Does anti-Interleukin suppress of Alpha and Beta receptors stop the progression of Osteoarthritis? Osteoarthritis (OA), is the most common musculoskeletal condition, is a long-term chronic disease involving depletion of cartilage over time. It is also the cause of bone rubbing on bone which causes pain, stiffness, immobility, which affects the overall quality of life. Osteoarthritis is known as “Degenerative joint disorder”. There are many factors that can cause OA: age, obesity, lack of physical activity, genetic contribution, bone density, trauma and gender.
The most common group of people affected by Osteoarthritis is the elderly populations around the globe, especially in developed countries. The prevalence of OA is increasing with people living longer. OA causes major impairments to the overall quality of life; Limiting the daily activity of the individuals. This not only causes burden on the individuals, but also to healthcare, communities, and social care system. There are several ways where OA can be controlled for a limited time, by cortisone shots into the joint areas, over-the-counter- pain medications, in severe cases joint replacement can be done.
Of course there are several factors that need to evaluate before surgery, such as Age, how much cartilage has been worn down, and will surgery improve the OA pain. There are two types of Osteoarthritis Primary and Secondary: Primary OA: Is considered the “wear and tear” or overuse osteoarthritis, primary OA is the most common diagnosed OA in people. This affects age group from 55-65 yrs. Old (Middle age group and onward). The longer we live; we will be exposed to this form of OA to some degree, whether it’s mild or severe will be determined by various factors, such as: Physical activity, obesity, genetic pre-disposition.
Secondary OA: is considered to be caused by another disease or condition such as: repeated trauma or surgery to the joint structures, abnormal joints at birth (congenital abnormalities), gout (Crystallization formation in bones), rheumatoid Arthritis, hormonal disorders, and diabetes. Osteoarthritis cannot be cured; however, there are various medications and change in one’s life style can help relieve the pain. Patients are advised to make lifestyle modification by exercise and instilling healthy eating habits. Patients are given canes and braces to help alleviate the pain along with NSAIDs, Cortisone shots, to surgery.
While many pharmaceutical companies are trying to come up with a cure, none to date have been successful. Around 20-27 million American people are affected by primary arthritis, however, around 50 American million people are affected those included with secondary arthritis. Figure 1. Projected Prevalence of Doctor-Diagnosed Arthritis among U. S. Adults Aged18 Years and Older, 2005-2030. Data Source: 2003 National Health Interview Survey; 2030 Census projected population. http://www. cdc. gov/arthritis/data_statistics/national-statistics. html Barbour KE, Helmick CG, Theis KA, Murphy LB, Hootman JM, Brady TJ, Cheng YJ.
Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation-United States, 2010-2012. Morb Mortal Wkly Rep. 2013; 62(44): 869–873. PubMed PMID: 24196662. Html Interleukin relationship with OA formation: Interleukin, a group of proteins to regulate the immune response. Studies in early phase 1 and Phase 2 of clinical trials are showing many compounds and agents have been tested, and some of them have already shown positive effects on the progression of knee and/or hip OA. One of the key components in the inflammatory disease of the OA is Cytokines.
Cytokines are a group of small proteins such as the interleukin. Cytokines acts through receptors, such as the IL-1alpa and IL-1beta receptors. IL-1alpha and IL-1 B, play a major role in loss of homeostasis of tissue forming joints by them promoting catabolic and destructive process in OA. Many pharmaceutical companies are looking at the two greatest components IL1 alpha and IL-1B , majority of the cells that are in the joints impact via giving signals within the cellular pathways of signaling to produce cytokines as well as other inflammatory compounds and enzymes, such as the IL-1alpha and IL-1B.
Out of the two, IL-1B is considered the most responsible cytokines for OA. This cytokine can induce inflammatory responses alone or with group of other cytokines in the cartilage or the joints. In pre-clinical phase Intra articular injection of Il-1 into animal knew resulted in leukocyte infiltration and loss of cartilage. In contrast, intra-articular injection given reduced the progression of OA. Purpose: The purpose of this study was to observe subjects with mild to severe OA; who were able to improve their OA by giving subcutaneous injections which suppressed the production of cytokines (IL-1Alpa and IL-1Beta).
Method: A Double Blinded- Randomized trial as was conducted to see the effect I Subjects both Male and Female over the age of 45 were observed over 52 week’s period. The screening criteria for these subjects were pretty stringent. Subjects were excluded if they had any of the following conditions: Hep C, Hep B, HIV, if they have had any type of corticosteroid injections within 6 weeks of screening, and severe trauma to the joint in question. Subjects cannot be on any controlled substance. An MRI of the knee was taken to see how much spacing between the knees joint was present.
Subject’s that presented with Knee on Knee were excluded from the study. Subjects were monitored for 52 weeks, resulting in them coming every two weeks for their injection. Subjects completed their initial pain scale diary and continued to do at each visit until the conclusion of the study, to see if the pain scores had decreased from the beginning of the study. There is a 1:4 chance that the subjects receive the actual drug versus a placebo. Doctor and staff were completely blinded. Results: Patients were observed over 52 week period to access the decrease in overall OA pain using pain score diaries as assessment tool.
This displayed graph shows the Pain score of each subject over 52 weeks in three phases (Screening, Middle, and 52 weeks). The data shows Overall pain score ranging from scale 0-30. The mean of all the patients pain score after 52 weeks was 3. 3. Indicating the subjects that were receiving the drug worked. Conclusion: The objective of this trial was to show if suppressing the release of cytokines (IL-1Alpha and IL-1 B) would decrease cartilage degeneration by using pain score diaries and MRI results, showing depletion of cartilage in knee joint