Vitamin D in osteoarthritis therapy: new opportunities and prospects
M.A. Kabalyk
Pacific State Medical University, Vladivostok
Osteoarthritis (OA) is a degenerative inflammatory disease of the synovial joints, leading to their function loss. OA affects all joint structures, including subchondral bone, articular cartilage, muscles and ligaments, which requires multimodal approaches to therapy, providing adequate impact on all tissues involved in the disease development and progression. The article analyzes the study results on vitamin D use and its active metabolites in OA therapy. Long-term administration of vitamin D high doses leads to a decrease in pain intensity and functional deficiency in patients with OA. Vitamin D and its active metabolites compensate for the cholecalciferol deficiency and thereby reduce the synovial inflammation intensity in OA, in maximum dosages demonstrate chondroprotective effect by inhibiting chondrocytes apoptosis, in the early stages prevent maladaptive subchondral bone remodeling. The article discusses the effectiveness and safety of the use of oil and aqueous solutions of vitamin D. Aqueous solutions are characterized by higher vitamin D bioavailability than in oil. The fundamental and randomized clinical study results suggest the feasibility of including vitamin D in the complex therapy of OA. It is important to include vitamin D in complex therapy during the disease onset.
Keywords: osteoarthritis, cholecalciferol, vitamin D, inflammation, cartilage, subchondral bone, pain, aqueous solution, D-3 Ferol.
For citation: Kabalyk M.A. Vitamin D in osteoarthritis therapy: new opportunities and prospects. RMJ. Medical Review. 2019;11(II)54:–58.
References
1. Кабалык М.А. Распространенность остеоартрита в России: региональные аспекты динамики статистических показателей за 2011–2016 гг. Научно-практическая ревматология. 2018;56(4):416–422. [Kabalyk M.A. Prevalence of osteoarthritis in Russia: regional aspects of trends in statistical parameters during 2011–2016. Rheumatology Science and Practice. 2018;56(4):416–422 (in Russ.)].
2. Schacht E., Richy F., Reginster J.Y.D. J Musculoskelet Neuronal Interact. 2005;5(3):273–284.
3. Кабалык М.А. Характеристика параметров костного метаболизма у городских жителей. Казанский медицинский журнал. 2017;98(3):354–358. [Kabalyk M.A. Characteristics of bone metabolism parameters in urban residents. Kazan Medical Journal. 2017;98(3):354–358 (in Russ.)].
4. Wu Z., Malihi Z., Stewart A.W. et al. Effect of Vitamin D Supplementation on Pain: A Systematic Review and meta-analysis. Pain Physician. 2016;19(7):415–427.
5. Gao X.R., Chen Y.S., Deng W. The effect of vitamin D supplementation on knee osteoarthritis: A meta-analysis of randomized controlled trials. Int J Surg. 2017;46:14–20.
6. George J. Vitamin D Supplementation and Progression of Knee Osteoarthritis. JAMA. 2016;316(3):347–348.
7. Brennan-Speranza T.C., Mor D., Mason R.S. et al. Skeletal muscle vitamin D in patients with end stage osteoarthritis of the knee. J Steroid Biochem Mol Biol. 2017;173:180–184.
8. Heidari B., Javadian Y., Babaei M., Yousef-Ghahari B. Restorative Effect of Vitamin D Deficiency on Knee Pain and Quadriceps Muscle Strength in Knee Osteoarthritis. Acta Med Iran. 2015;53(8):466–470.
9. Scharla S.H., Schacht E., Lempert U.G. Alfacalcidol versus plain vitamin D in inflammation induced bone loss. J Rheumatol Suppl. 2005;76:26–32.
10. Askari A., Naghizadeh M.M., Homayounfar R. at al. Increased Serum Levels of IL-17A and IL-23 Are Associated with Decreased Vitamin D3 and Increased Pain in Osteoarthritis. PLoS One. 2016;11(11):e0164757.
11. Huhtakangas J.A., Veijola J., Turunen S. et al. 1,25(OH)(2)D(3) and calcipotriol, its hypocalcemic analog, exert a long-lasting anti-inflammatory and anti-proliferative effect in synoviocytes cultured from patients with rheumatoid arthritis and osteoarthritis. J Steroid Biochem Mol Biol. 2017;173:13–22.
12. Rizka A., Setiati S., Harimurti K. et al. Effect of Alfacalcidol on Inflammatory markers and T Cell Subsets in Elderly with Frailty Syndrome: a Double Blind Randomized Controlled Trial. Acta Med Indones. 2018;50(3):215–221.
13. Дубиков А.И., Кабалык М.А., Корецкая Т.Ю. Микрокристаллический стресс в патогенезе остеоартроза. Терапевтический архив. 2016;88(5):32–36. [Dubikov A.I., Kabalyk M.A., Koretskaya T.Y. Microcrystalline stress in the pathogenesis of osteoarthritis. Ter Arkh. 2016;88(5):32–36 (in Russ.)].
14. Кабалык М.А., Невзорова В.А., Коваленко Т.С. Особенности неадаптивного остеогенеза субхондральной кости при артериальной гипертонии и дислипидемии. Кафедра травматологии и ортопедии. 2018;2:25–30. [Kabalyk M.A., Nevzorova V.A., Kovalenko T.S. Features of the non-adaptive osteogenesis of the subchondral bone with arterial hypertension and dyslipidemia. Department of Traumatology and Orthopedics. 2018;2:25–30 (in Russ.)].
15. Kobayashi M., Squires G.R., Mousa A. et al. Role of interleukin-1 and tumor necrosis factor alpha in matrix degradation of human osteoarthritic cartilage. Arthritis Rheum. 2005;52(1):128–135.
16. Wachsmuth L., Bau B., Fan Z. et al. ADAMTS-1, a gene product of articular chondrocytes in vivo and in vitro, is downregulated by interleukin 1beta. J Rheumatol. 2004;31(2):315–320.
17. Schwartz Z., Schlader D.L., Ramirez V. et al. Effects of vitamin D metabolites on collagen production and cell proliferation of growth zone and resting zone cartilage cells in vitro. J Bone Miner Res. 1989;4(2):199–207.
18. Hurst-Kennedy J., Zhong M., Gupta V. et al. 24R,25-Dihydroxyvitamin D3, lysophosphatidic acid, and p53: a signaling axis in the inhibition of phosphate-induced chondrocyte apoptosis. J Steroid Biochem Mol Biol. 2010;122(4):264–271.
19. Boyan B.D., Hyzy S.L., Pan Q. et al. 24R,25-Dihydroxyvitamin D3 Protects against Articular Cartilage Damage following Anterior Cruciate Ligament Transection in Male Rats. PLoS One. 2016;11(8):e0161782.
20. Arden N.K., Cro S., Sheard S. et al. The effect of vitamin D supplementation on knee osteoarthritis, the VIDEO study: a randomised controlled trial. Osteoarthritis Cartilage. 2016;24(11):1858–1866.
21. Кабалык М.А. Физические свойства и особенности организации суставного хряща при остеоартрозе. Дневник казанской медицинской школы. 2016;4:40–43. [Kabalyk M.A. Physical properties and features of the organization of articular cartilage in osteoarthrosis. Diary of Kazan Medical School. 2016;4:40–43 (in Russ.)].
22. Кабалык М.А. Возможности магнитно-резонансной томографии в диагностике микроструктурных изменений суставного хряща при остеоартрите. Пермский медицинский журнал. 2018;35(3):15–23. [Kabalyk M.A. The possibilities of magnetic resonance imaging in the diagnosis of microstructural changes in articular cartilage in osteoarthritis. Perm Medical Journal. 2018;35(3):15–23 (in Russ.)].
23. Hilal G., Martel-Pelletier J., Pelletier J.P. et al. Osteoblast-like cells from human subchondral osteoarthritic bone demonstrate an altered phenotype in vitro: possible role in subchondral bone sclerosis. Arthritis Rheum. 1998;41(5):891–899.
24. Kabalyk M.A. Age-related aspects of the involvement of heat shock proteins in the pathogenesis of osteoarthritis. Advances in Gerontology. 2017;7(4):276–280.
25. Geusens P., Vanderschueren D., Verstraeten A. at al. Short-term course of 1,25(OH)2D3 stimulates osteoblasts but not osteoclasts in osteoporosis and osteoarthritis. Calcif Tissue Int. 1991;49(3):168–173.
26. Hu Y., Liu Y., Lajeunesse D. et al. Identification of two populations of osteoarthritic osteoblasts according to the 1,25[OH]₂ vitamin D₃ potency to stimulate osteocalcin. Biomed Mater Eng. 2015;25(1 Suppl):103–110.
27. Bergink A.P., Uitterlinden A.G., Van Leeuwen J.P. et al. Vitamin D status, bone mineral density, and the development of radiographic osteoarthritis of the knee: The Rotterdam Study. J Clin Rheumatol. 2009;15(5):230–237.
28. Silva M.C., Furlanetto T.W. Intestinal absorption of vitamin D: a systematic review. Nutr Rev. 2018;76(1):60–76.
29. Reboul E. Intestinal absorption of vitamin D: from the meal to the enterocyte. Food Funct. 2015;6(2):356–362.
30. Šimoliūnas E., Rinkūnaitė I., Bukelskienė Ž., Bukelskienė V. Bioavailability of Different Vitamin D Oral Supplements in Laboratory Animal Model. Medicina (Kaunas). 2019 Jun 10;55(6). pii: E265.
31. Rautureau M., Rambaud J.C. Aqueous solubilisation of vitamin D3 in normal man. Gut. 1981 May;22(5):393–397.
32. Cranney A., Horsley T., O’Donnell S. et al. Effectiveness and safety of vitamin D in relation to bone health. Evid Rep Technol Assess (Full Rep). 2007;(158):1–235.
33. Gallagher J.C. Vitamin D and falls — the dosage conundrum. Nat Rev Endocrinol. 2016 Nov;12(11):680–684.
2. Schacht E., Richy F., Reginster J.Y.D. J Musculoskelet Neuronal Interact. 2005;5(3):273–284.
3. Кабалык М.А. Характеристика параметров костного метаболизма у городских жителей. Казанский медицинский журнал. 2017;98(3):354–358. [Kabalyk M.A. Characteristics of bone metabolism parameters in urban residents. Kazan Medical Journal. 2017;98(3):354–358 (in Russ.)].
4. Wu Z., Malihi Z., Stewart A.W. et al. Effect of Vitamin D Supplementation on Pain: A Systematic Review and meta-analysis. Pain Physician. 2016;19(7):415–427.
5. Gao X.R., Chen Y.S., Deng W. The effect of vitamin D supplementation on knee osteoarthritis: A meta-analysis of randomized controlled trials. Int J Surg. 2017;46:14–20.
6. George J. Vitamin D Supplementation and Progression of Knee Osteoarthritis. JAMA. 2016;316(3):347–348.
7. Brennan-Speranza T.C., Mor D., Mason R.S. et al. Skeletal muscle vitamin D in patients with end stage osteoarthritis of the knee. J Steroid Biochem Mol Biol. 2017;173:180–184.
8. Heidari B., Javadian Y., Babaei M., Yousef-Ghahari B. Restorative Effect of Vitamin D Deficiency on Knee Pain and Quadriceps Muscle Strength in Knee Osteoarthritis. Acta Med Iran. 2015;53(8):466–470.
9. Scharla S.H., Schacht E., Lempert U.G. Alfacalcidol versus plain vitamin D in inflammation induced bone loss. J Rheumatol Suppl. 2005;76:26–32.
10. Askari A., Naghizadeh M.M., Homayounfar R. at al. Increased Serum Levels of IL-17A and IL-23 Are Associated with Decreased Vitamin D3 and Increased Pain in Osteoarthritis. PLoS One. 2016;11(11):e0164757.
11. Huhtakangas J.A., Veijola J., Turunen S. et al. 1,25(OH)(2)D(3) and calcipotriol, its hypocalcemic analog, exert a long-lasting anti-inflammatory and anti-proliferative effect in synoviocytes cultured from patients with rheumatoid arthritis and osteoarthritis. J Steroid Biochem Mol Biol. 2017;173:13–22.
12. Rizka A., Setiati S., Harimurti K. et al. Effect of Alfacalcidol on Inflammatory markers and T Cell Subsets in Elderly with Frailty Syndrome: a Double Blind Randomized Controlled Trial. Acta Med Indones. 2018;50(3):215–221.
13. Дубиков А.И., Кабалык М.А., Корецкая Т.Ю. Микрокристаллический стресс в патогенезе остеоартроза. Терапевтический архив. 2016;88(5):32–36. [Dubikov A.I., Kabalyk M.A., Koretskaya T.Y. Microcrystalline stress in the pathogenesis of osteoarthritis. Ter Arkh. 2016;88(5):32–36 (in Russ.)].
14. Кабалык М.А., Невзорова В.А., Коваленко Т.С. Особенности неадаптивного остеогенеза субхондральной кости при артериальной гипертонии и дислипидемии. Кафедра травматологии и ортопедии. 2018;2:25–30. [Kabalyk M.A., Nevzorova V.A., Kovalenko T.S. Features of the non-adaptive osteogenesis of the subchondral bone with arterial hypertension and dyslipidemia. Department of Traumatology and Orthopedics. 2018;2:25–30 (in Russ.)].
15. Kobayashi M., Squires G.R., Mousa A. et al. Role of interleukin-1 and tumor necrosis factor alpha in matrix degradation of human osteoarthritic cartilage. Arthritis Rheum. 2005;52(1):128–135.
16. Wachsmuth L., Bau B., Fan Z. et al. ADAMTS-1, a gene product of articular chondrocytes in vivo and in vitro, is downregulated by interleukin 1beta. J Rheumatol. 2004;31(2):315–320.
17. Schwartz Z., Schlader D.L., Ramirez V. et al. Effects of vitamin D metabolites on collagen production and cell proliferation of growth zone and resting zone cartilage cells in vitro. J Bone Miner Res. 1989;4(2):199–207.
18. Hurst-Kennedy J., Zhong M., Gupta V. et al. 24R,25-Dihydroxyvitamin D3, lysophosphatidic acid, and p53: a signaling axis in the inhibition of phosphate-induced chondrocyte apoptosis. J Steroid Biochem Mol Biol. 2010;122(4):264–271.
19. Boyan B.D., Hyzy S.L., Pan Q. et al. 24R,25-Dihydroxyvitamin D3 Protects against Articular Cartilage Damage following Anterior Cruciate Ligament Transection in Male Rats. PLoS One. 2016;11(8):e0161782.
20. Arden N.K., Cro S., Sheard S. et al. The effect of vitamin D supplementation on knee osteoarthritis, the VIDEO study: a randomised controlled trial. Osteoarthritis Cartilage. 2016;24(11):1858–1866.
21. Кабалык М.А. Физические свойства и особенности организации суставного хряща при остеоартрозе. Дневник казанской медицинской школы. 2016;4:40–43. [Kabalyk M.A. Physical properties and features of the organization of articular cartilage in osteoarthrosis. Diary of Kazan Medical School. 2016;4:40–43 (in Russ.)].
22. Кабалык М.А. Возможности магнитно-резонансной томографии в диагностике микроструктурных изменений суставного хряща при остеоартрите. Пермский медицинский журнал. 2018;35(3):15–23. [Kabalyk M.A. The possibilities of magnetic resonance imaging in the diagnosis of microstructural changes in articular cartilage in osteoarthritis. Perm Medical Journal. 2018;35(3):15–23 (in Russ.)].
23. Hilal G., Martel-Pelletier J., Pelletier J.P. et al. Osteoblast-like cells from human subchondral osteoarthritic bone demonstrate an altered phenotype in vitro: possible role in subchondral bone sclerosis. Arthritis Rheum. 1998;41(5):891–899.
24. Kabalyk M.A. Age-related aspects of the involvement of heat shock proteins in the pathogenesis of osteoarthritis. Advances in Gerontology. 2017;7(4):276–280.
25. Geusens P., Vanderschueren D., Verstraeten A. at al. Short-term course of 1,25(OH)2D3 stimulates osteoblasts but not osteoclasts in osteoporosis and osteoarthritis. Calcif Tissue Int. 1991;49(3):168–173.
26. Hu Y., Liu Y., Lajeunesse D. et al. Identification of two populations of osteoarthritic osteoblasts according to the 1,25[OH]₂ vitamin D₃ potency to stimulate osteocalcin. Biomed Mater Eng. 2015;25(1 Suppl):103–110.
27. Bergink A.P., Uitterlinden A.G., Van Leeuwen J.P. et al. Vitamin D status, bone mineral density, and the development of radiographic osteoarthritis of the knee: The Rotterdam Study. J Clin Rheumatol. 2009;15(5):230–237.
28. Silva M.C., Furlanetto T.W. Intestinal absorption of vitamin D: a systematic review. Nutr Rev. 2018;76(1):60–76.
29. Reboul E. Intestinal absorption of vitamin D: from the meal to the enterocyte. Food Funct. 2015;6(2):356–362.
30. Šimoliūnas E., Rinkūnaitė I., Bukelskienė Ž., Bukelskienė V. Bioavailability of Different Vitamin D Oral Supplements in Laboratory Animal Model. Medicina (Kaunas). 2019 Jun 10;55(6). pii: E265.
31. Rautureau M., Rambaud J.C. Aqueous solubilisation of vitamin D3 in normal man. Gut. 1981 May;22(5):393–397.
32. Cranney A., Horsley T., O’Donnell S. et al. Effectiveness and safety of vitamin D in relation to bone health. Evid Rep Technol Assess (Full Rep). 2007;(158):1–235.
33. Gallagher J.C. Vitamin D and falls — the dosage conundrum. Nat Rev Endocrinol. 2016 Nov;12(11):680–684.
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Previous article
Next article
Распечатать