Glucosamine and chondroitin sulfate supplementation to treat symptomatic disc degeneration: Biochemical rationale and case report

BACKGROUND: Glucosamine and chondroitin sulfate preparations are widely used as food supplements against osteoarthritis, but critics are skeptical about their efficacy, because of the lack of convincing clinical trials and a reasonable scientific rationale for the use of these nutraceuticals. Most trials were on osteoarthritis of the knee, while virtually no documentation exists on spinal disc degeneration. The purpose of this article is to highlight the potential of these food additives against cartilage degeneration in general, and against symptomatic spinal disc degeneration in particular, as is illustrated by a case report. The water content of the intervertebral disc is a reliable measure of its degeneration/ regeneration status, and can be objectively determined by Magnetic Resonance Imaging (MRI) signals. CASE PRESENTATION: Oral intake of glucosamine and chondroitin sulfate for two years associated with disk recovery (brightening of MRI signal) in a case of symptomatic spinal disc degeneration. We provide a biochemical explanation for the possible efficacy of these nutraceuticals. They are bioavailable to cartilage chondrocytes, may stimulate the biosynthesis and inhibit the breakdown of their extracellular matrix proteoglycans. CONCLUSION: The case suggests that long-term glucosamine and chondroitin sulfate intake may counteract symptomatic spinal disc degeneration, particularly at an early stage. However, definite proof requires well-conducted clinical trials with these food supplements, in which disc de-/regeneration can be objectively determined by MRI. A number of biochemical reasons (that mechanistically need to be further resolved) explain why these agents may have cartilage structure- and symptom-modifying effects, suggesting their therapeutic efficacy against osteoarthritis in general

Inorganic Carbon Limitation and Light Control the Expression of Transcripts Related to the CO(2)-Concentrating Mechanism in the Cyanobacterium Synechocystis sp. Strain PCC6803

The cyanobacterium Synechocystis sp. strain PCC6803 possesses three modes of inorganic carbon (Ci) uptake that are inducible under Ci stress and that dramatically enhance the efficiency of the CO(2)-concentrating mechanism (CCM). The effects of Ci limitation on the mRNA transcript abundance of these inducible uptake systems and on the physiological expression of the CCM were investigated in detail in this cyanobacterium. Transcript abundance was assessed with semiquantitative and real-time reverse transcriptase-polymerase chain reaction techniques. Cells aerated with CO(2)-free air for 30 min in the light, but not in the dark, depleted the total [Ci] to near zero levels. Under these conditions, the full physiological expression of the CCM was apparent within 2 h. Transcripts for the three inducible Ci uptake systems, ndhF3, sbtA, and cmpA, showed near-maximal abundance at 15 min under Ci limitation. The transcriptional regulators, cmpR and ndhR, were more moderately expressed, whereas the rbcLXS and ccmK-N operons and ndhF4/ndhD4/chpX and ccaA genes were insensitive to the low-Ci treatment. The combined requirement of low Ci and light for the expression of several CCM-related transcripts was examined using real-time reverse transcriptase-polymerase chain reaction. CmpA, ndhF3, and sbtA were strongly expressed in the light, but not in the dark, under low-Ci conditions. We could find no evidence for induction of these or other CCM-related genes by a high-light treatment under high-CO(2) conditions. This provided evidence that high-light stress alone could not trigger the expression of CCM-related transcripts in Synechocystis sp. PCC6803. Potential signals triggering induction of the high-affinity state of the CCM are discussed

Survival prediction nomogram for patients with vertebral bone metastases treated with palliative radiotherapy

Background: In the treatment of vertebral bone metastases, estimating patient prognosis is important to select the optimal treatment strategy. The purpose of this study was to identify prognostic factors for vertebral bone metastases treated with palliative radiotherapy and to establish a nomogram for predicting patient survival. Materials and methods: We analyzed patients who underwent palliative radiotherapy for vertebral bone metastasis between January 2010 and December 2020 at a single institution. Exclusion criteria were as follows: (1) primary bone malignancy, (2) stereotactic body radiotherapy, (3) concurrent radiotherapy to sites other than the vertebral bone, (4) radiotherapy to other sites within 12 weeks before or after the current radiotherapy, and (5) lack of more than half of blood test data before radiotherapy. Results: A total of 487 patients met the inclusion criteria. Clinical and hematologic data were collected from the patient record system. Patients were divided into training and test groups in a 7:3 ratio. Multivariate Cox regression analysis in the training cohort revealed six significant factors, including a history of chemotherapy, primary site (breast cancer, prostate cancer, or hematologic malignancy), use of analgesics, neutrophil-lymphocyte ratio, serum albumin, and lactate dehydrogenase. A prognostic nomogram was developed and validated in the test cohort. The area under the curve (AUC) values in predicting survival at 6, 24, and 60 months were 0.83, 0.88, and 0.88 in the training cohort and 0.85, 0.81, and 0.79 in the test cohort, respectively. Conclusions: This nomogram may help to select the treatment strategy for vertebral bone metastases

Stereotactic Radiosurgery for Lung Cancer with a Risk-Adapted Strategy Using the Volumetric Modulated Arc Therapy Technique: A Single Arm Phase II Study

Purpose: A phase II study carried out to assess the efficacy of a risk-adapted strategy of stereotactic radiosurgery (SRS) for lung cancer. The primary endpoint was 3-year local recurrence, and the secondary endpoints were overall survival (OS), disease-free survival (DFS), rate of start of systemic therapy or best supportive care (SST-BSC), and toxicity. Materials and Methods: Eligible patients fulfilled the following criteria: performance status of 2 or less, forced expiratory volume in 1 s of 700 mL or more, and tumor not located in central or attached to the chest wall. Twenty-eight Gy was prescribed for primary lung cancers with diameters of 3 cm or less and 30 Gy was prescribed for primary lung cancers with diameters of 3.1–5.0 cm or solitary metastatic lung cancer diameters of 5 cm or less. Results: Twenty-one patients were analyzed. The patients included 7 patients with adenocarcinoma, 2 patients with squamous cell carcinoma, 1 patient with metastasis, and 11 patients with clinical diagnosis. The median tumor diameter was 1.9 cm. SRS was prescribed at 28 Gy for 18 tumors and 30 Gy for 3 tumors. During the median follow-up period of 38.9 months for survivors, 1 patient had local recurrence, 7 patients had regional or distant metastasis, and 5 patients died. The 3-year local recurrence, SST-BSC, DFS, and OS rates were 5.3% (95% confidence interval [CI]: 0.3–22.2%), 20.1% (95% CI: 6.0–40.2%), 59.2% (95% CI: 34.4–77.3%), and 78.2% (95% CI: 51.4–91.3%), respectively. The 95% CI upper value of local recurrence was lower than the null local recurrence probability. There was no severe toxicity, and grade 2 radiation pneumonitis occurred in 1 patient. Conclusions: Patients who received SRS for lung cancer had a low rate of 3-year local recurrence and tolerable toxicity

Predictive factors of relative parameter changes in pulmonary function tests from baseline to 12 months after SRT.

Predictive factors of relative parameter changes in pulmonary function tests from baseline to 12 months after SRT.</p

Predictive factors of absolute changes in parameters of pulmonary function tests from baseline to 12 months after SRT.

Predictive factors of absolute changes in parameters of pulmonary function tests from baseline to 12 months after SRT.</p