Boiogito, a Kampo medicine, improves hydrarthrosis in a rat model of knee osteoarthritis

Abstract

BackgroundHydrarthrosis, which is associated with knee pain and limited range of motion, decreases the quality of life (QOL) of patients with osteoarthritis (OA). The Kampo medicine boiogito is prescribed for the treatment of knee OA with hydrarthrosis; however, its precise mechanisms of action remain unknown. The purposes of this study were to assess the pharmacological effects of boiogito and its mechanisms of action on joint effusion in rats with surgically induced OA.MethodsA rat OA model was produced by transecting the anterior (cranial) cruciate ligament, medial collateral ligament, and medial meniscus in the right knee joints of 7-week-old female Wistar rats. The rats were given chow containing boiogito (1 or 2 %) or indomethacin (0.002 %) for 4 weeks after surgical transection. Levels of interleukin-1β (IL-1β) and hyaluronic acid (HA) were measured by enzyme-linked immunosorbent assay. Knee joint pain was assessed using an incapacitance tester. Osmotic water permeability in cultured rabbit synovial cells was assessed using stopped-flow analysis.ResultsIncreased synovial fluid volume and knee joint pain were observed in rats with surgically induced OA. In rats with OA, levels of IL-1β and HA in the articular cavity were higher but concentration of HA in synovial fluid was lower than in sham-operated rats, suggesting excessive synovial fluid secretion. Administration of boiogito improved hydrarthrosis, IL-1β, and HA concentrations and alleviated knee joint pain in rats with OA. Indomethacin reduced IL-1β and knee joint pain but failed to improve hydrarthrosis or HA concentration in rats with OA. Osmotic water permeability in synovial cells, which is related to the function of the water channel aquaporin, was decreased by treatment with boiogito.ConclusionBoiogito ameliorates the increased knee joint effusion in rats with OA by suppressing pro-inflammatory cytokine IL-1β production in the articular cavity and regulating function of water transport in the synovium. The improvement of hydrarthrosis by boiogito results in the increased HA concentration in synovial fluid, thus reducing joint pain. Boiogito may be a clinically useful treatment of QOL in patients with OA with hydrarthrosis.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-015-0979-7) contains supplementary material, which is available to authorized users.

Traditional Chinese medicine therapy reduces the risk of total knee replacement in patients with knee osteoarthritis

“…FJHQT, also named Boogie in Japan, is composed mainly of the Sinomeniumstem and Astragalus root and has been reported to reduce joint effusion by suppressing the production of pro-inflammatory cytokine IL-1β and increasing the hyaluronan concentrations in the synovial fluid. [37] A recent clinical study demonstrated that oral administration of FJHQT for 12 weeks lowered the knee effusion in patients with osteoarthritis without any adverse effects. [38] In our study cohort, FJHQT was the most effective Chinese herbal formula for patients with knee osteoarthritis and lowered the risk of total knee replacement (HR: 0.68; 95% CI: 0.50–0.93).…”

Analgesic Effect of Boiogito, a Japanese Traditional Kampo Medicine, on Post-Traumatic Knee Osteoarthritis through Inhibition of ERK1/2 Phosphorylation in the Dorsal Horn of the Spinal Cord

“…Therefore, BO may possess other analgesic mechanisms in addition to the inhibition of ERK1/2 phosphorylation. Fujitsuka et al [15] reported that BO inhibited IL-1β secretion as well as joint fluid retention in the KOA rat model. Among the crude drugs present in BO, Astragalus root [31], Glycyrrhiza [32], and ginger [33] have been reported to exert analgesic effects against neuropathic pain.…”

“…According to oriental medicine, BO improves water metabolism and eliminates swelling and pain in the knee joint [14] and hence may prevent KOA. Oral administration of BO has been found to relieve gait pain in patients with KOA, and some basic research has reported that it suppresses the inflammatory response in the knee joint [15,16]. We had earlier clarified that BO suppressed the progression of KOA in rats with surgically induced KOA; moreover, BO could also improve locomotive function in the early stage of the disease [17].…”

Kampo for the Treatment of Pain in Japan: A Review

“…Sinomenin, which is extracted from the Chinese plant Sinomenium acutum and has been reported to have an antiinflammatory effect [35,36], has been used for rheumatic diseases for over 2000 years [36]. Research has reported that Boiogito [37,38], a Kampo medicine, which includes sinomenin as a principle component, could reduce symptoms of osteoarthritis in humans [37,39] and rodents [40]. Moreover, another study revealed the antiinflammatory effects of Keishikajutsubuto [41].…”