morphinans and Osteoarthritis--Knee

Osteoarthritis (OA) is a common chronic progressing disease in the elderly. In current there are many methods of drug treatment for knee osteoarthritis, the intra-articular injection belongs to local application, can direct effect on arthritis, is the most used and most effective methods in osteoarthritis treatment. A single medication may exist that anti-inflammatory effects produce a marked effect but articular cartilage injury is induced, or articular cartilage repairing are promoted but anti-inflammatory effects is not ideal. Therefore,the best method of treatment should be a comprehensive analysis of articular structure, function and possible pathogenic factor to understand the expectations of level of recovery and use in patients to design an individualized treatment plan.

Topics: Glucocorticoids; Humans; Injections, Intra-Articular; Morphinans; Osteoarthritis, Knee

Knee osteoarthritis (KOA) is a degenerative disease in the knee joint, with chronic joint pain, swelling, stiffness, and dysfunction as the primary manifestations. Sinomenine hydrochloride injection is a proprietary Chinese medicine injection of sinomenine, the main active component of traditional Chinese medicine (TCM). Clinical studies show that Sinomenine hydrochloride injection has a good effect on the treatment of KOA. At present, there is still a lack of systematic reviews and meta-analyses to evaluate the efficacy and safety of sinomenine hydrochloride injection in the treatment of KOA. Our purpose is to supplement this deficiency.. Randomized controlled trials of sinomenine hydrochloride injection in the treatment of KOA were searched for Eight electronic resource databases. We will use Review Manager 5.3 software for heterogeneity assessment, meta-analysis, and subgroup analysis. We will use the Cochrane Manual to assess the quality of the included studies, and use reporting biases assessment and sensitivity analysis to evaluate the reliability and stability of the results.. This study will provide a high-quality synthesis to assess the efficacy and safety of sinomenine hydrochloride injection in the treatment of KOA.. This systematic review evaluates the efficacy and safety of sinomenine hydrochloride injection in the treatment of KOA.. INPLASY2021110057.

Topics: Humans; Meta-Analysis as Topic; Morphinans; Osteoarthritis, Knee; Reproducibility of Results; Systematic Reviews as Topic

Intra-articular injection of sinomenine (SN) is an effective treatment method for knee osteoarthritis (OA), however, SN could be eliminated quickly in vivo. To extend the residence time of SN in the joint cavity, the SN-hyaluronic acid (HA) conjugate was prepared previously. This study was performed to evaluate the pharmacokinetics and pharmacodynamics of SN-HA conjugate after intra-articular administration for the treatment of OA.. A high performance liquid chromatography-mass spectrometry (HPLC-MS/MS) method was established to determine the SN content in rat synovial fluid. One hundred and twenty rats were randomly divided into two groups, the SN-HA group and SN group. The concentration of SN in articular cavity washings was determined by HPLC-MS/MS. The protective effect on the cartilage was evaluated by histological evaluation in a model of papain induced rabbit knee osteoarthritis.. The method was validated with respect to sensitivity, specificity, linearity, precision, accuracy and especially the stability of analytes under various conditions, and was successfully applied in evaluating the pharmacokinetic profiles of SN in the joint cavity. Compared to the SN injection, the drug exposure in joint cavity was significantly increased following SN-HA injection administration, and AUC(0-12h) was 2.9 times of SN injection, mean residence time (MRT) was 1.88 times of SN injection. In the pharmacodynamic study, there was no significant difference between the SN-HA twice-treated group and SH/HA five-times mixture-treated group.. The local bioavailability of SN in joint cavity was improved significantly after conjugated with HA. The SN-HA conjugate showed good synergism effect of OA inhibition. The results indicated that the SN-HA conjugate seemed to be an effective therapeutic means for the treatment of OA.

Topics: Animals; Hyaluronic Acid; Injections, Intra-Articular; Male; Morphinans; Osteoarthritis, Knee; Rats; Rats, Sprague-Dawley

To investigate the effects of intra-articular injection of sinomenine on interleukin-1beta (IL-1beta) content in synovial fluid and serum in rabbits with osteoarthritis (OA).. Degenerative osteoarthritis in the knee joint of left posterior limb was induced in 36 rabbits by full extension using plaster cast for 6 weeks. Then the rabbits were randomly divided into untreated group, hyaluronic acid group and sinomenine group. Another 4 normal rabbits were selected as normal control group. Rabbits in the sinomenine group and the hyaluronic acid group received intraarticular injections of sinomenine and hyaluronic acid once a week for 5 weeks, respectively. The content of IL-1beta in synovial fluid and serum were measured before and after treatment by enzyme-linked immunosorbent assay. The pathological changes of cartilaginous tissue were analyzed by using Mankin's score.. Compared with those in the untreated group, synovial fluid and serum IL-1beta contents in the sinomenine group and the hyaluronic acid group were significantly decreased (P<0.01). And the synovial fluid and serum IL-1beta contents in the sinomenine group were lower than those in the hyaluronic acid group (P<0.05). The mean Mankin's score of cartilage in the sinomenine group was significantly lower than that in hyaluronic acid group (P<0.05).. Sinomenine may reduce the degree of articular degeneration in rabbit with OA through decreasing the content of IL-1beta in synovial fluid and serum.

Topics: Animals; Disease Models, Animal; Hyaluronic Acid; Interleukin-1beta; Male; Morphinans; Osteoarthritis, Knee; Rabbits; Serum; Synovial Fluid