Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Nov 18, 2018; 9(11): 255-261
Published online Nov 18, 2018. doi: 10.5312/wjo.v9.i11.255
Recently highlighted nutraceuticals for preventive management of osteoarthritis
Silvia Ravalli, Marta Anna Szychlinska, Rosalia Maria Leonardi, Giuseppe Musumeci
Silvia Ravalli, Marta Anna Szychlinska, Giuseppe Musumeci, Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania 95123, Italy
Rosalia Maria Leonardi, Department of Orthodontics, Policlinico Universitario “Vittorio Emanuele”, University of Catania, Catania 95124, Italy
Author contributions: Ravalli S generated the figures and wrote the manuscript; Szychlinska MA contributed to the writing of the manuscript; Leonardi RM contributed to manuscript revision; Musumeci G designed the aim of the review and supervised the manuscript writing.
Conflict-of-interest statement: All authors have no competing interests to declare.
Open-Access: This is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Giuseppe Musumeci, BSc, MSc, PhD, Associate Professor, Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Via S. Sofia 87, Catania 95123, Italy.
Telephone: +39-95-3782043 Fax: +39-95-3782034
Received: August 28, 2018
Peer-review started: August 28, 2018
First decision: October 5, 2018
Revised: October 11, 2018
Accepted: October 17, 2018
Article in press: October 18, 2018
Published online: November 18, 2018

Osteoarthritis (OA) is a chronic degenerative disease of articular cartilage with limited treatment options. This reality encourages clinicians to suggest preventive measures to delay and contain the outbreak of the pathological conditions. Articular cartilage and synovium suffering from OA are characterised by an inflammatory state and by significant oxidative stress, responsible for pain, swelling and loss of mobility in the advanced stages. This review will focus on the ability of olive oil to exert positive effects on the entire joint to reduce pro-inflammatory cytokine release and increase lubricin synthesis, olive leaf extract, since it maintains lubrication by stimulating high molecular weight hyaluronan synthesis in synovial cells, curcumin, which delays the start of pathological cartilage breakdown, sanguinarine, which downregulates catabolic proteases, vitamin D for its capacity to influence the oxidative and pro-inflammatory environment, and carnosic acid as an inducer of heme oxygenase-1, which helps preserve cartilage degeneration. These molecules, considered as natural dietary supplements, appear like a cutting-edge answer to this tough health problem, playing a major role in controlling homeostatic balance loss and slowing down the pathology progression. Natural or food-derived molecules that are able to exert potential therapeutic effects are known as “nutraceutical”, resulting from the combination of the words “nutrition” and “pharmaceutical”. These compounds have gained popularity due to their easy availability, which represents a huge advantage for food and pharmaceutical industries. In addition, the chronic nature of OA implies the use of pharmacological compounds with proven long-term safety, especially because current treatments like nonsteroidal anti-inflammatory drugs and analgesics improve pain relief but have no effect on degenerative progression and can also cause serious side effects.

Keywords: Osteoarthritis, Nutraceuticals, Prevention, Diet, Inflammation, Oxidative stress

Core tip: Osteoarthritis involves the significant expression of inflammatory cytokines, matrix proteins and proteolytic enzymes. For this reason, anti-inflammatory molecules play a major role in controlling the adverse effects of cartilage homeostatic balance loss. Olive oil, olive leaf extract, curcumin and sanguinarine have been studied as supplements with anti-inflammatory properties. Moreover, chondrocytes undergo senescence and cell death in the presence of oxidative stress. Potential targets involved in this mechanism are counteracted by anti-oxidant molecules like vitamin D and carnosic acid.