Reduce Cartilage Loss in Osteoarthritis

Osteoarthritis is the most common cause of joint pain, affecting more than 30 million adults in the U.S.¹

Most standard approaches address its symptoms,^2,3 such as pain and stiffness.

But osteoarthritis damages and ultimately destroys the cartilage that allows the joint to function.¹

Targeting only the pain and stiffness risks letting cartilage damage and joint degeneration continue unabated.

A novel solution may address not only pain and stiffness, but also underlying damage and destruction.

In two animal models, three botanical extracts demonstrated the ability to relieve pain and swelling and reduce damage to cartilage.^4,5

Human studies have demonstrated that these plant extracts can provide symptomatic relief as well as benefits for joint structure.^6,7

How They Work

Pain relief is the immediate goal of anyone suffering from osteoarthritis and the limitations it imposes.

But protecting against joint damage and improving joint structure is just as important.

Separate studies have shown that a combination of Chinese skullcap, cutch tree, and white mulberry tree extracts makes it possible to support both.

All three extracts help fight inflammation and maintain comfortable joints.

Cutch trees are rich in catechins,⁸ compounds that inhibit pro-inflammatory signaling molecules. They suppress major pro-inflammatory molecules, such as COX-2, 5-LOX, and "master inflammatory promoter" nuclear factor-kappa B (NF-kB).^7,9

The root and bark of the mulberry tree are similarly rich in compounds with anti-inflammatory properties.^10,11

Chinese skullcap (Scutellaria baicalensis) is rich in a compound called baicalin, with known anti-inflammatory properties that complement those in cutch tree.^4,12

Reduced Joint Damage

Researchers conducted a randomized controlled clinical trial to compare two non-drug treatments to placebo.

This study enrolled 135 subjects aged 35-75 with mild to moderate knee osteoarthritis. Subjects had to have had symptoms for at least six months before the start of the study, and for at least 15 out of the previous 30 days at admission. They received one of three treatments for 12 weeks:⁷

1. Cutch tree and white mulberry extracts (400 mg/day),
2. Glucosamine (1,500 mg/day) and chondroitin (1,200 mg/day), or
3. Placebo.

The botanical extracts appeared to protect against joint damage and potentially stop the progression of the disease.

This was seen by measuring urinary levels of C-terminal crosslinking telopeptide (CTX-II), a urinary biomarker of cartilage breakdown. Higher CTX-II levels in urine indicate more joint damage.

CTX-II rose sharply in the placebo group during the study (indicating additional joint damage), while there was little change in those taking glucosamine/chondroitin.

In the group taking cutch tree and white mulberry, there was a significant decrease in CTX-II levels.

This finding indicates that the plant extracts were protecting the joint against damage and could help reduce osteoarthritis progression over time.⁷

Clinical Study Shows Pain Relief

A randomized, placebo-controlled 90-day trial in 60 subjects aged 40-75, with symptomatic osteoarthritis of the knee or hip tested the effect of a different herbal combination supplement, made of Chinese skullcap and cutch tree.

The patients were randomized to receive either a placebo, 200 mg/day of the drug celecoxib (Celebrex®), or one of two doses of the combination herbal supplement (250 or 500 mg/day of Chinese skullcap or cutch tree). Subjects were followed-up for pain, stiffness, functional impairment, and physical function using standard measurement scales.⁶

Both doses of the dual-ingredient herbal supplement significantly reduced pain scores by the end of the 90 days.

Stiffness and functional impairment were significantly reduced in both herbal dosage groups, compared to baseline, and at all time points.  These measures did not significantly improve in the celecoxib or placebo groups.

A measure of physical function significantly improved at all time points in the herbal-supplemented groups compared to placebo.⁶

Cartilage and Bone Protection

Animal and laboratory research confirms the results of the clinical trial that showed that the cutch tree-white mulberry combination preserves joint health.

An animal model showed that when used together, cutch tree + white mulberry reduced cartilage breakdown by nearly 55% with a 41% reduction in sensitivity to pain after five weeks.⁵

A similar animal model showed this same combination (cutch tree + white mulberry) resulted in an improvement in pain and inflammation much like that of a commonly used over-the-counter and pain medication, ibuprofen.¹³

Comparison to Common Medications

Many people suffering from joint pain turn to nonsteroidal anti-inflammatory drugs (NSAIDs).

Unfortunately, this standard care manages only the symptoms,^2,3 such as pain and stiffness, overlooking damage to cartilage and bone.

A combination of cutch tree and white mulberry extracts was found in an animal study to be similar to ibuprofen in its ability to reduce pain and swelling.¹⁴

Chinese skullcap is also rich in anti-inflammatory compounds.

A blend of Chinese skullcap and cutch tree extracts was tested head-to-head against the drug celecoxib in people with severe knee osteoarthritis.⁶

After 90 days, the cutch tree-Chinese skullcap blend was more effective than the drug at relieving pain, reducing stiffness, and improving physical function.

The combination was evaluated in animal and lab studies and has been shown to inhibit production and activity of inflammatory signaling molecules and significantly reduced pain and swelling.^4,15-17

Summary

In addition to causing pain, stiffness, and loss of mobility, osteoarthritis causes progressive cartilage damage and joint degradation.

The three herbs—Chinese skullcap, cutch tree, and white mulberry—have been shown to reduce markers of inflammation, joint destruction, and cartilage degradation…indicating their potential to change the osteoarthritis landscape.

Studies indicate that combinations of these extracts are equal or superior to common medications at relieving pain, swelling, and stiffness.

As with any approach that offers prevention and relief of symptoms, the earlier you start, the better the long-term protective effect.

If you have any questions on the scientific content of this article, please call a Life Extension Wellness Specialist at 1-866-864-3027.

References

1. Available at: https://oaaction.unc.edu/oa-module/oa-prevalence-and-burden/. Accessed September 6, 2023.
2. Grassel S, Muschter D. Recent advances in the treatment of osteoarthritis. F1000Res.2020;9.
3. da Costa BR, Pereira TV, Saadat P, et al. Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis. BMJ.2021Oct 12;375:n2321.
4. Yimam M, Brownell L, Pantier M, et al. UP446, analgesic and anti-inflammatory botanical composition. Pharmacognosy Res.2013Jul;5(3):139-45.
5. Yimam M, Lee YC, Wright L, et al. A Botanical Composition Mitigates Cartilage Degradations and Pain Sensitivity in Osteoarthritis Disease Model. J Med Food.2017Jun;20(6):568-76.
6. Sampalis JS, Brownell LA. A randomized, double blind, placebo and active comparator controlled pilot study of UP446, a novel dual pathway inhibitor anti-inflammatory agent of botanical origin. Nutr J.2012Apr 5;11:21.
7. Kalman DS, Hewlings SJ. The Effects of Morus alba and Acacia catechu on Quality of Life and Overall Function in Adults with Osteoarthritis of the Knee. J Nutr Metab.2017;2017:4893104.
8. Kumari M, Radha, Kumar M, et al. Acacia catechu (L.f.) Willd.: A Review on Bioactive Compounds and Their Health Promoting Functionalities. Plants (Basel).2022Nov 14;11(22).
9. Kim JM, Heo HJ. The roles of catechins in regulation of systemic inflammation. Food Sci Biotechnol.2022Jul;31(8):957-70.
10. Chan EW, Lye PY, Wong SK. Phytochemistry, pharmacology, and clinical trials of Morus alba. Chin J Nat Med.2016Jan;14(1):17-30.
11. Lin Z, Gan T, Huang Y, et al. Anti-Inflammatory Activity of Mulberry Leaf Flavonoids In Vitro and In Vivo. Int J Mol Sci.2022Jul 12;23(14).
12. Wen Y, Wang Y, Zhao C, et al. The Pharmacological Efficacy of Baicalin in Inflammatory Diseases. Int J Mol Sci.2023May 26;24(11):9317.
13. Yimam M, Lee YC, Moore B, et al. UP1304, a Botanical Composition Containing Two Standardized Extracts of Curcuma longa and Morus alba, Mitigates Pain and Inflammation in Adjuvant-induced Arthritic Rats. Pharmacognosy Res. 2016Apr-Jun;8(2):112-7.
14. Yimam M, Lee YC, Jiao P, et al. UP1306, a Botanical Composition with Analgesic and Anti-inflammatory Effect. Pharmacognosy Res.2016Jul-Sep;8(3):186-92.
15. Burnett BP, Jia Q, Zhao Y, et al. A medicinal extract of Scutellaria baicalensis and Acacia catechu acts as a dual inhibitor of cyclooxygenase and 5-lipoxygenase to reduce inflammation. J Med Food. 2007Sep;10(3):442-51.
16. Tseng-Crank J, Sung S, Jia Q, et al. A medicinal plant extract of Scutellaria Baicalensis and Acacia catechu reduced LPS-stimulated gene expression in immune cells: a comprehensive genomic study using QPCR, ELISA, and microarray. J Diet Suppl.2010Sep;7(3):253-72.
17. Yimam M, Brownell L, Hodges M, et al. Analgesic effects of a standardized bioflavonoid composition from Scutellaria baicalensis and Acacia catechu. J Diet Suppl.2012Sep;9(3):155-65.