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Metabolic Processes of OA |  |
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| Oxidative Activity Oxidative activity determines the body’s ability to absorb reactive oxygen species (ROS) (also called oxygen free radicals or oxidative products) that are generated by a variety of endogenous and exogenous processes. Production of ROS generally is the result of tissue damage, or directly causes tissue damage, associated with osteoarthritis (30). While epidemiological studies are complex and probably require further validated method development, experts do agree that ROS play a key role in the degradation of cartilage, a key factor in the etiology of osteoarthritis (31-32). In osteoarthritis patients, F2-isoprostanes, 4-hydroxynonenal, and malondialdehyde, products of ROS AA oxidation which directly degrade cartilage, are elevated in synovial fluid and serum (31). Elderly and aging populations, because of reduced nutritional intake, and lowered ability to ingest, adsorb, and digest foods, generally take in reduced levels of antioxidants (33). Poor intake of antioxidants in conjunction with oxidative stress has been associated with chronic disease states in the elderly (34). Conversely, intake of antioxidants has been shown to improve osteoarthritis symptoms (35). Therefore, poor oxidative status and intake of antioxidants has a direct impact on cartilage health and integrity (36). Some antioxidants, such as Lipoic acid and Coenzyme Q-10 are endogenously produced. Other antioxidants, such as Vitamins C and E, must be obtained from our diet. Good sources of Vitamin C include citrus fruits and juices, green peppers, spinach, broccoli and strawberries. Good sources of Vitamin E include nuts, whole grains, green vegetables and fish oils. Both Vitamins C and E have been shown to reduce oxidative load which may be beneficial in preventing osteoarthritis (37). Flavonoids are naturally occurring phytochemical antioxidants that “soak up” free radicals and convert them into harmless molecules which cannot destroy tissue (38). ROS generated by WBC influx into the joint cause increased production of the transcription factor NFκB at the cellular level which induces the production of pro-inflammatory cytokines such as TNFα which in turn induces IL-6 (39). TNFα, along with IL-1β and IL-6, are the initial signals that induce further expression of 5-LOX and COX-2 in osteoarthritis (36). Limbrel has an antioxidant ORAC (Oxygen Radical Absorbency Capacity) score that is higher than Vitamin C (5517 vs. 5000 μmole TE/g) (40). By reducing these key cytokines on a cellular level, via this antioxidant mechanism, Limbrel manages the production of excess inflammatory metabolites which contribute to osteoarthritis. Therefore, Limbrel’s antioxidant capacity may reduce oxidative stress and minimize further cartilage damage caused over time by ROS produced by the action of WBCs or environmental influences. |
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