Vascular mechanisms in osteoarthritis: rationale for treatment with a marine-based complementary medicine
To undertake in vitro laboratory studies in Biolane Green Lipped Mussel Extract (GLME) to determine the levels of selected biological activities indicated by a vascular concept of osteoarthritis causation to be potentially useful in modifying disease progression.
The assays tested cholesterol synthesis inhibition, antioxidant capacity and inhibition of the following components of the inflammatory pathways – tissue necrosis factor alpha (TNFa), nuclear factor kB (NfkB), Cox-2 expression, prostaglandin E2 (PGE2) and phospholipase A2 (PLA 2). Platelet aggregation inhibitory activity was assessed with the agonists collagen and ADP and fibrinolytic activity was also assessed with the euglobulin clot lysis time (ECLT). An in vitro model based on gastric and duodenal secretions was used to simulate in vivo digestive processes. The digest prepared from the GLME samples contained the prominent gastric enzyme pepsin followed by pancreatic enzymes.
Table 1 shows reduced anti-inflammatory activity associated with GLME complete digest across a range of inflammatory mediators though it is apparently not mediated through Cox-2 inhibition. Mild anti-oxidant activity is shown together with inhibition of platelet aggregation. Fibrinolytic activity is enhanced as shown by the reduced clot lysis time while cholesterol biosynthesis is inhibited by a level that would be clinically beneficial if it was translated to a clinical outcome.
A vascular concept of OA causation predicts that a range of biological activities including anti-inflammatory, anticoagulant, lipolytic and fibrinolytic activity are potentially necessary in order to effectively break the web of pathology linking increased coagulation risk factors, decreased fibrinolytic activity and inflammation that drives the pathomechanisms associated with OA. Biolane Green Lipped Mussel Extract shows these in vitro biological activities in a laboratory system designed to mimic gastric and duodenal secretions. These findings are consistent with anecdotal claims of symptomatic OA benefit in patients treated with GLME.