Chamazulene reverses osteoarthritic inflammation through regulation of matrix metalloproteinases (MMPs) and NF-kß pathway in in-vitro and in-vivo models.

This study was conducted to evaluate the protective effects of chamazulene against IL-1ß-induced rat primary chondrocytes and complete Freund's adjuvant (CFA)-induced osteoarthritic inflammation in rats. Oxidative stress markers, pro-inflammatory cytokines, and regulatory proteins were measured. Chamazulene significantly reverted (p < 0.05) the levels of lipid peroxidation and enhanced the activities of superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) enzymes against IL-1ß and CFA-induced oxidative stress. The levels of TNF-α and IL-6 were reduced (p < 0.05) in chamazulene treatment against IL-1ß and CFA-induced inflammation. Western blot analysis results on the expressions of MMP-3, MMP-9, p65 NF-kß, iNOS, and COX-2 showed chamazulene was able to protect the chondrocytes against IL-1ß-induced osteoarthritic inflammation. Histopathology of rat hind ankle showed chamazulene significantly protected against CFA-induced osteoarthritic inflammation. Therefore, chamazulene can be recommended as a therapeutic agent for clinical trials against osteoarthritic inflammation.

Percutaneous Electrical Nerve Stimulation for Chronic Knee Pain: A Randomized, Sham-controlled Trial.

CONTEXT: Anti-inflammatory drugs are often used to treat chronic knee pain (CKP), but their long-term use is associated with decreased effectiveness and numerous side effects. Complementary and alternative medicine provides additional treatments for the condition, including percutaneous electrical nerve stimulation (PENS). However, the benefits of PENS for treatment of CKP are still controversial. OBJECTIVE: The study intended to assess the effects and safety of PENS for treatment of CKP. METHODS: This study was a 2-arm, randomized, sham-controlled trial. SETTING: The study took place at the Fourth People's Hospital of Shaanxi (Xi'an, China). PARTICIPANTS: Participants were 72 patients at the hospital being treated for CKP. INTERVENTION: Participants were randomly divided into a real PENS group and a sham PENS group at a ratio of 1:1. All patients received etoricoxib and either real or sham PENS therapy, 3 ×/wk for 8 wk, at the same local acupoints around the knee. OUTCOME MEASURES: The primary outcome, pain, was measured on a numeric rating scale (NRS). Secondary outcomes, stiffness and physical function, were evaluated using the Western Ontario and McMaster Universities arthritis index (WOMAC) and the short-form 36-item health survey (SF-36) to obtain a score on the physical component scale (PCS) and the mental component scale (MCS). The NRS and the WOMAC were administered at initiation of treatment to establish a baseline and again after 8 wk of treatment. The SF-36 was administered postintervention. RESULTS: At the end of 8 wk, the group receiving the real PENS exhibited statistically significant improvements in both primary and secondary outcomes compared with the group receiving the sham PENS treatment. CONCLUSIONS: The findings suggest that treatment with the real PENS with etoricoxib is effective for treatment of CKP.