[Efficacy and safety of undenatured type II collagen in patients with knee osteoarthritis: a multicenter, prospective, double-blind, placebo-controlled, randomized trial].

BACKGROUND: Non-pharmacological treatments based on collagen as a dietary supplement are emerging as a new area of interest to support preventive or therapeutic effects in patients with osteoarthritis (OA). AIM: In a multicenter, prospective, double-blind, placebo-controlled, randomized study, to evaluate the effectiveness and safety of the use of the Artneo complex containing undenatured chicken collagen type II in patients with OA of the knee joints. MATERIALS AND METHODS: The study enrolled 212 outpatients from 12 centers in the Russian Federation with knee OA, stages II and III according to the Kellgren-Lawrence classification. The participants included 171 women (80.7%) and 41 men (19.3%), with an average age of 60.2±9.0 years (range: 40 to 75 years). The study population was randomly allocated in equal proportions into two groups using an interactive web response system (IWRS). Group 1 (Artneo) consisted of 106 patients who took one capsule of the drug once daily for 180 days. Group 2 (Placebo) also had 106 patients, with the dosage form and regimen identical to Group 1. During the treatment period, the following outcomes were assessed: WOMAC index, KOOS, pain according to VAS, quality of life using the EQ-5D questionnaire, and the need for NSAIDs. All patients underwent a clinical blood test, general urine analysis, biochemical blood test, and ultrasound examination of the affected knee joint. RESULTS: In a prospective, double-blind, placebo-controlled, randomized study, it was demonstrated that the Artneo combination, containing undenatured chicken collagen type II, has a positive effect on all clinical manifestations of OA: it effectively reduces pain, stiffness, and improves the functional state of joints and quality of life. It has a good safety profile and is superior to placebo in all parameters studied. CONCLUSION: The results of the study confirm the good effectiveness and safety of the Artneo combination in patients with OA of the knee joints.

[Evaluating the activity of the apoptosis-regulating genes from Bcl-2, Bax expression, and caspase-3 activity in bronchial epithelial cells in patients with asthma].

The specific features of bronchial epithelial cell apoptosis in asthma were studied, by evaluating the activity of the apoptosis-regulating genes Bcl-2, Bax, and caspase-3. Fibrobronchoscopy with target biopsy of the bronchial mucosa was carried out in 21 asthmatic patients (the latter had given informed consent). The expression of Bcl-2, Bax, and CPP32 (caspase-3 activity) was determined in the bronchial epithelial cells by the immunohistochemical technique using the DAKO kits. Allergic asthma is characterized by higher Bcl-2 and lower Bax expression than non-allergic asthma and in patients receiving systemic glucocorticosteroids. The similar nature of changes was found in the analysis of the Bcl2/Bax ratio. Regardless of the type of asthma, the expression of caspase-3 was rather high. The specific features of impaired bronchial epithelial cell apoptosis in different types of asthma can determine the pathogenetic value of apoptotic disorders in the persistence of allergic inflammation.

[Disturbance of apoptosis of peripheral blood lymphocytes in different variants of bronchial asthma].

AIM: To reveal disturbances of peripheral blood lymphocytes apoptosis in different variants of bronchial asthma (BA). MATERIAL AND METHODS: Apoptosis was studied in 20 healthy subjects, 70 BA patients: 32 patients with allergic BA (ABA) and 26 patients with non-allergic (NABA), 12 patients with BA treated with oral glucocorticosteroids. The following parameters of apoptosis were assessed: cell readiness for apoptosis (expression of CD95/Fas/APO-1 receptors), an early reversible stage of apoptosis (expression of phosphatidylserine on outer leaflet of lymphocyte membrane) and a late stage of apoptosis (the key effector caspase 3 activity). RESULTS: ABA is characterized by increased peripheral blood lymphocytes resistance to apoptosis: a decrease in expression of CD95/Fas/APO-1 receptors and phosphatidylserine on lymphocyte surface and caspase 3 activity. NABA is characterized by peripheral blood lymphocyte apoptosis activation at all stages: high expression of CD95/Fas/APO-1 receptors, expression of phosphatidylserine and caspase 3 activity. BA patients on systemic glucocorticosteroids are characterized by maximal expression of CD95/Fas/APO-1 receptors and phosphatidylserine on lymphocyte surface and the highest caspase 3 activity. CONCLUSION: The findings allow more accurate definition of the features of peripheral blood lymphocytes apoptosis in different variants of bronchial asthma and characteristics of relations between disturbed apoptosis and inflammation. Disturbances of apoptosis may be of pathogenetic importance in persistence ofallergic inflammation.

[Effect of adrenergic and histaminergic disorders on the subclinical course of atopic bronchial asthma]. / Vyiavlenie narushenii v adrenergicheskoi i gistaminergicheskoi sistemakh na doklinicheskom étape pri atopicheskoi bronkhial'noi astme.

To characterize membrane-receptor peculiarities of the adrenergic and histaminergic systems under the model of peroxide and hyperosmolar effect in atopic bronchial asthma (ABA) and preclinical stage of BA, we have examined 25 patients with ABA, 19 patients with nonpulmonary allergy, 28 healthy men and 21 healthy blood relatives of ABA patients. The phenomenon of inversion of the effect of beta-adrenoblocker (obzidan) and of the combined effect of histamine and H1-antagonist (dimedrol) was revealed in ABA patients. The same phenomenon was registered at the preclinical stage of BA. In ABA and in preclinical BA the shift of H1/H2-histaminergic balance to increased H1-activity exists. Peroxide and hyperosmolar effects modeled on red cell membranes allowed us to characterize reactivity of adrenergic and histaminergic systems not only in ABA but also in preclinical BA.

[Membrane-receptor disorders in adrenergic and histaminergic systems under peroxide exposure in bronchial asthma patients]. / Membranno-retseptornye narusheniia v adrenergicheskoi i gistaminergicheskoi sistemakh pri perikisnom vozdeistvii u bol'nykh bronkhial'noi astmoi.

AIM: To characterize membrane-receptor peculiarities in adrenergic and histaminergic systems under model peroxide effect in bronchial asthma (BA). MATERIALS AND METHODS: 172 patients with BA, 17 patients with nonpulmonary allergy, 38 healthy men and 19 healthy blood relatives of BA patients were examined for peroxide resistance of erythrocytic membrane to modulation with adrenergic and histaminergic agonists and antagonists. The modified method by A. A. Abramov and A. A. Pokrovsky was used. RESULTS: In atopic BA the phenomenon of inversion of the effect of beta-adrenoblocker (obzidan) and of combined effect of histamine and H1-antagonist (dimedrol) was revealed. The same phenomenon was registered at the stage of preasthma and at the preclinical stage of BA. In infection-dependent BA this phenomenon occurred less frequently being rare in remission. In both BA variants the shift of H1/H2-histaminergic balance to increased H1-activity exists which is more significant in atopic BA, preasthma and preclinical BA. CONCLUSION: Peroxide effects modelled on red cell membranes enabled to characterize reactivity of adrenergic and histaminergic systems not only in BA but also in preasthma and preclinical BA.

[Peculiarities of cell reception in bronchial asthma patients with bronchial hyperreactivity to hyperosmolar provocation]. / Osobennosti kletochnoi retseptsii u bol'nykh bronkhial'noi astmoi s giperrektivnost'iu bronkhov na giperosmoliarnuiu provokatsiiu.

AIM: To investigate characteristics of the cell receptor systems in bronchial asthma (BA) patients with bronchial hyperreactivity (BHR) induced by hyperosmolar provocation. MATERIALS AND METHODS: 15 patients with BA, in most cases atopic, in remission were studied. The bronchoprovocative test (BPT) with ultrasonically nebulized 3.6% hypertonic NaCl solution (UNHS) FEV1-control was performed. Cell receptors reactivity was analysed on the model of erythrocyte resistance (ER) to hyperosmolar provocation (HP) under the modulation by adrenergic and histaminergic agents. RESULTS: It was revealed that ER was significantly higher (p < 0.05) in BA patients with BHR to UNHS under histaminergic modulation, but ER did not differ in BA patients with or without BHR to UNHS under the adrenergic modulation. The correlation was found between DFEV1 on BPT and magnitude of ER to HP under the blockade of H1-histaminergic receptors (r = 0.72; p < 0.02). CONCLUSION: The development of BHR to hyperosmolar stimulus may be due primarily to disturbance of histaminergic receptor system.