Skip to main content

Advertisement

SpringerLink
Log in

The effect of mud pack therapy on serum YKL-40 and hsCRP levels in patients with knee osteoarthritis

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The aim of this study was to evaluate the efficacy of treatment with mud pack in knee osteoarthritis (OA) and to determine whether mud pack effects serum levels of YKL-40 and high-sensitivity C-reactive protein (hsCRP) which are reported to be biological markers for articular damage or inflammation in patients with OA. Forty-four patients with the diagnosis of knee OA assigned into two groups were treated with local natural mineral-rich mud pack or hot pack. Treatments were applied for 6 days a week for 2 weeks as a total of 12 sessions. Patients were assessed at baseline, post-treatment, and 3 months after the treatment. VAS, range of motion, 15-m walking time, WOMAC index, Nottingham Health Profile, serum YKL-40, and hsCRP levels were the outcome measures. Pain intensity and joint stiffness decreased in both groups at all follow-ups. Physical activity status was found to persist for 3 months after treatment only in mud pack group. Serum mean YKL-40 and hsCRP levels of the patients were higher compared to healthy control group. Serum YKL-40 level increased significantly only in hot pack group 3 months after the treatment (P < 0.017). No significant change was observed in hsCRP levels in both groups during the whole follow-up periods (P > 0.05). Mud pack and hot pack therapy were both demonstrated to be effective in symptomatic treatment of knee OA until the end of the 2-week treatment period, whereas only mud pack therapy was shown to be effective in functional status over time. In the hot pack group, increased serum YKL-40 level 3 months after the treatment might indicate persistence of cartilage degradation. Maintenance of YKL-40 level in mud pack therapy seems to slow down the progression of knee OA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Garnero P, Delmas PD (2003) Biomarkers in osteoarthritis. Curr Opin Rheumatol 15:641–646

    Article  PubMed  CAS  Google Scholar 

  2. Abe M, Takahashi M, Naitou K, Ohmura K, Nagano A (2003) Investigation of generalized osteoarthritis by combining X-ray grading of the knee, spine and hand using biochemical markers for arthritis in patients with knee osteoarthritis. Clin Rheumatol 22:425–431

    Article  PubMed  Google Scholar 

  3. Garnero P, Ayral X, Rousseau JC, Christgau S, Sandell LJ, Dougados M, Delmas PD (2002) Uncoupling of type II collagen synthesis and degradation predicts progression of joint damage in patients with knee osteoarthritis. Arthritis Rheum 46:2613–2624

    Article  PubMed  CAS  Google Scholar 

  4. Vignon E, Garnero P, Delmas P et al (2001) Recommendations for the registration of drugs used in the treatment of osteoarthritis: an update on biochemical markers. Osteoarthr Cartil 4:289–293

    Article  Google Scholar 

  5. Harvey S, Weisman M, O’Dell J, Scott T, Krusemeier M, Visor J, Swindlehurst C (1998) Chondrex: new marker of joint disease. Clin Chem 44:509–516

    PubMed  CAS  Google Scholar 

  6. Hakala BE, White C, Recklies AD (1993) Human cartilage gp-39, a major secretory product of articular chondrocytes and synovial cells, is a mammalian member of a chitinase protein family. J Biol Chem 268:25803–25810

    PubMed  CAS  Google Scholar 

  7. Johansen JS, Hvolris J, Hansen M, Backer V, Lorenzen I, Price PA (1996) Serum YKL-40 levels on healthy children and adults. Comparison with serum and synovial fluid levels of YKL-40 in patients with osteoarthritis or trauma of the knee joint. Br J Rheumatol 35:553–559

    Article  PubMed  CAS  Google Scholar 

  8. Volck B, Ostergaard K, Jhansen JS, Garbarsch C, Price PA (1999) The distribution of YKL-40 in osteoarthritic and normal human cartilage. Scand J Rheumatol 28:171–179

    Article  PubMed  CAS  Google Scholar 

  9. Volck B, Johansen JS, Stoltenberg M et al (2001) Studies on YKL-40 in knee joints of patients with rheumatoid arthritis and osteoarthritis. Involvement of YKL-40 in the joint pathology. Osteoarthr Cartil 9:203–214

    Article  PubMed  CAS  Google Scholar 

  10. Conrozier T, Carlier MC, Mathieu P, Colson F, Debard AL, Richard S, Favret H, Bienvenu J, Vignon E (2000) Serum levels of YKL-40 and C reactive protein in patients with hip osteoarthritis and healthy subjects: a cross sectional study. Ann Rheum Dis 59:828–831

    Article  PubMed  CAS  Google Scholar 

  11. Garnero P, Piperno M, Gineyts E, Christgau S, Delmas PD, Vignon E (2001) Cross sectional evaluation of biochemical markers of bone, cartilage, and synovial tissue metabolism in patients with knee osteoarthritis: relations with disease activity and joint damage. Ann Rheum Dis 60:619–626

    Article  PubMed  CAS  Google Scholar 

  12. Connor JR, Dodds RA, Emery JG, Kirkpatrick RB, Rosenberg M, Gowen M (2000) Human cartliage glycoprotein 39 (HC-gp 39) mRNA expression in adult and fetal chondrocytes, osteoblasts and osteocytes by in situ hybridization. Osteoarthr Cartil 8:87–95

    Article  PubMed  CAS  Google Scholar 

  13. Kawasaki M, Hasegawa Y, Kondo S, Iwata H (2001) Concentration and localization of YKL-40 in hip joint diseases. J Rheumatol 28:341–345

    PubMed  CAS  Google Scholar 

  14. Wolfe F (1997) The C-reactive protein but not erythrocyte sedimentation rate is associated with clinical severity in patients with osteoarthritis of the knee or hip. J Rheumatol 8:1486–1488

    Google Scholar 

  15. Sowers M, Jannausch M, Stein E, Jamadar D, Hochberg M, Lachance L (2002) C-reactive protein as a biomarker of emergent osteoarthritis. Osteoarthr Cartil 10:595–601

    Article  PubMed  Google Scholar 

  16. Sturmer T, Brenner H, Koenig W, Gunther KP (2004) Severity and extent of osteoarthritis and low grade systemic inflammation as assessed by high sensitivity C reactive protein. Ann Rheum Dis 63:200–205

    Article  PubMed  CAS  Google Scholar 

  17. Pearle AD, Scanzello CR, George S, Mandl LA, DiCarlo EF, Peterson M, Sculco TP, Crow MK (2007) Elevated high-sensitivity C-reactive protein levels are associated with local inflammatory findings in patients with osteoarthritis. Osteoarthr Cartil 15:516–523

    Article  PubMed  CAS  Google Scholar 

  18. Lange U, Müller-Lander U, Schmidt KL (2006) Balneotheraphy in rheumatic diseases: an overview of novel and known aspect. Rheumatol Int 26:497–499

    Article  PubMed  CAS  Google Scholar 

  19. Zhang W, Doherty M, Arden N et al (2005) EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 64:669–681

    Article  PubMed  CAS  Google Scholar 

  20. Flusser D, Abu-Shakra M, Friger M, Codish S, Sukenik S (2002) Therapy with mud compresses for knee osteoarthritis: comparison of natural mud preparations with mineral-depleted mud. J Clin Rheumatol 8:197–203

    Article  PubMed  Google Scholar 

  21. Evcik D, Kavuncu V, Yeter A, Yigit I (2007) The efficacy of balneotherapy and mud-pack therapy in patients with knee osteoarthritis. Joint Bone Spine 74:60–65

    Article  PubMed  Google Scholar 

  22. Codish S, Abu-Shakra M, Flusser D, Friger M, Sukenik S (2005) Mud compress therapy for the hands of patients with rheumatoid arthritis. Rheumatol Int 25:49–54

    Article  PubMed  Google Scholar 

  23. Sukenik S, Buskila D, Neumann L, Kleiner-Baumgarten A, Zimlichman S, Horowitz J (1990) Sulphur bath and mud pack treatment for rheumatoid arthritis at the Dead Sea area. Ann Rheum Dis 49:99–102

    Article  PubMed  CAS  Google Scholar 

  24. Elkayam O, Ophir J, Brener S, Paran D, Wigler I, Efron D, Even-Paz Z, Politi Y, Yaron M (2000) Immediate and delayed effects of treatment at the Dead Sea in patients with psoriatic arthritis. Rheumatol Int 19:77–82

    Article  PubMed  CAS  Google Scholar 

  25. Fioravanti A, Perpignano G, Tirri G, Cardinale G, Gianniti C, Lanza CE, Loi A, Tirri E, Sfriso P, Cozzi F (2007) Effects of mud-bath treatment on fibromyalgia patients: a randomized clinical trial. Rheumatol Int 27:1157–1161

    Article  PubMed  Google Scholar 

  26. Sert F (2008) Osteoartrit hastalarında YKL-40 ve yüksek-duyarlıklı CRP (hsCRP) düzeylerinin değerlendirilmesi. Dissertation, University of Pamukkale

  27. Bellamy N, Buchanan WW, Goldsmith CH, Campbell SLW (1988) Validation 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 15:1833–1840

    PubMed  CAS  Google Scholar 

  28. Tüzün EH, Eker L, Aytar A (2005) Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthr Cartil 13:28–33

    Article  PubMed  Google Scholar 

  29. Martini CJM, Waugh IM (1978) A method for self-assessment of disability before and after hip replacement operation. BMJ 2:258–259

    Google Scholar 

  30. Kucukdeveci AA, McKenna SP, Kutlay S, Gursel Y, Whalley D, Arasil T (2000) The development and psychometric assessment of the Turkish version of the Nottingham health profile. Int J Rehabil Res 23(1):31–38

    Article  PubMed  CAS  Google Scholar 

  31. Odabaşı E, Turan M, Erdem H, Pay S, Güleç M, Karagülle MZ (2009) The effect of Mud pack treatment in knee osteoarthritis. Turk J Rheumatol 24:72–76

    Google Scholar 

  32. Fioravanti A, Iacoponi F, Bellisai B, Cantarini L, Galeazzi M (2010) Short- and long-term effects of spa therapy in knee osteoarthritis. Am J Phys Med Rehabil 89(2):125–132

    Article  PubMed  Google Scholar 

  33. Tolomio C, Ceschi-Berrini C, Moschin E, Galzigna L (1999) Colonization by diatoms and antirheumatic activity of thermal mud. Cell Biochem Funct 17:169–175

    Article  Google Scholar 

  34. Sulenik S, Abu-Shakra M, Flusser D (1997) Balneotheraphy in autoimmun disease. Isr J Med Sci 33:258–261

    Google Scholar 

  35. Ghersetich I, Freedman D, Lotti T (2000) Balneology today. J Eur Acad Dermatol Venereol 14:346–348

    Article  PubMed  CAS  Google Scholar 

  36. Beer AM, Junginger HE, Lukanov J, Sagorchev P (2003) Evaluation of the permeation of peat substances through human skin in vitro. Int J Pharm 253:169–175

    Article  PubMed  CAS  Google Scholar 

  37. Beer AM, Lukanov J, Sagorchev P (2000) Mechanism of the effect of aqueous peat extract on spontaneous contractile activity of smooth muscles. Forsch Komplementärmed Klass Naturheilkd 7:237–241

    Article  PubMed  CAS  Google Scholar 

  38. Odabasi E, Turan M, Erdem H, Tekbas F (2008) Does mud pack treatment have any effect? A randomized controlled clinical study. J Altern Complement Med 14:559–565

    Article  PubMed  Google Scholar 

  39. Cechettin M, Bellometti S, Lalli A, Galzigna L (1995) Serum interleukin-1 changes in arthrosis patients after mud-pack treatment. Phys Rehab Kur Med 5:92–93

    Article  Google Scholar 

  40. Bellometti S, Galzigna L (1998) Serum levels of a prostaglandin and a leukotriene after thermal mud pack therapy. J Investig Med 46:140–145

    PubMed  CAS  Google Scholar 

  41. Bellometti S, Richelmi P, Tassoni T et al (2005) Production of matrix metalloproteinases and their inhibitors in osteoarthritic patients undergoing mud-bath therapy. Int J Clin Pharmacol Res 25:77–94

    PubMed  CAS  Google Scholar 

  42. Bellometti S, Galzigna L, Richelmi P et al (2002) Both serum receptors of tumor necrosis factor are influenced by mud-pack treatment in osteoarthritic patients. Int J Tissue React 24:57–64

    PubMed  CAS  Google Scholar 

  43. Bellometti S, Giannini S, Sartori L, Crepaldi G (1997) Cytokine levels in osteoarthrosis patients undergoing mud bath therapy. Int J Clin Pharmacol Res 17:149–153

    PubMed  CAS  Google Scholar 

  44. Bellometti S, Cecchettin M, Galzigna L (1997) Mud pack therapy in osteoarthrosis: changes in serum levels of chondrocyte markers. Clin Chim Acta 268:101–106

    Article  PubMed  CAS  Google Scholar 

  45. Bellometti S, Poletto M, Gregotti C, Richelmi P, Berte F (2000) Mud bath therapy influences nitric oxide, myeloperoxidase and glutathione peroxidase serum levels in arthritic patients. Int J Clin Pharmacol Res 20(3–4):69–80

    PubMed  CAS  Google Scholar 

  46. Swaak AJ, van Rooyen A, Nieuwenhuis E, Aarden LA (1988) Interleukin-6 (IL-6) in synovial fluid and serum of patients with rheumatic diseases. Scand J Rheumatol 17:469–474

    Article  PubMed  CAS  Google Scholar 

  47. Abramson SB, Attur M, Amin AR, Clancy R (2001) Nitric oxide and inflammatory mediators in the perpetuation of osteoarthritis. Curr Rheumatol Rep 3:535–541

    Article  PubMed  CAS  Google Scholar 

  48. Westacott CI, Whicher JT, Barnes IC, Thompson D, Swan AJ, Dieppe PA (1990) Synovial fluid concentration of five different cytokines in rheumatic diseases. Ann Rheum Dis 49:676–681

    Article  PubMed  CAS  Google Scholar 

  49. Guerne PA, Zuraw BL, Vaughan JH, Carson DA, Lotz M (1989) Synovium as a source of interleukin 6 in vitro. Contribution to local and systemic manifestations of arthritis. J Clin Invest 83:585–592

    Article  PubMed  CAS  Google Scholar 

  50. Ridker PM (2001) High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation 103:1813–1818

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We would like to thank Umut Thermal & Spa Resort for their contribution for sponsoring mud and transportation. “Pamukkale University Scientific Research Projects Management Unit” provided funding for the study (Project number: 2002MHF001).

Author information

Authors and Affiliations

  1. Pamukkale University, Denizli, Turkey

    Gonca Güngen, Fusun Ardic, Gülin Fιndıkoğlu & Simin Rota

Authors
  1. Gonca Güngen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fusun Ardic
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gülin Fιndıkoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Simin Rota
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fusun Ardic.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Güngen, G., Ardic, F., Fιndıkoğlu, G. et al. The effect of mud pack therapy on serum YKL-40 and hsCRP levels in patients with knee osteoarthritis. Rheumatol Int 32, 1235–1244 (2012). https://doi.org/10.1007/s00296-010-1727-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-010-1727-4

Keywords

Search

Navigation