Article

Osteoarthritis (OA) is the most common cause of musculoskeletal disability in the
elderly, and it places an enormous economic burden on society, which will remain
a major health care challenge with an aging population. Management of OA is
primarily focused on palliative relief using agents such as nonsteroidal
anti-inflammatory drugs (NSAID) and analgesics. However, such an approach is
limited by a narrow therapeutic focus that fails to address the progressive and
multimodal nature of OA. Given the favorable safety profile of most nutritional
interventions, identifying disease-modifying pharmaconutrients capable of
improving symptoms and also preventing, slowing, or even reversing the
degenerative process in OA should remain an important paradigm in translational
and clinical research. The goals of pharmaconutrition for metabolic optimization
are to drive biochemical reactions in a desired direction and to meet health
condition-specific metabolic demands. Applying advances in nutritional science to
musculoskeletal medicine remains challenging, given the fluid and dynamic nature
of the field, along with a rapidly developing regulatory climate over
manufacturing and commerce requirements. The purpose of this article is to review
the available literature on effectiveness and potential mechanism for OA of
micronutrient vitamins; minerals; glycosaminoglycans; avocado-soybean
unsaponifiable fractions; methylsulfonylmethane; s-adenosylmethionine;
undenatured and hydrolyzed collagen preparations; phytoflavonoid compounds found
in fruits, vegetables, spices, teas, and nuts; and other nutrients on the
horizon. There also is a discussion on the concept of rational
polysupplementation via the strategic integration of multiple nutraceuticals with
potential complementary mechanisms for improving outcomes in OA. As applied
nutritional science evolves, it will be important to stay on the forefront of
proteomics, metabolomics, epigenetics, and nutrigenomics, because they hold
enormous potential for developing novel therapeutic and prognostic breakthroughs
in many areas of medicine, including OA.
CI - Copyright (c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS