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Despite the fact that the glucosamine group showed less than one-tenth the joint narrowing (0.013 mm) as the placebo group (0.166 mm), none of the groups experienced joint space narrowing to the degree the researchers expected (0.4 mm) over the two-year period based on earlier studies of OA disease progression.
Members of the glycosaminoglycan family vary in the type of hexosamine, hexose or hexuronic acid unit they contain (e.g. glucuronic acid, iduronic acid, galactose, galactosamine, glucosamine). They also vary in the geometry of the glycosidic linkage. Examples of GAGs include:
As the formation of glucosamine-6-phosphate is the first step for the synthesis of these products, glucosamine may be important in regulating their production; however, the way that the hexosamine biosynthesis pathway is actually regulated, and whether this could be involved in contributing to human disease remains unclear. [17]
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Chondroitin as a supplement is now commonly used (often in combination with glucosamine) in treating the joint disease of osteoarthritis. [2] In contrast to the symptomatic treatments, chondroitin can modify the progression of a disease process in the patient which it can be used as an alternative medicine. [2]
Chemical structure of one unit in a chondroitin sulfate chain. Chondroitin-4-sulfate: R 1 = H; R 2 = SO 3 H; R 3 = H. Chondroitin-6-sulfate: R 1 = SO 3 H; R 2, R 3 = H.. Chondroitin sulfate is a sulfated glycosaminoglycan (GAG) [1] composed of a chain of alternating sugars (N-acetylgalactosamine and glucuronic acid).
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