Biochemical markers as a basis for optimizing chondroprotective therapy in osteoarthritis of the knee joints (literature review and own research observations)
Smiyan S.I., Bodnar R.Ya., Sverstyuk A.S.
Summary. Osteoarthritis (OA) is the most common chronic musculoskeletal disease with complex and not yet fully known etiopathogenic pathways. The search for effective therapies for OA patients requires further research. Aim. Comprehensive assessment of the role of biochemical markers such as N-terminal human procollagen II propeptide (PIINP) and C-terminal collagen type II telopeptide (CTX-II) in monitoring cartilage destruction and treatment efficacy according to the current literature and determination of therapeutic possibilities of chondroprotective therapy based on fish collagen peptide, glucosamine hydrochloride, calcium gluconate, methylsulfonylmethane, hyaluronic acid, unkaria pubescent extract, royal jelly (Articon) on the symptoms and dynamics of PIINP and CTX-II levels in knee osteoarthritis. Materials and methods. A scientific search was carried out and 52 outpatients and inpatients with primary gonarthrosis of radiological stage I-II according to Kellgren and Lawrence were examined, who were divided into two clinical groups: Group I (n=20) — patients receiving standard OA therapy (NSAIDs, chondroprotectors, physiotherapy, symptomatic treatment); Group II (n=32) — patients receiving the dietary supplement «Articon» in combination with standard OA therapy. The examination was performed twice: before the start of treatment (during hospitalization) and on the 90th day of therapy. Results. A comparative analysis of the VAS pain intensity, WOMAC pain severity and gonarthrosis severity (total Lecken index) to determine the effectiveness of OA treatment with standard therapy with the addition of the dietary supplement «Articon» revealed a statistically significant difference between the groups after treatment with the addition of «Articon» (ATTA) compared to the group after treatment with standard therapy (ATST), which indicates the effectiveness of using standard therapy with the addition of the dietary supplement Articon. This is also confirmed by the statistically significant difference between the ATTA group and the ATST group with a significance level of p=0.02<0.05 when comparing the biochemical marker PIINP and CTX-II, in which the median value in the ATTA group (0.302 [0.207; 0.376]) is 0.164 units less compared to the ATTA group (0.466 [0.141;0.836]), which confirms the positive effect of using the dietary supplement «Articon» in combination with standard therapy of OA. Conclusions. The literature review demonstrates the importance of biochemical markers PIINP and CTX-II in the context of cartilage tissue assessment and the effectiveness of therapeutic interventions. Changes in the levels of these markers can serve as indicators of not only cartilage destruction but also stimulation of bone synthesis. A decrease in CTX-II in response to therapy indicates positive changes, while an increase in PIINP demonstrates active regeneration processes. The results of our research confirm that chondroprotective therapy based on fish collagen peptide, glucosamine hydrochloride, calcium gluconate, methylsulfonylmethane, hyaluronic acid, unkaria pubescent extract, royal jelly («Articon») for 90 days has a statistically significant positive effect on the symptoms of knee osteoarthritis, including pain reduction and improved mobility. The established positive dynamics of PIINP and CTX-II levels indicate the potential of this therapy in slowing the progression of knee osteoarthritis.
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