Chondromodulation and tolerogenicity: a new concept in the management of osteoarthritis

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MEDICINA

Published on Jan 2, 2025
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Osteoarthritis is one of the most common causes of pain and disability in the elderly. Given the increase in the elderly population, there is an increasing need for therapeutic interventions that allow the delay of its deleterious effects on people's health. Therefore, a responsible health policy should take into account this social demand and a priority focus of resources for this increasingly prevalent disease. Clinical and research interest in this condition has been renewed. The greater pathophysiological knowledge of the immunological and enzymatic changes that operate in the disease has modified the mechanistic concept that was held of its pathogenesis, incorporating a more dynamic and biological one, in which the chondrocyte plays a fundamental role, and would also be sensitive to pharmacological treatment, which would delay the degenerative process. Glucosamine sulphate (GS) is a molecule with a wide range of biological actions, among which the anti-inflammatory and the upregulation of the metabolism of the cartilage matrix stand out. Recent in vitro studies demonstrate this chondromodulatory profile that favors chondrocyte anabolism. Likewise, long-term, randomized, placebo-controlled studies have shown an improvement in symptoms and progression of joint narrowing in people treated with SG, along with a safety profile similar to that of the placebo groups. The following article approaches disease control with slow-acting symptomatic and structure-modifying drugs in osteoarthritis and reviews the available evidence on SG in the specific treatment of osteoarthritis.

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