Balneolojik Tedavinin Osteoartrit Biyomarker Düzeyleri Üzerine Etkileri , Effects of Balneological Treatment on Biomarkers in Osteoarthritis

Abstract

Effects of Balneological Treatment on Biomarkers in Osteoarthritis Dr. Tuba Adıgüzel1 , Prof. Dr. Hatice Gürdal1 1 Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Turkey tuba.adiguzel@istanbul.edu.tr

Background: Balneological treatment (BT) is one of the most commonly used non-pharmacological approach for osteoarthritis (OA). Recent studies indicate that BT may effect serum/urine biomarkers that play role in the pathopyhsiology of OA. Objective: To present the data on the serum/urine biomarkers in OA patients that undergo mudbath therapy. Methods: Literature search by Medline to identify randomised controlled studies on the serum biomarkers of osteoarthritis patients that treated with balneotherapy with/or peloidotherapy. Results: 12 studies were found between 1995-2018 that describe the effects of balneological treatment on substances involved in anabolic-catabolic processes of cartilage and the inflammatory reactions. Catabolic cytokines (IL-1, TNF-α) are main mediators of joint damage in OA. Matrix metalloproteinases also frequently implicated in the destruction of articular cartilage. Experimental evidence is emerging that BT decrease the serum concentrations of these cytokines and proteinases. Studies documents the increase of IGF-1 that has a protective influence on cartilage structure after BT. Cartilage turn-over markers like YKL-40 and CTX-II also improved after BT. Recently it has been showed that BT is able to affect the synthesis of PGE2 and other pain related mediators like LTB4. Also BT can exert beneficial effects on cartilage homeostasis and inflammatory reactions by influencing NO and decreasing myelopeoxidase serum values. Conclusion: It is suggested that balneological treatment can control and decrease the inflammatory reactions, joint damage and consequently, relief the pain in OA patients. Keywords: Balneotherapy, Mud, Cytokine