Journal of Glycobiology
Open Access

Efficacy, Mechanism of Action and Biochemical Properties Chondroitin Sulfate

Fatemeh Hesaraki^{* *}Correspondence: Fatemeh Hesaraki, Department of Biomaterials, Iran Polymer and Petrochemical Institute, Tehran, Iran,

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Description

Chondroitin sulfate is a naturally occurring polysaccharide found in connective tissues, such as cartilage and bone, and in the extracellular matrix of animal cells. It has been widely used as a dietary supplement for the treatment of Osteoarthritis (OA), a degenerative joint disease that affects millions of people worldwide. In this commentary, I will discuss the biochemical properties of chondroitin sulfate, its mechanism of action, clinical evidence for its efficacy in the treatment of OA and potential side effects.

Biochemical properties of chondroitin sulfate

Chondroitin sulfate is a complex molecule consisting of a core protein and long chains of repeating disaccharides (glucuronic acid and N-acetyl-galactosamine) that are modified with sulfate groups. The size and degree of sulfation of chondroitin sulfate chains vary, depending on the source of the molecule. For example, bovine tracheal cartilage-derived chondroitin sulfate is composed of longer chains with more sulfation than those derived from shark cartilage.

The molecular weight of chondroitin sulfate ranges from 5 to 50 kDa, with an average of 20 kDa. Chondroitin sulfate can be isolated from animal tissues by enzymatic digestion and subsequent purification steps. Commercially available chondroitin sulfate products are usually derived from bovine or porcine cartilage.

Mechanism of action

The exact mechanism by which chondroitin sulfate exerts its therapeutic effects is not fully understood. However, several mechanisms have been proposed. Chondroitin sulfate may:

1. Stimulate the synthesis of proteoglycans and collagen in cartilage.

2. Inhibit the activity of enzymes that break down cartilage, such as Matrix Metalloproteinases (MMPs) and aggrecanases.

3. Modulate the expression of cytokines and other mediators of inflammation.

4. Provide structural support and cushioning to the joint.

Clinical evidence for efficacy

Numerous clinical trials have investigated the efficacy of chondroitin sulfate in the treatment of osteoarthritis. A meta-analysis of 43 Randomized Controlled Trials (RCTs) involving over 9,000 patients found that chondroitin sulfate reduced pain and improved joint function in patients with knee osteoarthritis, with an effect size comparable to that of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). Another meta-analysis of 20 RCTs found that chondroitin sulfate was more effective than placebo in reducing pain and improving joint function in patients with hand osteoarthritis.

The efficacy of chondroitin sulfate in the treatment of hip osteoarthritis is less clear. A meta-analysis of 11 RCTs found no significant difference between chondroitin sulfate and placebo in reducing pain or improving function in patients with hip osteoarthritis.

Potential side effects

Chondroitin sulfate is generally well-tolerated, with few reported side effects. The most common side effects include gastrointestinal symptoms, such as nausea, diarrhea, and constipation. Allergic reactions to chondroitin sulfate have also been reported, although they are rare.

There has been concern about the safety of chondroitin sulfate derived from animal sources due to the potential risk of contamination with prions, the infectious agents responsible for Transmissible Spongiform Encephalopathies (TSEs), such as Bovine Spongiform Encephalopathy (BSE) and Creutzfeldt-Jakob Disease (CJD). However, there is no evidence to suggest that chondroitin sulfate products derived from bovine or porcine cartilage pose risk of contamination with prions.