-3; Cell Signaling Technology (CST), Danvers, MA, USA], phosphorylated Smad-3 [CST], MMP-2 [Abcam, Waltham, MA, USA], MMP-3 [Abcam], MMP-9 [Abclonal Science Inc., Woburn, MA, USA], MMP-13 [Abcam], inhibitor kappa B-alpha [IκBα; CST], phosphorylated IκBα [CST], p65 [Abcam], phosphorylated p65 [CST], cyclooxygenase-2 [COX-2; CST], inducible nitric oxide synthase [iNOS; Abcam], and β-actin [Bethyl Laboratories Inc., Montgomery, TX, USA]) and secondary antibodies (Bethyl Laboratories Inc). Bands were captured using the ChemiDoc™ Imaging System (Bio-Rad, Hercules, CA, USA) and quantified using ImageJ software (version 1.53e; National Institutes of Health, Bethesda, MD, USA).
Total RNA was extracted from chondrocytes and cartilage tissue using a commercial RNA extraction kit (QIAGEN, Gaithersburg, MD, USA). The extracted RNA was assessed for ratio and concentration using a NanoDrop™ spectrophotometer. Thereafter, complementary DNA (cDNA) was synthesised from purified total RNA (500 ng/mL) using the iScriptTM cDNA Synthesis Kit (Bio-Rad). Real-time polymerase chain reaction (PCR) was performed using a CFX ConnectTM Real Time System (Bio-Rad) with the iScriptTM Green Supermix, cDNA, and custom-designed primers (Table 1), and the real-time PCR reactions were run in duplicate. Data analysis was conducted using CFX ManagerTM 3.1 analysis software (Bio-Rad).
All data are expressed as the mean ± standard deviation (SD). Significant differences were determined using one-way analysis of variance (ANOVA) and Duncan’s multiple range test (SPSS PASW Statistics version 23.0; SPSS Inc., Chicago, IL, USA). Statistical significance was set at P < 0.05.
Pre-treatment with CL suppressed the death of chondrocytes in H2O2-treated cells (Supplementary Fig. 1). Therefore, we speculated that CL would be able to protect against cartilage damage in animal models. We observed morphological modifications characterised by the presence of cartilage fibrillation, fissuring, erosion, and matrix degradation in the knee joints of MIA-induced OA rats (Fig. 2). Additionally, MIA injection induced a decrease in bone mineral density, bone volume/total tissue volume, trabecular number, and trabecular thickness along with an increase in trabecular separation when knee joints were assessed using micro-CT (Table 2). In contrast, rats treated with ibuprofen or CL exhibited suppressed morphological alterations and mineralisation parameters, including bone mineral density, bone volume/total tissue volume, trabecular number, and trabecular thickness, and increased trabecular separation (P < 0.05; Fig. 2 and Table 1). These results indicate that dietary CL administration has a protective effect against MIA-induced cartilage tissue damage, potentially mitigating the degenerative effects of OA.
Fig. 2. Effects of CL on the morphological and histological alterations in rats with MIA-induced osteoarthritis. NC: normal diet; Control (C): normal diet + MIA injection; PC: diet containing 20 mg/kg/bw ibuprofen + MIA injection; CL5: diet containing 5 mg/kg/bw CL + MIA injection; CL25: diet containing 25 mg/kg/bw CL + MIA injection; CL40: diet containing 40 mg/kg/bw CL + MIA injection. CL = Curcuma longa L. extract; MIA = monosodium iodoacetate; NC = Normal Control; PC = Positive control.
We measured the rear pressure, rear propulsion, and running speed of rats using a treadmill to confirm the effect of CL on pain intensity. We found that rear pressure, rear propulsion, and running speed significantly decreased in the MIA-induced OA group compared with those in the normal control group. However, dietary administration of ibuprofen, CL25, or CL40 to MIA-induced OA rats increased rear pressure, rear propulsion, and running speed compared with that of the control (P < 0.05; Fig. 3). Therefore, these findings suggest that dietary administration of CL potentially alleviates OA-associated pain.
Fig. 3. Effects of CL on the rear pressure (A), rear propulsion (B), and running speed (C) of rats with MIA-induced osteoarthritis. NC: normal diet; Control (C): normal diet + MIA injection; PC: diet containing 20 mg/kg/bw ibuprofen + MIA injection; CL5: diet containing 5 mg/kg/bw CL + MIA injection; CL25: diet containing 25 mg/kg/bw CL + MIA injection; CL40: diet containing 40 mg/kg/bw CL + MIA injection. Values are presented as the mean + SD. Different letters (a > b > c > d > e) indicate significant differences with P < 0.05, as determined using Duncan’s multiple range test. CL = Curcuma longa L. extract; MIA = monosodium iodoacetate; NC = Normal Control; PC = Positive control.
Figure 4 illustrates that MIA-injected rats exhibited significant increases in the serum levels of PGE2 and NO, compared with normal rats. Additionally, MIA-induced OA rats exhibited increased serum GAG levels in articular cartilage, indicating articular cartilage damage. However, the PGE2, NO, and GAG levels were significantly reduced in ibuprofen- and CL-treated rats compared with those in control rats (P < 0.05).
Fig. 4. Effects of CL on serum PGE2 (A), NO (B), and GAG (C) in rats with MIA-induced osteoarthritis. Normal Control (NC): normal diet; Control (C): normal diet + MIA injection; Positive control (PC): diet containing 20 mg/kg/bw ibuprofen + MIA injection; CL5: diet containing 5 mg/kg/bw CL + MIA injection; CL25: diet containing 25 mg/kg/bw CL + MIA injection; CL40: diet containing 40 mg/kg bw CL + MIA injection. Values are presented as the mean + SD. Different letters (a > b > c > d > e > f) indicate significant differences with P < 0.05, as determined using Duncan’s multiple range test. CL = Curcuma longa L. extract; MIA = monosodium iodoacetate.
MIA injection in rats led to elevated levels of 5-LOX and LTB4 (Fig. 5A and B) and protein expression of p-IκBα, p-p65, COX-2, and iNOS in cartilage tissue (Fig. 5C). Moreover, MIA injection increased the mRNA expression of COX-2, iNOS, tumour necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6 in cartilage tissue (Fig. 5D–H). However, in the PC and CL groups, MIA injection resulted in a notable reduction in the levels of 5-LOX and LTB4; protein expression of p-IκBα, p-p65, COX-2, and iNOS in cartilage tissue; and mRNA expression levels of COX-2, iNOS, TNF-α, IL-1β, and IL-6 compared with that in the MIA control group (P < 0.05; Fig. 5).
Fig. 5. Effects of CL on the levels of 5-LOX (A) and LTB4 (B); protein expression of p-IκBα, p-p65, COX-2, and iNOS (C); and mRNA expression of COX-2 (D), iNOS (E), TNF-α (F), IL-1β (G), and IL-6 (H) in cartilage tissue from rats with MIA-induced osteoarthritis. NC: normal diet; Control (C): normal diet + MIA injection; PC: diet containing 20 mg/kg/bw ibuprofen + MIA injection; CL5: diet containing 5 mg/kg/bw CL + MIA injection; CL25: diet containing 25 mg/kg/bw CL + MIA injection; CL40: diet containing 40 mg/kg/bw CL + MIA injection. Values are presented as the mean + SD. Different letters (a > b > c > d > e) indicate significant differences with P < 0.05, as determined using Duncan’s multiple range test. CL = Curcuma longa L. extract; MIA = monosodium iodoacetate; NC = Normal Control; PC = Positive control.
We investigated the anabolic and catabolic factors in the articular cartilage of MIA-induced OA rats to elucidate the molecular mechanism underlying CL’s effect on OA. The protein expression level of p-Smad3 decreased, while that of MMP-2, MMP-3, MMP-9, and MMP-13 increased in cartilage tissue from MIA-injected rats compared with that in cartilage tissue from normal control rats. However, dietary administration of ibuprofen or CL increased the protein expression of p-Smad3 and decreased that of MMP-2, MMP-3, MMP-9, and MMP-13 in cartilage tissue compared with that of the control (P < 0.05; Fig. 6A).
Fig. 6. Effects of CL on the protein expression of p-Smad3 and MMPs (A) and mRNA expression of MMP-2 (B), MMP-3 (C), MMP-9 (D), MMP-13 (E), TIMP-1 (F), TIMP-3 (G), aggrecan (H), collagen type 1 (I), and collagen type 2 (J) in cartilage tissue from rats with MIA-induced osteoarthritis. NC: normal diet; Control (C): normal diet + MIA injection; PC: diet containing 20 mg/kg/bw ibuprofen + MIA injection; CL5: diet containing 5 mg/kg/bw CL + MIA injection; CL25: diet containing 25 mg/kg/bw CL + MIA injection; CL40: diet containing 40 mg/kg/bw CL + MIA injection. Values are presented as the mean + SD. Different letters (a > b > c > d > e) indicate significant differences with P < 0.05, as determined using Duncan’s multiple range test. CL = Curcuma longa L. extract; MMP = Matrix metalloproteinases; MIA = monosodium iodoacetate; NC = Normal Control; PC = Positive control.
The mRNA expression levels of MMP-2, MMP-3, MMP-9, and MMP-13 significantly increased, while those of tissue inhibitor of metalloproteinases (TIMP)-1, TIMP-3, aggrecan, collagen type I, and collagen type II significantly decreased in cartilage tissue from MIA-injected rats compared with those in cartilage tissue from normal rats. However, the mRNA expression levels of MMP-2, MMP-3, MMP-9, and MMP-13 significantly decreased, while those of TIMP-1, TIMP-3, aggrecan, collagen type I, and collagen type II significantly increased in the ibuprofen- and CL-treated groups compared with those in the MIA-induced OA group (P < 0.05; Fig. 6B–J). These findings suggest that CL potentially plays a role in the onset of degenerative OA via Smad3 activation and MMP suppression in the anabolic and catabolic pathways, respectively.
Interest in the use of natural products as complementary and alternative medicine for OA has grown, driven by their potentially reduced side effects and toxicity (13). In this study, we investigated the effect of CL in MIA-induced OA rats to evaluate the efficacy of novel alternative medicines in the treatment of OA. MIA, known for inhibiting glyceraldehyde-3-phosphate dehydrogenase activity (14), was used to induce OA via intra-articular injection, leading to chondrocyte death in articular cartilage. Our findings revealed that intra-articular MIA injection triggered matrix degradation and inflammation in the articular cartilage of rats. However, CL ameliorated histological and mineralisation-parameter alterations and pain intensity in rats with MIA-induced OA.
In OA, the over-activation of 5-LOX and subsequent increase in LTB4 contribute to the inflammatory cascade. The enzyme 5-LOX is responsible for the synthesis of leukotrienes, including LTB4, from arachidonic acid. LTB4 induces the recruitment of immune cells, such as neutrophils, to the inflamed joint. The accumulation of these immune cells exacerbates inflammation, leading to tissue damage and OA progression (15, 16). We observed a significant reduction in 5-LOX and LTB4 levels in the articular cartilage of CL-treated rats compared with that in control rats. Additionally, CL administration decreased serum PGE2and NO levels as well as the protein expression of p-IκBα, p-p65, COX-2, and iNOS in the cartilage of MIA-injected rats. Moreover, it also reduced the mRNA expression levels of COX-2, iNOS, TNF-α, IL-1β, and IL-6 in the cartilage of MIA-injected rats. These findings further corroborate the notion that CL exhibits anti-inflammatory properties for the treatment of OA.
OA is characterised by a progressive deterioration of the ECM of articular cartilage, primarily orchestrated by MMPs. The ECM predominantly comprises collagen, constituting approximately 30% of the body’s total protein, and aggrecan, a crucial proteoglycan essential for the normal function of joints. The structural integrity and proper functioning of articular cartilage rely on key factors, such as aggrecan and collagen, within the ECM. The Smad signalling pathway and TIMPs are pivotal MMP inhibitors in chondrocytes (17–22). We observed increases in the protein and mRNA expression levels of MMPs in the articular cartilage of OA rats. Conversely, the expression of p-Smad3, TIMP-1, TIMP-3, aggrecan, collagen type I, and collagen type II decreased in the articular cartilage of OA rats. In CL-treated OA rats, MMPs decreased, while p-Smad3, TIMPs, aggrecan, collagen type I, and collagen type II increased. These results suggest that CL effectively suppresses the degradation of articular cartilage in OA.
Curcumin derived from CL has been established to exhibit multifaceted actions in the pathogenesis of OA. Notably, studies by Mathy-Hartertet et al. (23) have suggested the effectiveness of curcumin in treating OA by inhibiting the production of inflammatory and catabolic mediators in chondrocytes. Additionally, Li et al. (24) demonstrated that curcumin exerts inhibitory effects on apoptosis and inflammatory signalling by modulating extracellular signal-regulated kinase 1/2-induced autophagy in chondrocytes. In our study, the efficacy of CL was evaluated in animal models, and CL was found to exhibit significant pain suppression and joint-damage inhibition in OA rats. Previous findings and our results collectively indicate that curcumin possesses the potential to directly impact chondrocytes, suggesting a plausible role in OA treatment via its anti-inflammatory and cytoprotective functions. However, numerous studies and more extensive clinical trials are still required to definitively recommend curcumin as an alternative treatment. In conclusion, our findings suggest that CL supplementation may prevent OA development and exhibit effectiveness in OA therapies.
1. | Loeser RF, Collins JA, Diekman BO. Ageing and the pathogenesis of osteoarthritis. Nat Rev Rheumatol 2016; 12(7): 412–20. doi: 10.1038/nrrheum.2016.65 |
2. | Mobasheri A. Role of chondrocyte death and hypocellularity in ageing human articular cartilage and the pathogenesis of osteoarthritis. Med Hypotheses 2002; 58(3): 193–7. doi: 10.1054/mehy.2000.1180 |
3. | Goldring MB, Goldring SR. Articular cartilage and subchondral bone in the pathogenesis of osteoarthritis. Ann N Y Acad Sci 2010; 1192: 230–7. doi: 10.1111/j.1749-6632.2009.05240.x |
4. | Hashimoto M, Nakasa T, Hikata T, Asahara H. Molecular network of cartilage homeostasis and osteoarthritis. Med Res Rev 2008; 28(3): 464–81. doi: 10.1002/med.20113 |
5. | Beaupré GS, Stevens SS, Carter DR. Mechanobiology in the development, maintenance, and degeneration of articular cartilage. J Rehabil Res Dev 2000; 37(2): 145–51. |
6. | Huber M, Trattnig S, Lintner F. Anatomy, biochemistry, and physiology of articular cartilage. Invest Radiol 2000; 35(10): 573–80. doi: 10.1097/00004424-200010000-00003 |
7. | Caterson B, Flannery CR, Hughes CE, Little CB. Mechanisms involved in cartilage proteoglycan catabolism. Matrix Biol 2000; 19(4): 333–44. doi: 10.1016/S0945-053X(00)00078-0 |
8. | Lark MW, Bayne EK, Flanagan J, Harper CF, Hoerrner LA, Hutchinson NI, et al. Aggrecan degradation in human cartilage. Evidence for both matrix metalloproteinase and aggrecanase activity in normal, osteoarthritic, and rheumatoid joints. J Clin Invest 1997; 100(1): 93–106. doi: 10.1172/JCI119526 |
9. | Taty Anna K, Elvy Suhana MR, Das S, Faizah O, Hamzaini AH. Anti-inflammatory effect of Curcuma longa (turmeric) on collagen-induced arthritis: an anatomico-radiological study. Clin Ter 2011; 162(3): 201–7. |
10. | Murugan S, Bethapudi B, Purusothaman D, Chandrasekaran PR, Velusami CC. Antiarthritic effect of polar extract of Curcuma longa on monosodium iodoacetate induced osteoarthritis in rats. Antiinflamm Antiallergy Agents Med Chem 2017; 16(3): 193–202. doi: 10.2174/1871523017666180126150341 |
11. | Kahkhaie KR, Mirhosseini A, Aliabadi A, Mohammadi A, Mousavi MJ, Haftcheshmeh SM, et al. Curcumin: a modulator of inflammatory signaling pathways in the immune system. Inflammopharmacology 2019; 27(5): 885–900. doi: 10.1007/s10787-019-00607-3 |
12. | He Y, Yue Y, Zheng X, Zhang K, Chen S, Du Z. Curcumin, inflammation, and chronic diseases: how are they linked? Molecules 2015; 20(5): 9183–213. doi: 10.3390/molecules20059183 |
13. | Guan VX, Mobasheri A, Probst YC. A systematic review of osteoarthritis prevention and management with dietary phytochemicals from foods. Maturitas 2019; 122: 35–43. doi: 10.1016/j.maturitas.2019.01.005 |
14. | Pitcher T, Sousa-Valente J, Malcangio M. The monoiodoacetate model of osteoarthritis pain in the mouse. J Vis Exp 2016; 111: 53746. doi: 10.3791/53746-v |
15. | Martel-Pelletier J, Mineau F, Fahmi H, Laufer S, Reboul P, Boileau C, et al. Regulation of the expression of 5-lipoxygenase-activating protein/5-lipoxygenase and the synthesis of leukotriene B(4) in osteoarthritic chondrocytes: role of transforming growth factor beta and eicosanoids. Arthritis Rheum 2004; 50(12): 3925–33. doi: 10.1002/art.20632 |
16. | Paredes Y, Massicotte F, Pelletier JP, Martel-Pelletier J, Laufer S, Lajeunesse D. Study of the role of leukotriene B()4 in abnormal function of human subchondral osteoarthritis osteoblasts: effects of cyclooxygenase and/or 5-lipoxygenase inhibition. Arthritis Rheum 2002; 46(7): 1804–12. doi: 10.1002/art.10357 |
17. | Troeberg L, Nagase H. Proteases involved in cartilage matrix degradation in osteoarthritis. Biochim Biophys Acta 2012; 1824: 133–45. doi: 10.1016/j.bbapap.2011.06.020 |
18. | Luo Y, Sinkeviciute D, He Y, Karsdal M, Henrotin Y, Mobasheri A, et al. The minor collagens in articular cartilage. Protein Cell 2017; 8(8): 560–72. doi: 10.1007/s13238-017-0377-7 |
19. | Klatt AR, Paul-Klausch B, Klinger G, Kühn G, Renno JH, Banerjee M, et al. A critical role for collagen II in cartilage matrix degradation: collagen II induces pro-inflammatory cytokines and MMPs in primary human chondrocytes. J Orthop Res 2009; 27(1): 65–70. doi: 10.1002/jor.20716 |
20. | Cui N, Hu M, Khalil RA. Biochemical and biological attributes of matrix metalloproteinases. Prog Mol Biol Transl Sci 2017; 147: 1–73. doi: 10.1016/bs.pmbts.2017.02.005 |
21. | Akkiraju H, Nohe A. Role of chondrocytes in cartilage formation, progression of osteoarthritis and cartilage regeneration. J Dev Biol 2015; 3(4): 177–92. doi: 10.3390/jdb3040177 |
22. | Yu G, Xiang W, Zhang T, Zeng L, Yang K, Li J. Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis. BMC Complement Med Ther 2020; 20(1): 225. doi: 10.1186/s12906-020-02985-6 |
23. | Mathy-Hartert M, Jacquemond-Collet I, Priem F, Sanchez C, Lambert C, Henrotin Y. Curcumin inhibits pro-inflammatory mediators and metalloproteinase-3 production by chondrocytes. Inflamm Res 2009; 58(12): 899–908. doi: 10.1007/s00011-009-0063-1 |
24. | Li X, Feng K, Li J, Yu D, Fan Q, Tang T, et al. Curcumin inhibits apoptosis of chondrocytes through activation ERK1/2 signaling pathways induced autophagy. Nutrients 2017; 9(4): 414. doi: 10.3390/nu9040414 |