Dangguijihwang-tang and Dangguijakyak-san Prevent Menopausal Symptoms and Dangguijihwang-tang Prevents Articular Cartilage Deterioration in Ovariectomized Obese Rats with Monoiodoacetate-Induced Osteoarthritis

Protection against Osteoporosis by Fermented Mulberry Vinegar Supplementation via Inhibiting Osteoclastic Activity in Ovariectomized Rats and Osteoclastic Cells

Menopause increases the osteoporosis risk, to which phytoestrogen intake can be beneficial. This study hypothesized that mulberry vinegar had a preventive effect on osteoporosis by decreasing osteoclastic activity. The hypothesis was tested in ovariectomized (OVX) rats and RANKL-differentiated osteoclast cells. OVX rats were given 0(OVX-CON), 0.5(OVX-MVL), 1(OVX-MVM), and 2(OVX-MVH) fermented mulberry vinegar (MV) mL/kg body weight (BW) daily for 12 weeks. Sham-operated rats had no MV supplementation (Normal-CON). The osteoporosis-related biomarkers were measured, and Micro-CT determined the bone mass of the femur. RANKL-differentiated Raw 264.7 cells were treated with MV (0–100 μg/mL). The cell viability, osteoporosis-related mRNA expression, and protein contents were measured. MV contained Acetobacter pasteurianus (7.31 log CFU/mL), citric acid (106 mg/mL), lactic acid (19.2 mg/mL), acetic acid (15.0 mg/mL), and rutin (0.36 mg/mL). OVX-MVM elevated the serum 17β-estradiol concentration similar to the Normal-CON group, but it did not prevent the decrease in uterine weight. OVX-MVM prevented the increase in osteoclastic-related parameters, including cathepsin K(CtsK), receptor activator of NF-κB ligand (RANKL), and tartrate-resistant acid phosphatase (TRAP) in the circulation. OVX-MVH also lowered C-telopeptide of type Ⅰ collagen as much as the Normal-CON group (p < 0.05). By contrast, OVX-MVH increased the serum osteoprotegerin concentration, an inhibitor of osteoclasts, better than the Normal-CON group (p < 0.05). These changes were integrated to alter the bone mineral density (BMD) in Micro-CT analysis: OVX-MVM and OVX-MVH prevented BMD decrease after OVX as much as the Normal-CON. In RANKL-differentiated osteoclast cells, the MV treatment for 24 and 48 h decreased RANKL-induced differentiation in osteoclast cells dose-dependently up to 100 µg/mL. Its decrease was related to inhibiting the TRAP activity and reducing TRAP-positive multinucleated cells during the five-day administration of RANKL. MV treatments also decreased mRNA expression of osteoclast-related genes (TRAP, Ctsk, OSCAR, and NFATc1). MV suppressed the protein contents of NFATc1 and c-FOS-related osteoclast. In conclusion, MV intake (1 mg/kg bw) protected against BMD loss mainly by inhibiting the osteoclastic activity (RANKL/RANK/TRAP) in OVX rats. MV may develop as a functional food for anti-osteoporosis in menopausal women.

Chondroprotection and Molecular Mechanism of Action of Phytonutraceuticals on Osteoarthritis

Osteoarthritis (OA) is a degenerative joint disease and an important cause of incapacitation. There is a lack of drugs and effective treatments that stop or slow the OA progression. Modern pharmacological treatments, such as analgesics, have analgesic effects but do not affect the course of OA. Long-term use of these drugs can lead to serious side effects. Given the OA nature, it is likely that lifelong treatment will be required to stop or slow its progression. Therefore, there is an urgent need for disease-modifying OA treatments that are also safe for clinical use over long periods. Phytonutraceuticals are herbal products that provide a therapeutic effect, including disease prevention, which not only have favorable safety characteristics but may have an alleviating effect on the OA and its symptoms. An estimated 47% of OA patients use alternative drugs, including phytonutraceuticals. The review studies the efficacy and action mechanism of widely used phytonutraceuticals, analyzes the available experimental and clinical data on the effect of some phytonutraceuticals (phytoflavonoids, polyphenols, and bioflavonoids) on OA, and examines the known molecular effect and the possibility of their use for chondroprotection.

Effects of herbal medicine (Danggwijagyaksan) for treating climacteric syndrome with a blood-deficiency-dominant pattern: A randomized, double-blind, placebo-controlled pilot trial

Background

Danggwijagyaksan (DJS) has been one of the most widely used herbal medicines for gynecological disorders in traditional East Asian medicine. Several clinical studies about DJS have shown improvement in menopausal symptoms. This pilot study aimed to evaluate the efficacy, safety and feasibility of DJS for treating climacteric syndrome with a blood-deficiency-dominant pattern.

Methods

This was a randomized, double-blind, placebo-controlled pilot trial. A group of 45-to 60-year-old women with climacteric syndrome were registered for the trial. The participants received treatment over a 4-week period and were then followed for 4 weeks. The primary outcome measure was the mean change in the Menopause Rating Scale (MRS). Secondary outcome measures included the World Health Organization Quality of Life-BREF (WHOQOL-BREF), the Blood-Deficiency Scoring System (BDSS), lean body mass, and serum hormone levels, including follicle-stimulating hormone (FSH) and estradiol (E₂) levels.

Results

The MRS and BDSS scores decreased significantly in both groups, but the differences between two groups were not significant. The WHOQOL-BREF scores increased in the control group. No statistically meaningful differences in serum hormone levels or lean body mass were observed in both groups. There were no serious adverse events, and the laboratory tests were within the normal range. The recruitment rate, completion rate and medication adherence rate were over 90% in both groups, indicating high feasibility.

Conclusions

DJS showed clinical effectiveness in the treatment of climacteric syndrome with a blood-deficiency-dominant pattern. Additionally, DJS was shown to be safe and feasible for a large-scale study to confirm the efficacy of the treatment. Trial registration: Clinical Research Information Service (CRIS, https://cris.nih.go.kr): KCT0002387.