Advances in Gerontology

, Volume 8, Issue 1, pp 26–32 | Cite as

The Cognitive Cytokine Effect of Nonsteroidal Antiinflammatory Drugs in the Treatment of Elderly Patients with Osteoarthritis

Article
  • 3 Downloads

Abstract

The goal of this study was to evaluate the effect of long-term nonsteroidal antiinflammatory drug (NSAID) therapy on the severity of cognitive deficiency in elderly patients with osteoarthritis (OA) and the relationship between this effect and cytokine fluctuations in the blood serum of the patients. This prospective observational study took 540 ± 5.5 days and was conducted in two stages: phase I consisted of active medication therapy based on NSAIDs, and phase II was connected with nonpharmacological OA management. A cohort of 128 OA patients aged 65–75 years (the mean age was 70 ± 4.6 years, 10.2% men and 89.8% women) participated in the study. Patients from the main group were divided into four subgroups: the first group (n = 30) received etoricoxib at a daily dose of 60 mg, the second group (n = 32) took celecoxib at a daily dose of 200 mg, the third group (n = 32) was given a daily 100-mg dose of nimesulid, and the patients of the fourth group (n = 34) took meloxicam at a daily dose of 7.5 mg. The control group was formed of 40 patients with OA having analogous clinical and demographic characteristics and not taking NSAIDs in the previous six months and in the course of the study. The initial stiffness and pain indices were measured in all patients by the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) subscales, while their condition was evaluated during all visits to the clinic by the Montreal Cognitive Assessment (MoCA) Scale along with laboratory investigations for the blood serum contents of Transforming Growth Factor (TGF)-β1, Interleukin (IL)-1β, and IL-6. Statistically significant decreases in the levels of cytokines were recorded in the period from the first to the third visits in all patients of the main group, as were increases in the indices of cognitive functions by the MoCA scale with a high degree of correlation relative to the cytokine indicators were observed by the end of the study. The results of the study have allowed us to suggest that the NSAID therapy may have an effect on the cognitive functions of elderly patients with OA in real clinical practice.

Keywords

osteoarthritis NSAIDs cytokines cognitive functions 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Karataev, A.E., Nasonov, E.L., Yakhno, N.N., et al., Clinical recommendations “Rational use of nonsteroidal anti-inflammatory drugs (NSAIDs) in clinical practice,” Sovrem. Revmatol., 2015, vol. 9, no. 1, pp. 4–23.Google Scholar
  2. 2.
    Seminskii, I.Zh., Serebrennikova, S.N., Guzovskaya, E.V., et al., The role of cytokines in the pathogenesis. Part 2, Sib. Med. Zh. (Irkutsk), 2015, vol. 1, pp. 14–17.Google Scholar
  3. 3.
    Freidlin, I.S., Paracrine and autocrine mechanisms of cytokine immunoregulation, Immunologiya, 2001, vol. 5, pp. 4–7.Google Scholar
  4. 4.
    Altman, R., Asch, E., Bloch, D., et al., Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association, Arthritis Rheum., 1986, vol. 29, no. 8, pp. 1039–1049.CrossRefPubMedGoogle Scholar
  5. 5.
    Bellamy, N., Buchanan, W.W., Goldsmith, C.H., et al., Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee, J. Rheumatol., 1988, vol. 15, no. 12, pp. 1833–1840.PubMedGoogle Scholar
  6. 6.
    Blaney Davidson, E.N., van der Kraan, P.M., and van den Berg, W.B., TGF-β and osteoarthritis, Osteoarthritis Cartilage, 2007, vol. 15, no. 6, pp. 597–604.CrossRefPubMedGoogle Scholar
  7. 7.
    Breitner, J.C., Baker, L.D., Montine, T.J., et al., Extended results of the Alzheimer’s disease antiinflammatory prevention trial, Alzheimer’s Dementia, 2011, vol. 7, pp. 402–411.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Bruyère, O., Cooper, C., Pelletier, J.P., et al., A consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis—from evidence-based medicine to the real-life setting, Semin. Arthritis Rheum., 2016, vol. 45, pp. 3–11.CrossRefGoogle Scholar
  9. 9.
    De Lange-Brokaar, B.J., Ioan-Facsinay, A., van Osch, G.J., et al., Synovial inflammation, immune cells and their cytokines in osteoarthritis: a review, Osteoarthritis Cartilage, 2012, vol. 20, no. 12, pp. 1484–1499.CrossRefPubMedGoogle Scholar
  10. 10.
    Goldring, S.R. and Goldring, M.B., The role of cytokines in cartilage matrix degeneration in osteoarthritis, Clin. Orthopaed. Relat. Res., 2004, vol. 427, pp. 27–36.CrossRefGoogle Scholar
  11. 11.
    Huang, S.W., Wang, W.T., Chou, L.C., et al., Osteoarthritis increases the risk of dementia: A nationwide cohort study in Taiwan, Sci. Rep., 2015, vol. 5, p. 10145.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Hebert, L.E., Scherr, P.A., Bienias, J.L., et al., Alzheimer disease in the US population: prevalence estimates using the 2000 census, Arch. Neurol., 2003, vol. 60, pp. 1119–1122.CrossRefPubMedGoogle Scholar
  13. 13.
    Hoozemans, J.J., Bruckner, M.K., Rozemuller, A.J., et al., Cyclin D1 and cyclin E are co-localized with cyclo-oxygenase 2 (COX-2) in pyramidal neurons in Alzheimer disease temporal cortex, J. Neuropathol. Exp. Neurol., 2002, vol. 61, pp. 678–688.CrossRefPubMedGoogle Scholar
  14. 14.
    Kyrkanides, S., Tallents, R.H., Miller, J.H., et al., Osteoarthritis accelerates and exacerbates Alzheimer’s disease pathology in mice, J. Neuroinflammation, 2011, vol. 8, p. 12.CrossRefGoogle Scholar
  15. 15.
    Marcu, K.B., Otero, M., Olivotto, E., et al., NF-κB signaling: multiple angles to target OA, Curr. Drug Targets, 2010, vol. 11, no. 5, pp. 599–613.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Melnikova, T., Savonenko, A., Wang, Q., et al., Cycloxygenase-2 activity promotes cognitive deficits but not increased amyloid burden in a model of Alzheimer’s disease in a sex-dimorphic pattern, Neuroscience, 2006, vol. 141, pp. 1149–1162.CrossRefPubMedGoogle Scholar
  17. 17.
    Mueller, M.B. and Tuan, R.S., Anabolic/catabolic balance in pathogenesis of osteoarthritis: identifying molecular targets, PM&R, 2011, vol. 3, no. 6, pp. 3–11.CrossRefGoogle Scholar
  18. 18.
    Nasreddine, Z.S., Phillips, N.A., Bedirian, V., et al., The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment, J. Am. Geriatr. Soc., 2005, vol. 53, pp. 695–699.PubMedGoogle Scholar
  19. 19.
    Sil, S. and Ghosh, T., Role of cox-2 mediated neuroinflammation on the neurodegeneration and cognitive impairments in colchicines induced rat model of Alzheimer’s disease, J. Neuroimmunol., 2016, vol. 291, pp. 115–124.CrossRefPubMedGoogle Scholar
  20. 20.
    Sohn, D.H., Sokolove, J., Sharpe, O., et al., Plasma proteins present in osteoarthritic synovial fluid can stimulate cytokine production via Toll-like receptor 4, Arthritis Res. Ther., 2012, vol. 14, no. 1, p. 7.CrossRefGoogle Scholar
  21. 21.
    Yang, H., Zhang, J., Andreasson, K., and Chen, C., COX-2 oxidative metabolism of endocannabinoids augments hippocampal synaptic plasticity, Mol. Cell Neurosci., 2008, vol. 37, pp. 682–695.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Yermakova, A.V. and O’Banion, M.K., Down regulation of neuronal cyclooxygenase-2 expression in end stage Alzheimer’s disease, Neurobiol. Aging, 2001, vol. 22, pp. 823–836.CrossRefPubMedGoogle Scholar
  23. 23.
    Vangsness, C.T., Jr., Burke, W.S., Narvy, S.J., et al., Human knee synovial fluid cytokines correlated with grade of knee osteoarthritis—a pilot study, Bull. Hosp. Jt. Dis., 2011, vol. 69, no. 2, pp. 122–127.Google Scholar

Copyright information

© Pleiades Publishing, Ltd. 2018

Authors and Affiliations

  1. 1.Samara State Medical UniversitySamaraRussia

Personalised recommendations