Prescribing Optimal Nutrition and Physical Activity as “First-Line” Interventions for Best Practice Management of Chronic Low-Grade Inflammation Associated with Osteoarthritis: Evidence Synthesis
Table 1
Synthesis of evidence of chronic low-grade inflammation being associated with osteoarthritis.
Inflammation-induced chondrocyte hypertrophy is driven by receptor for advanced glycation end products
Basic science study Experimental study
Analysis of human cartilage, cultured human articular chondrocytes, and recombinant human S100A11, soluble RAGE (advanced glycation end products), and RAGE-specific blocking antibodies
Normal human knee cartilages showed constitutive RAGE and S100A11 expression, and RAGE and S100A11 expression were upregulated in OA cartilages
Up-regulated chondrocyte expression in OA cartilage and RAGE signaling promote inflammation-associated chondrocyte hypertrophy
Rojas-Rodríguezet al., 2007 Medical Hypotheses [10]
The relation between the metabolic syndrome and energy-utilization deficit in the pathogenesis of obesity-induced osteoarthritis
Narrative review to examine a medical hypothesis: pathogenesis of obesity-induced OA may be explained by metabolic changes in striated muscle by interaction of insulin resistance and systemic inflammation in obese individuals
Evidence search strategy unspecified
Increased TH1 cytokines are produced by macrophages in presence of chronic infection and suppress insulin sensitivity Muscle cells and adipocytes are activated by inflammatory cytokines and contribute to chronic low-grade inflammation in apparently healthy obese individuals
The fatigue and muscle weakness induced by insulin resistance and inflammation in obese patients with metabolic syndrome (pro-inflammatory state) increase trauma to joints that result in breaking of tenoperiosteal junction and abrasive damage of cartilage
Schlesinger and Thiele, 2010 Annals of Rheumatic Diseases [11]
The pathogenesis of bone erosions are in gouty arthritis
Review
Synthesis of mechanical, pathological, cellular, and immunological factors role in the pathogenesis of bone erosions in gouty arthritis Search strategy unspecified
Monosodium urate crystal deposition associated with underlying OA Gouty tophus and bone erosions associated with chronic low-grade inflammation
Tophus eroding underlying bone is pivotal for development of bone erosions in gouty arthritis
Synovial membrane inflammation and cytokine production in patients with early osteoarthritis
Clinical trial of patients with varying stages of early OA ()
Synovial membrane samples obtained from the knees of patients
Thickening of lining layer, increased vascularity, and inflammatory cell infiltration in synovial membranes; changes proportional to severity Inflammatory markers increased in the synovial membranes of patients irrespective of degree of articular damage
Chronic inflammatory changes with production of pro-inflammatory cytokines characterize the synovial membranes of patients with early OA Low-grade synovitis results in the production of cytokines that may contribute to OA pathogenesis
