RESUMO
Objective: To test the hypothesis that undenatured type II collagen (UC-II) relieves pain, quality of life, and joint function in women aged from 60 to 80 years with knee osteoarthritis. Methods: 53 patients in the UC-II treatment group (for 90 days) and 52 in the control group (without UC-II) were evaluated at 1, 30, and 90 days regarding health-related quality of life, pain, and function with questionnaires, anthropometric data, alignment, range of motion, and radiographic analysis. Results: Quality of life increased significantly in the Physical domain in the treatment vs control group. Also, there was a difference between the first and the last evaluation on the pain visual analog scale (-3.8 ± 1.8 versus -1.3 ± 2.0) and on the WOMAC score (-9.5 ± 11.9 versus -1.3 ± 11.1). No variation in the temporal evolution of the Mental domain was found. Conclusion: Pain, joint stiffness, and quality of life (Physical domain) improved with the inclusion of UC-II for 90 days to the therapeutic toolbox for knee osteoarthritis in individuals aged 60 to 80 years. Level of evidence II, Comparative Prospective Study.
Objetivo: Testar a hipótese de que o colágeno não hidrolisado tipo II (UC-II) melhora a dor, qualidade de vida e função articular de indivíduos entre 60 e 80 anos com osteoartrite (OA) de joelho. Métodos: Cinquenta e três pacientes do grupo tratamento com UC-II (por 90 dias) e 52 do grupo controle (GC - sem UC-II) foram avaliados no tempo 0, 30 e 90 dias quanto à qualidade de vida em saúde, dor e função com os questionários, além de dados antropométricos, alinhamento, amplitude de movimento e análise radiográfica. Resultados: A qualidade de vida aumentou significantemente no domínio PCS no grupo tratamento versus controle. Houve ainda diferença entre a primeira e última avaliação na dor pela escala visual analógica (−3.8 ± 1.8 versus −1.3 ± 2.0) e no escore WOMAC (−9.5 ± 11.9 versus −1.3 ± 11.1). Não houve variação na evolução temporal do domínio MCS. Conclusão: Dor, rigidez articular e qualidade de vida (domínio físico) melhoram com a inclusão do UC-II por 90 dias ao arsenal terapêutico na OA do joelho em indivíduos de 60 a 80 anos. Nível de Evidência II, Estudo Prospectivo Comparativo.
RESUMO
ABSTRACT Objective: To test the hypothesis that undenatured type II collagen (UC-II) relieves pain, quality of life, and joint function in women aged from 60 to 80 years with knee osteoarthritis. Methods: 53 patients in the UC-II treatment group (for 90 days) and 52 in the control group (without UC-II) were evaluated at 1, 30, and 90 days regarding health-related quality of life, pain, and function with questionnaires, anthropometric data, alignment, range of motion, and radiographic analysis. Results: Quality of life increased significantly in the Physical domain in the treatment vs control group. Also, there was a difference between the first and the last evaluation on the pain visual analog scale (−3.8 ± 1.8 versus −1.3 ± 2.0) and on the WOMAC score (−9.5 ± 11.9 versus −1.3 ± 11.1). No variation in the temporal evolution of the Mental domain was found. Conclusion: Pain, joint stiffness, and quality of life (Physical domain) improved with the inclusion of UC-II for 90 days to the therapeutic toolbox for knee osteoarthritis in individuals aged 60 to 80 years. Level of evidence II, Comparative Prospective Study.
RESUMO Objetivo: Testar a hipótese de que o colágeno não hidrolisado tipo II (UC-II) melhora a dor, qualidade de vida e função articular de indivíduos entre 60 e 80 anos com osteoartrite (OA) de joelho. Métodos: Cinquenta e três pacientes do grupo tratamento com UC-II (por 90 dias) e 52 do grupo controle (GC - sem UC-II) foram avaliados no tempo 0, 30 e 90 dias quanto à qualidade de vida em saúde, dor e função com os questionários, além de dados antropométricos, alinhamento, amplitude de movimento e análise radiográfica. Resultados: A qualidade de vida aumentou significantemente no domínio PCS no grupo tratamento versus controle. Houve ainda diferença entre a primeira e última avaliação na dor pela escala visual analógica (−3.8 ± 1.8 versus −1.3 ± 2.0) e no escore WOMAC (−9.5 ± 11.9 versus −1.3 ± 11.1). Não houve variação na evolução temporal do domínio MCS. Conclusão: Dor, rigidez articular e qualidade de vida (domínio físico) melhoram com a inclusão do UC-II por 90 dias ao arsenal terapêutico na OA do joelho em indivíduos de 60 a 80 anos. Nível de Evidência II, Estudo Prospectivo Comparativo.
RESUMO
Osteoarthritis (OA) of the knee causes disability, pain, and progressive destruction of cartilage in adult women. The objective of the study was to evaluate the concentrations of the urinary biomarker C-terminal telopeptide of type II collagen (CTX-II) and pain by radiographic grade in women with knee OA in northeastern Mexico: Cross-sectional study of 155 women with knee OA. Concentrations of biochemical parameters were evaluated and urine samples were collected to measure biomarker levels (uCTX-II) ng/mmol by competitive enzyme-linked immunoabsorbent assay (ELISA) technique and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale was used for pain classification; median age of 49 years and 29.1 kg/m2 of body mass index (BMI). uCTX-II biomarker levels were grade 2 (210.7 ng/mmol), grade 3 (314.8 ng/mmol), and grade 4 (478.8 ng/mmol) relative to Kellgren and Lawrence, uCTX-II levels were compared with WOMAC scale and presented significant statistical difference (p = 0.0001). An association of the biomarker CTX-II and an increase in BMI was found in female patients with knee OA (odds ratio = 1.01; 95% confidence interval 1.001-1.005; p = 0.047).This study demonstrates an increase in the levels of the biomarker uCTX-II, the degree of pain, and radiographic grade in women with knee OA in northeastern Mexico.
RESUMO
Dentro de las enfermedades autoinmunes, la Artritis Reumatoide es una de las más estudiadas, dada su alta prevalencia. Numerosos estudios han reportado como posible mecanismo gatillante la existencia de una respuesta inmune contra el Colágeno tipo II. El presente trabajo busca contribuir al conocimiento y significación de este proceso, a través de la determinación de diferentes auto-anticuerpos en sujetos con Artritis Reumatoide (diagnosticados bajo criterios del American College of Rheumatology) y en sujetos con artralgias inespecíficas en comparación con sujetos normales. Para esto, se realizó un estudio descriptivo, de corte transversal, en el que se determinó la presencia, en sueros, de anticuerpos anti-colágeno tipo II y de anticuerpos anti-Péptidos Cíclicos Citrulinizados (CCP) por ELISA y de Anticuerpos anti-sinovial por Inmunofluorescencia Indirecta (IFI) con métodos previamente estandarizados de acuerdo a procedimientos convencionales. No se encontró diferencia significativa entre los promedios de los niveles de los anticuerpos anti-colágeno tipo II en los 3 grupos; sin embargo, la distribución de los títulos de anticuerpos presenta, en los tres grupos, curvas de frecuencia de tipo bi-modal cuyos perfiles son totalmente diferentes entre ellos. En este orden, se identificó un subgrupo conformado por el 20 por ciento del grupo con Artritis Reumatoide quienes presentaban anticuerpos anti-colágeno tipo II con niveles muy altos, por encima de las dos desviaciones estándar; dichos sujetos correspondían a adultos jóvenes (edad promedio 41 años) que no recibieron tratamiento inmunosupresor. No se encontró ninguna correlación entre los niveles de anticuerpos anti-colágeno tipo II, los anticuerpos anti-CCP, y los de anticuerpos anti-sinovial. Se discute la significación de estos hallazgos.
Between the Autoimmune Diseases, Rheumatoid Arthritis (RA) is one of the most studied, due to its high prevalence. Several studies have reported as possible shooting mechanism the existence of an immune response against Collagen type II. The present work look for contributing to the knowledge and meaning of the autoimmune process through determinations of different serum antibodies in subjects with Rheumatoid Arthritis (diagnosed under the American College of Rheumatology criteria) and in subjects with unspecific arthralgia in comparison with normal subjects. For this purpose, a transversal descriptive study was carried out, determining the presence of anti-collagen type II antibodies, anti-CCP (Citrulinated Cyclic Peptides) antibodies and anti-synovial antibodies by indirect immuno fluorescence (IFI) in sera, using previously standardized methods according to conventional procedures. No significant differences was found between the averages of the levels of anti-collagen type II in the 3 groups; however, the distribution of the antibody titles shows, in the three groups, curves of frequency of a bi-modal type, with profiles totally different between them. In this order, inside the group with Rheumatoid Arthritis it was identified a subgroup formed by the 20 percent of the subjects that presents very high levels of anti-collagen type II Antibodies (over the two standard deviations), made by young adults (average age 41 years) that did not receive inmunosuppresive treatment. It was not found relationship between the levels of anti-collagen type II antibodies, anti-CCP antibodies and anti-synovial antibodies. The significance of these findings is discussed.