Phytochemicals and Overview of the Evolving Landscape in Management of Osteoarthritis

Osteoarthritis (OA), characterized by degeneration of the joints, is forecast to be the major cause of disability for older people by 2030. The primary pathology of osteoarthritis are cartilage and bone rebuilding. Osteoarthritis management consists of pharmacotherapy, physiotherapy, and surgery. OA should traditionally be treated using herbal medications in various medical systems around the world in addition to steroid use. These provide symptomatic relief from pain and inflammation, but minimally reduce joint destruction. Structural damage needs to be effectively prevented and should be the main goal of new therapeutic regimens. Phytoconstituents especially belonging to phenolics, flavonoids, steroids, terpenoids, sterols, sesquiterpenes, triterpenes, and phytoalexins class exhibit antioxidant, anti-inflammatory, anti-arthritic effects and prove beneficial in OA. These phytochemicals modulate different targets like cyclooxygenases, lipoxygenases, and other signaling pathways involved in the pathophysiology of OA, thereby providing immense benefits. These also serve as potential leads for the development of new chemical entities as potential anti-inflammatory molecules of diverse utility. A number of clinical trials have found that herbal remedies and their components are essential to mitigate osteoarthritis. Reflex plus™ is a patented combination of collagen hydrolysate and rosehip extract. Ingredients in the blend have been thoroughly researched for their efficacy in arthritis. Collagen hydrolysate tends to accumulate within cartilage and assists in repairing the damage caused by osteoarthritis and other cartilage alterations. The rose hip works on the anti-inflammatory pathway to reduce joint discomfort and inflammation. The most important pro-inflammatory cytokines implicated in the pathogenesis of osteoarthritis are TNF-α and IL-1β, which act on synoviocytes and chondrocytes by specific interactions with cytokine receptors at the cell surface, assisting in the construction of cartilage for the effective functioning of the joints and the relief of pain associated with osteoarthritis and also help in the protection of cartilage. The purpose of this chapter is to incorporate the impact of phytochemicals on various molecular targets of inflammation into the overall management of osteoarthritis.