Can bioactive compounds from the diet prevent the onset or slow the progression of osteoarthritis?

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Osteoarthritis is a disabling joint disease where the cartilage is destroyed leading to pain and immobility. There is a lack of medicines to treat osteoarthritis, and since the elderly population are more likely to have severe osteoarthritis, this will be an increasing problem. Despite many years of research, there are no drugs available which can slow or stop the progression of osteoarthritis. In part, this is due to the fact that drugs for use in any disease which is not life threatening must be very safe (i.e. have few side effects). Also, the costs of running clinical trials in osteoarthritis are prohibitive. There is a need to develop new strategies to combat this disease. The connection between diet and osteoarthritis has been explored to some extent. The high intake of some foodstuffs has been linked a slower progression of the disease. These analyses are imperfect since diet is recorded via a retrospective questionnaire across a long time period. Nevertheless, they prove the concept that diet can influence joint health. There are many compounds found in food which have biological activities. To date, we have focused on two compounds: sulforaphane which is found at high amounts in broccoli and other related vegetables; diallyl disulphide which is found at high amounts in garlic. Both of these compounds have been investigated for activity in other diseases e.g. heart disease and cancer, but have not been looked at in terms of arthritis. We have added sulforaphane and diallyl disulphide to our laboratory models of the cartilage destruction that is a key facet of osteoarthritis. We have shown that they are effective in slowing or preventing cartilage destruction in these. We have also added these compounds to human cartilage taken from patients with osteoarthritis and maintained in the laboratory and shown that they slow destruction. The objectives of this study are therefore: to refine and improve our work to identify which foods are associated with protection from osteoarthritis; to continue to identify the components of these foods which will prevent or slow cartilage destruction; to test these compounds in a variety of laboratory models using cells or tissues from patients with osteoarthritis; to undertake studies in man to find out whether these compounds get into the joint and/or cartilage tissue in appropriate amounts to slow cartilage destruction. These studies are essential ahead of a full-scale clinical trial in human osteoarthritis and represent an exciting possibility in the prevention and treatment of this disabling disease.