Evidence base of pharmaconutraceuticals with chondroprotective action

Background. Osteoarthritis is one of the most common chronic diseases of the musculoskeletal system worldwide, being a common cause of chronic pain syndrome and disability. A number of pharmaconutraceuticals include well-known molecules, such as chondroitin sulfate, glucosamine sulfate, undenatured type II collagen, have proven effects on articular cartilage, subchondral bone, synovia. The use of these molecules makes it possible to influence main links in pathogenesis of osteoarthritis, and ultimately can slow down the progression of the disease, improve the quality of life of patients. Promising molecules for the prevention of osteoarthritis and a number of osteoarthritis diseases, along with chondroitin sulfate and glucosamine sulfate, are vitamin D3 and K2. One of the most important functions of vitamin D (25(OH)D) is to maintain the proper level of mineralization of the skeleton. By reducing 25(OH)D concentration in blood serum below optimal values leads to an increased risk of fractures, especially in the elderly. Vitamin K2, being a cofactor of osteocalcin carboxylation, improves bone mineral density and increases their strength. Chondroitin sulfate, glucosamine sulfate, undenatured type II collagen block the activity of proinflammatory cytokines, stimulate the activity of osteoblasts and reduce the excessive activity of osteoclasts. The molecules of chondroitin sulfate, glucosamine sulfate, vitamin D3, and vitamin K2 have proven clinical efficacy and safety against osteoarthritis.

Conclusion. Up to date, the molecules of chondroitin sulfate, glucosamine sulfate, undenatured type II collagen and vitamin D3 can be classified as to Disease Modifying Anti-Osteoarthritis Drug (DMOADs) that have both symptom-modifying and structural-modifying effects. Сhondroitin sulfate, glucosamine sulfate, vitamin D3 and K2 are prescribed for the treatment and prevention of diseases of musculoskeletal system. They can be presented both in the form of medicinal preparations and as part of biologically active food supplements. The use of these components may be warranted in patients with osteoarthritis and comorbidities (e.g., cardiovascular, type 2 diabetes mellitus).

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