Vitamin D and Cartilage: Does Vitamin D Influence Cartilage Integrity?

Research Article

Austin J Musculoskelet Disord. 2016; 3(2): 1034.

Vitamin D and Cartilage: Does Vitamin D Influence Cartilage Integrity?

Marks R*

Department of Health and Behavior Studies, Physical Education, School of Health Sciences and Professional Studies, Teachers College, Columbia University, USA

*Corresponding author: Marks Ray, Department of Health and Behavior Studies, Teachers College, Columbia University, Box 114, 525W, 120th Street, New York, USA

Received: June 05, 2016; Accepted: August 05, 2016; Published: August 08, 2016

Abstract

Osteoarthritis, a painful irreversible disabling joint disease, and one that predominantly affects articular cartilage, is rapidly increasing in prevalence among older populations. This work aimed to examine: 1) whether vitamin D, a powerful steroidal hormone involved in many physiological processes is an important determinant of osteoarthritis pathology, and 2) whether vitamin D supplementation can potentially restore articular cartilage integrity in damaged joints. To this end, a comprehensive overview of relevant English language research reports published over the last 30 years was undertaken. Regardless of study design, these data revealed no clear conclusion with respect to either study question, a wide array of study substrates, approaches, and outcome measures, plus equivocal findings even when similar research designs were applied, along with similar samples. In light of the limited consensus reached when examining the present data base, plus the presence of substantive methodological concerns within this literature, it is concluded more research to carefully delineate the possible protective, reparative or aversive role of vitamin D in mediating articular cartilage status in more representative samples is warranted, and will potentially prove of immense clinical value.

Keywords: Articular cartilage; Bone, Muscle; Osteoarthritis; Prevention; Vitamin D

Background

Osteoarthritis, a chronic health condition resulting in immense pain and disability is strongly associated with progressive lesions of the articular cartilage tissue lining synovial joints such as the hip and knee. Often considered an inevitable component of aging with no effective means of prevention or treatment, discussions about whether vitamin D, a key mediator of bone and cartilage tissue metabolism [1] is of potential value for reducing the risk of acquiring this disease, and its subsequent disabling symptoms have ensued for some time with no conclusion.

Given the enormity and extent of the disability incurred worldwide by adults in their older years who are diagnosed with osteoarthritis, and some evidence that a vitamin D deficiency may be implicated as one possible factor promoting the disease onset, and its progression, it was believed a comprehensive updated review of this line of inquiry would prove both timely and insightful. To this end, this brief examines whether there is a consistent directional association between vitamin D levels and the presence or absence of osteoarthritis in older adults. It further examines what is known about the direct effects of vitamin D on articular cartilage explants or models of arthritis conducted in the laboratory. Both basic research studies concerning vitamin D and its impact on healthy and damaged cartilage tissues and cells, plus related clinical studies were examined to ascertain whether there is conclusive evidence in favor of a possible role for vitamin D in the overall pathologic process of osteoarthritis and its possible treatment.

The scientific rationale for pursuing this line of thought is that a considerable volume of evidence does indicate that vitamin D or cholecalciferol, a collective of structurally related metabolites obtained either from dietary sources, dietary supplementation, and/or sunlight, is of potential relevance in the context of the pathogenesis of osteoarthritis, given its role in development, growth, and maintenance of a healthy skeleton. In addition, since cells such as chondrocytes of articular cartilage, the tissue most consistently identified as problematic in this disorder, possess vitamin D nuclear receptors [VDR (nuc)] as well as cell surface vitamin D receptors that regulate gene transcription [2,3], it is possible that these receptors, as well as the presence of vitamin D interact to impact chondrocyte gene expression and the biological responses of these cartilage cells. Vitamin D can also affect joint status indirectly through it regulatory impact on muscle and/or bone [5-9]. In addition, since inflammation [10], often accompanying osteoarthritis damage, and factors such as obesity [11], impaired neuromuscular function and balance [12] depression [13] and pain [14], implicated in osteoarthritis, can all be influenced by the prevailing degree of vitamin D, it appears that the presence of any vitamin D deficiency would do more harm than good in terms of directly or indirectly promoting optimal cartilage viability and joint integrity as outlined in (Figure 1).

Citation: Marks R. Vitamin D and Cartilage: Does Vitamin D Influence Cartilage Integrity?. Austin J Musculoskelet Disord. 2016; 3(2): 1034. ISSN : 2381-8948