Chondroitin sulfate belongs to the group of mucopolysaccharides and is a component of cartilage, connective tissue, tendons and skin. Chondroitin sulfate is a sulfated GAG – glycosaminoglycan – and one of the main components of cartilage ground substance. It inhibits the activity of cartilage-degrading lytic enzymes. Deficiency of chondroitin sulfate and other glycosaminoglycans leads to increased degradation of proteoglycans, collagens and chondrocytes (cartilage-forming cells) – cells originating from chondroblasts and resident in cartilage tissue – due to increased activity of catabolic enzymes (metabolic accelerators that promote degradation). As a result, cartilage substance is reduced, increasing frictional resistance as well as abrasion and increasing the risk of developing osteoarthritis. In old age, the risk of osteoarthritis is particularly high. The ability to synthesize chondroitin sulfate itself diminishes. As a result, the body does not produce enough proteoglycans and collagen to keep cartilage healthy. In addition, the activity of cartilage-degrading enzymes can no longer be inhibited and increased catabolism of cartilage mass occurs. Therefore, in old age, the additional supply of chondroitin sulfate plays an essential role.
Indications (areas of application)
- Osteoarthritis
- Coxarthrosis (osteoarthritis of the hip joint; hip osteoarthritis).
- Gonarthrosis (osteoarthritis of the knee joint; knee osteoarthritis).
- Primary osteoarthritis of other joints: hand (fingers, carpus, metacarpus, joints between these bones).
- Rhizarthrosis (osteoarthritis of the thumb saddle joint).
The mode of action
After oral intake – for example, as a capsule or tablet – chondroitin sulfate is divided by the enzymes (metabolic accelerators) into its cleavage products – mono- and disaccharides – which can pass through the intestinal wall. These cleavage products enter into relationship with the GAG-containing structures of cartilage and accumulate there. In this way, the cartilage cells produce all the GAG’s present in the cartilage.The chondroitin sulfates (vital substances* ) of the intercellular substance have hydrophilic, i.e. water-binding, properties and thus increase the ability to bind water in the cartilage. Mature cartilage contains 75% water. The ability to bind water gives cartilage its internal tension, which is the basis for cartilage’s mechanical properties, such as smooth movement, elasticity and shock absorption. Furthermore, they are believed to have anti-inflammatory (anti-inflammatory) properties. Several scientific studies show that chondroitin sulfate leads to the decrease of pain, swelling, and improved joint function and mobility. * Vital substances (micronutrients) include vitamins, minerals, trace elements, vital amino acids, vital fatty acids, etc..Chondroitin sulfate, like glucosamine sulfate, is classified as a chondroprotectant (cartilage protector), which is used for degenerative joint disease. They also belong to the SYSADOA (Symptomatic Slow Acting Drugs in Osteoarthritis) and are characterized by a lack of direct analgesic effect (painkilling effect). Chondroitin sulfate and glucosamine sulfate act synergistically, that is, in the same sense. They stimulate the formation of new cartilage, while at the same time inhibiting the cartilage-destroying enzymes in their activity. With the use of chondroprotectants, the regeneration of cartilage tissue can be promoted in osteoarthritis patients, further loss of cartilage mass can be prevented, and thus the disease process of osteoarthritis can be stopped. In a systematic review, it was shown that in patients with or at risk for osteoarthritis, the use of glucosamine and chondroitin sulfate as a conservative measure can serve to protect articular cartilage and delay the progression of osteoarthritis. Hyaluronic acid injections showed variable efficacy, while NSAIDs and vitamins E and D showed no effect on the progression of osteoarthritis. In a multicenter intervention study with 606 gonarthrosis patients it could be shown that the effect of glucosamine and chondroitin for the therapy of gonarthrosis, showed identical effects as a drug treatment with the selective COX-2 inhibitor celecoxib. Both forms of therapy reduced the pain index of gonarthrosis patients by approximately 50%.The decrease in joint swelling and joint effusion also decreased equally in both groups.
