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Inflammation May Be
Culprit in Osteoarthritis
Excerpt
By Janice Billingsley, HealthDay
It could be that your osteoarthritis
may be caused by something besides the fact that you're getting
older and falling apart.
British scientists found that nearly
one-third of patients ready to undergo joint replacement surgery
for osteoarthritis (OA) had severe inflammation in the synovial
fluid that surrounds and protects the joints. This inflammation,
already known to cause rheumatoid arthritis, could be a contributing
factor in osteoarthritis as well, the researchers suggest.
"Many people with early osteoarthritis
have few symptoms, and understanding the role of inflammation
in OA may enable markers of inflammation to be used to help decide
whether someone with early OA should be offered treatment or not,"
says study co-author David A. Walsh, a senior lecturer in rheumatology
at the University of Nottingham in the United Kingdom.
The finding appears in the August
issue of Arthritis & Rheumatism.
"Five to 10 years ago it was
thought that osteoarthritis was due to the degeneration of cartilage
due to wear and tear, but this is one of a number of studies finding
that inflammatory mediators promote more a rapid progression of
cartilage to be degraded," says Dr. Steven B. Abramson, chairman
of the department of rheumatology and medicine at the New York
University-Hospital for Joint Diseases.
As this association becomes clearer,
Abramson says, the practice of using magnetic resonance imaging
(MRI) in the finding of synovitis will become very common and
could serve as a marker for the disease.
Further, he says research will
aim to find out whether it would be useful to look at drugs now
used to treat rheumatoid arthritis to see if they might have a
role in treating osteoarthritis. At present the most powerful
drugs that actually modify the progression of the disease have
a fair amount of toxicities, Abramson says, so any drug management
would have to include a careful risk/benefit analysis.
Osteoarthritis is the most common
form of arthritis, especially among older people, affecting some
20 million Americans. By 2030, 20 percent of Americans -- about
70 million people -- will have passed their 65th birthday and
will be at risk for osteoarthritis, according to the National
Institute of Arthritis and Musculoskeletal and Skin Diseases.
Also called degenerative joint
disease, osteoarthritis causes the eroding of the cartilage that
covers the ends of the bones in the joints, leaving the bones
to rub together, which causes pain, swelling and loss of motion
in the joint.
For the study, the researchers
from the University of Nottingham obtained synovial tissue samples
from 104 patients, both men and women of an average age of 69,
who were about to undergo joint replacement of hips or knees due
to advanced osteoarthritis.
Thirty-two, or 31 percent of the
patients, showed evidence of the most severe inflammation, 36
showed evidence of moderate inflammation, 29 had minor inflammation,
and seven had none.
"The caveat of this study
is that the samples were taken just before surgery, so these were
very advanced cases of osteoarthritis," Abramson says, "and
critics will question whether this inflammation is important earlier
in the disease. But other studies, using arthroscopy, have looked
at this in the middle stage of osteoarthritis -- which is about
10 years before surgical intervention -- and about one-third to
one-half of those patients will have synovial inflammation."
More information
The
National Institute on Aging offers some tips on managing arthritis.
Meanwhile, the Arthritis
Foundation has information on glucosamine and chrondroitin
sulfate, alternative remedies popular among people with arthritis.
Reference
Source 101
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