Existing medications, such as NSAIDs, for the management of inflammation are not viable given their severe adverse effects,
viz. bleeding and ulceration. Colchicine and corticosteroids are related to an expanded danger of toxic signs along with severe complications, such as bone marrow demolition and deterioration of liver or kidney cells (
Schlesinger. 2004). For the best possible control and alleviation of inflammatory reactions, natural products are used as therapeutic solutions to control the aggravation of osteoarthritis
(Tanwar et al., 2015). Hence, this study evaluated the
in vivo efficacy of Mobility Plus® in managing osteoarthritis and joint inflammation in dogs.
The assessment parameters scores
viz. lameness, joint mobility, pain and weight-bearing scores, significantly (
p<0.001) decreased in dogs as early as day 15 after supplementation with Mobility Plus® along with standard treatment; hence, the overall clinical condition score significantly (
p<0.001) decreased as early as day 15 after Mobility Plus® supplementation. However, the complete amelioration of lameness, joint mobility, pain and weight-bearing was observed on day 45 (Table 2). The amelioration of lameness, joint mobility, pain and weight-bearing of dogs after supplementation could be attributed to the antiarthritic, anti-inflammatory and analgesic activities of Mobility Plus®.
The antiarthritic, anti-inflammatory and analgesic activities of Mobility Plus® could be understood by individual herbal ingredients,
viz.
Z. officinale,
A. sativum,
P. americana,
G. max,
A. comosus and
C. wightii, present in Mobility Plus®. It has been reported that gingerol, shogaol and other structurally related substances in ginger inhibit prostaglandin and leukotriene biosynthesis by suppressing 5-lipoxygenase or prostaglandin synthetase
(Hassan et al., 2017). These chemicals can also inhibit the synthesis of proinflammatory cytokines, such as interleukin (IL)-1, tumour necrosis factor-α (TNF-α) and IL-8 (Tjendraputra
et al., 2001; Verma
et al., 2004). Paw oedema in carrageenan-induced rats was considerably reduced by treatment with 400 mg/kg aqueous ginger extracts compared to untreated rats (
p<0.001). Hence, it was understood from the findings of
Hassan et al., (2017) that the aqueous extract of
Z. officinale possesses anti-inflammatory properties.
A. sativum extract and its related phytochemicals have been reported to possess anti-inflammatory activity.
Hobauer et al., (2000) and
Gu et al., (2013) observed that the anti-inflammatory activity of
A. sativum extracts is caused by inhibiting the emigration of neutrophilic granulocytes into the epithelia.
Jeong et al., (2016) reported that aged black garlic (ABG) exhibited potent antioxidant activities and these activities were found responsible for its anti-inflammatory activity. Furthermore, they revealed that ABG chloroform extract acts by reducing nuclear factor-êB (NF-êB) activation in human umbilical vein endothelial cells caused by TNF-α. Moreover, ABG methanolic extract was reported to prevent cyclooxygenase-2 and prostaglandin E
2 (PGE
2) production by NF-êB inactivation.
In a prospective multicenter randomised control trial,
Blotman et al., (1997) reported that 153 osteoarthritis patients treated with avocado/soybean unsaponifiables (ASU) along with NSAIDs for 45 days reduced the requirements of NSAIDs without significant changes in patients’ pain scores.
Ernst (2003) conducted three clinical trials to assess the effectiveness of ASU therapy on osteoarthritis patients and two of them demonstrated a reduction in Lequesne’s functional index, pain and disability. Furthermore, more than 50% reduction in NSAID requirement was observed in 71% of the patients in the case group compared to control (36%) (
Ernst, 2003).
Maheu et al., (2014) reported no improvement in joint space width (JSW) during 3 years of follow-up in the hip in osteoarthritis patients on ASU therapy. However, 20% prevention of JSW aggravation was noticed.
Based on the literature,
A. comosus possesses several medicinal properties,
viz. anti-inflammatory
(Secor et al., 2005), antirheumatic (Kargutkar and Brijesh, 2016) and other immunomodulatory
(Engwerda et al., 2001). Kargutkar and Brijesh, (2016) confirmed the anti-inflammatory property of
A. comosus leaf extract through its inhibitory effect on carrageenan-induced paw oedema in rats. Furthermore, these authors postulated that the possible mechanism of action of the anti-inflammatory activity of
A. comosus leaf extract could be through the inhibition of protein denaturation, proteinase activity and synthesis of TNF-α, IL-1β, PGE
2 and reactive oxygen species (
Kargutkar and Brijesh, 2018). The fruit and stem parts of
A. comosus are rich sources of bromelain. Bromelain belongs to a group of protein-digesting enzymes reported to possess antiarthritic, anti-inflammatory and analgesic properties. It has been recorded that treatment with the combination of bromelain, trypsin and rutin resulted in the reduction of pain and inflammation, which was at par when compared to diclofenac treatment
(Akhtar et al., 2004). According to
Brien et al., (2004) bromelain as a feed supplement could be recommended as an alternative treatment to NSAIDs.
Mojcik and Shevach (1997) reported the pivotal role of bromelain in the pathogenesis of arthritis. In addition, bromelain has analgesic properties that are thought to be the result of its direct influence on pain mediators, such as bradykinin
(Pavan et al., 2012; Maurer 2001).
Guggulsterone [4,17(20)-pregnadiene-3,16-dione] is a plant sterol derived from the gum resin (guggul) of the tree
C. wightii. The resin of the
C. wightii tree has been used in Ayurvedic medicine for centuries to treat diseases such as obesity, bone fractures, arthritis, inflammation, cardiovascular disease and lipid disorders (
Urizar and Moore, 2003;
Sinal and Gonzalez, 2002). Furthermore, literature reports evidenced the effectiveness of guggul for treating knee osteoarthritis
(Khanna et al., 2007; Singh et al., 2003).
In summary, this study demonstrated that joint inflammation and osteoarthritis in dogs were ameliorated after supplementation with Mobility Plus® along with standard treatment through the antiarthritic and anti-inflammatory activities of the individual ingredients present in Mobility Plus®. Hence, this study provided considerable preliminary data that Mobility Plus® has antiarthritic and anti-inflammatory activities.