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The effect of quercttin on Pro-inflammatory Cytokines and Clinical Picture of Patients with Knee Osteoarthritis: A Double Blind Comparative Study with Celecoxib
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| Author:
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MOHAMMED AL-REKABI, FURQAN HASHIM HUSSEIN, ASHWAQ N. AL-JAF, YASMEEN ALI HUSSEIN
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| Abstract:
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Background: Osteoarthritis (OA), as the most common age-related musculoskeletal disorder, is estimated to affect
between 20?27 million middle ageand older American people, and more than one million Iraqis. The disease is
manifested by cartilage degeneration, ossification of the joint margins (osteophytes), inflammation of the synovial
membrane, and sclerosis of the subchondral bone. The major pathological process of OA is associated with high
inductionof pro-inflammatory cytokines such as (TNF-a) and (IL-1ß). Objective: Our objective was to evaluate the
effects of quercttin (QUER) alone and in combination with Celecoxib (CELE), on pro-inflammatory cytokines and
the clinical picture of patients with knee OA. Methods: Seventy-eight subjects with painful knee OA (64 females
and 14 males) were participatingin this study. The study was performed at the outpatient multi-center clinic,
including Al-Sader Hospital, Al-Hakim hospital and some private clinics of Rheumatology and Orthopedics in the
Al-Najaf province of Iraq, during the period of November 2017 to October 2018. Patientswere randomly allocated
into three groups: group I included 28 patients treated with QUER capsule (500 mg/twice daily for 6 weeks).
Group II included 25 patients treated with 200 mg/day CELE capsule,taken at twice daily for 6 weeks. Group III
included 25 patients treated with a combination of QUER and CELE at the same doses, frequency and duration as
mentioned above. Out of these 78 patients, only 69 patients have completed the study. The serum was analyzed
for TNF-a and IL-1ß, using the enzyme-linked immunosorbent assay (ELISA) kits specific for human interleukins.
The clinical picture of the disease wasdetermined in every seven-day interval by direct interview with patients
through a questionnaire, known as Knee Injury and Osteoarthritis Outcome Score (KOOS).
Results:The serum levels of both IL-1ß and TNF-a after 6 weeks of treatment,were significantly (p<0.05) reduced,
using QUER either alone or in combination with CELE in patients with Knee OA The reduction was significantly
(p<0.05) better in combination case,compared toCELE alone. Furthermore, all elements of the KOOS were
improved, using QUER alone or combined with CELErather than using CELE alone.
Conclusion: In conclusion, the anti-inflammatory effect of QUER alone or combined with CELE provides a better
beneficial effect in OA patients,compared toCELE alone.
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| Keyword:
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Osteoarthritis, Quercttin, Celecoxib, KOOS, IL-1ß, TNF-a
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| EOI:
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| DOI:
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