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Cucumber Extract: A Novel Nutraceutical Treatment for Osteoarthritis

Cucumber Extract Cucumber Extract
Longevity By Nature
 
EuroMedica

“The mighty cucumber!” said nobody ever. But perhaps they should—at least where osteoarthritis (OA) is concerned. This article will explore research on a relatively new cucumber-based extract shown to have efficacy for the treatment of osteoarthritis at the lowest dose of any other joint-support nutraceutical on the market today: 20 mg. But let’s start with a short review of osteoarthritis.

About OA

According to the Centers for Disease Control and Prevention,1 OA is the most common form of arthritis, affecting more than 35.5 million U.S. adults. Often referred to as a degenerative joint disease or “wear and tear” arthritis, it occurs most frequently in the hands, hips and knees. In OA, the cartilage within a joint begins to break down and the underlying bone begins to change. These changes usually develop slowly and get worse over time. OA can cause pain, stiffness and swelling. In some cases, it also causes reduced function and disability; some people are no longer able to do daily tasks or work. Common symptoms include pain or aching, stiffness, decreased range of motion (i.e., lack of flexibility), and swelling. Conventional medical treatment for OA includes aspirin, ibuprofen, other non-steroidal anti-inflammatory drugs, synthetic forms of cortisone (both swallowed and injected), and surgery. Although all of these drugs relieve symptoms, they are not without side effects and there’s increasing evidence that they accelerate the deterioration of cartilage and actually make the underlying condition worse. Consequently, the use of nutraceutical alternatives is very popular.

OA Nutraceutical Options

When it comes to nutraceutical options for the treatment of OA, the sky’s the limit. If you narrow the field to those nutraceuticals which actually have human clinical research to support their efficacy, there are still a great many from which to choose. This includes:

• Glucosamine/chondroitin
• Curcuminoids
• Collagen (types 1 and 2)
• Terminalia chebula extract
• Eggshell membrane
• And a plethora of other nutraceuticals.

Make no mistake, many of these nutraceuticals are safe and effective for use in the treatment of OA, but the two things that make the cucumber extract especially interesting is its mechanism of action, and that only 20 mg is required daily for efficacy.

Cucumber’s Mechanism of Action

Tumor Necrosis Factor alpha (TNF-α), is an inflammatory cytokine produced during acute inflammation.2 TNF-α produced in articular cartilage significantly increases metalloproteinases, enzymes that lead to a breakdown of cartilage.3 As may seem evident, high levels of TNF-α is not a good thing for OA. In fact, high concentrations, systemically or in certain tissues, aggravate many inflammatory responses. So, what does this have to do with cucumber? Just this.

Cucumber has long been recognized by women for benefits to red, tired and puffy eyes and was introduced to Britain by the Roman soldiers, who presumably used it to ease sore feet or other wounds. It is able to do this since cucumber contains a small iminosugar called ido-BR1. This iminosugar reduces TNF-α. It appears to do so via a novel mechanism involving binding to a hyaluronic acid receptor (CD44) or inhibiting a sialidase (enzymes which enhance the ability of microorganisms to invade and destroy tissue) whose release is induced by interaction with this receptor and is involved in the inflammation process. The only problem is that there are many varieties of cucumber whose breeding has totally removed the ido-BR1. However, there is a water extract called Q-actin, which is derived from a cucumber fruit (Curcumis sativis) selected to ensure ido-BR1 content.

Animal Research

So now let’s take a look at some of the early animal research on cucumber extract. In one study,4 rats with an inflammatory bowel disease known as ulcerative colitis, were given Q-actin. Treatment with cucumber fruit extract significantly lowered the ulcer area, demonstrating therapeutic value in the amelioration of colitis in rats. In another study,5 mice with paw inflammation were administered cucumber fruit extract. Results were that paw volume (i.e. inflammation) progressively decreased within 5.5 hours of receiving the cucumber. The cucumber extract demonstrated anti-inflammatory activity, and there were no adverse effects.

The water fruit extract of cucumber was screened for free-radical scavenging and analgesic activities. The extract was subjected to in-vitro antioxidant and in-vivo analgesic studies with albino mice. The free-radical scavenging was compared with ascorbic acid and BHA (butylated hydroxyl anisole), whereas the analgesic effect was compared with diclofenac sodium. The cucumber extract demonstrated effective antioxidant effects and strong analgesic action in mice.6

Of course, all of these animal studies are all well and good in showing anti-inflammatory and pain-relieving effects, but the most relevant evidence can be found in reviewing the human clinical research.

Human Clinical Research

This six-month (180 days) randomized, double-blind, parallel-group clinical trial was carried out to evaluate the efficacy of Q-Actin against glucosamine-chondroitin (GC) in the management of moderate knee OA. It was conducted at seven centers in three countries (India, Cameroon and Wales) in 122 patients (56 males and 66 females) aged between 40 and 75 years. All were diagnosed with moderate knee OA. The study involved two groups of 61 participants in each group. The GC group received 1,350 mg of GC twice daily (2,700 mg/day) and the Q-Actin group, received 10 mg twice daily (20 mg/day) of cucumber extract. Three different tests were used to assess efficacy:

• Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) assessed physical function, stiffness and pain
• Visual Analog Scale (VAS) assessed resting and moving pain
• Lequesne’s Functional Index (LFI) assessed the effect of pain on daily activities

These tests were conducted at baseline (Day 0) and on Days 30, 60, 90, 120, 150 and 180. The results were that, in the Q-Actin group, the WOMAC score was decreased by 29.8 percent and 70.39 percent on Days 30 and 180, respectively, compared to a 14.8 percent and 33.7 percent decrease in the GC group. Similar trends were observed for all the other pain scores (see chart). No adverse effect was reported during the trial period.

The researchers concluded that the use of 10 mg CSE, twice daily (20 mg/day), was effective in reducing pain related to moderate knee OA and can have potential for the use in managing knee pain, stiffness and physical functions related to OA. Furthermore, Q-actin was significantly more effective than glucosamine-chondroitin in reducing knee pain and stiffness, as well as improving physical function.

Conclusion

OA is the most common form of arthritis, affecting more than 35.5 million U.S. adults. Since standard drugs used for the treatment of OA are associated with side effects, and there’s increasing evidence that they accelerate the deterioration of cartilage, nutraceutical alternatives have become popular. Due to its mechanism of reducing TNF-α, a daily dose of only 20 mg (the lowest of any nutraceutical used for treating OA), Q-Actin has been shown to have greater efficacy than 2,700 mg/day of glucosamine/chondroitin, with a significant improvement in the WOMAC score for physical function, stiffness and pain of 70.39 percent, compared to only 33.7 percent for glucosamine/chondroitin in the same timeframe. Researchers have concluded that the use of 20 mg Q-Actin daily was effective in reducing pain related to moderate knee OA and can have potential for the use in managing knee pain, stiffness and physical functions related to OA.

References:

1 Osteoarthritis (OA). Centers for Disease Control and Prevention. Page last reviewed: July 27, 2020. Retrieved February 10, 2021 from www.cdc.gov/arthritis/basics/osteoarthritis.htm.

2 Idriss HT, Naismith JH. TNF alpha and the TNF receptor superfamily: structure-function relationship(s). Microsc Res Tech. 2000 Aug 1;50(3):184-95.

3 Fernandes JC, Martel-Pelletier J, Pelletier J-P. The role of cytokines in osteoarthritis pathophysiology. Biorheology. 2002;39(1-2):237-46.

4 Patil MVK, Kandhare AD, Bhise SD. Effect of aqueous extract of Cucumis sativus Linn. fruit in ulcerative colitis in laboratory animals Asian Pac J Trop Biomed. 2012:S962-S969

5 Agatemor UM-M, Nwodo OFC, Anosike CA. Anti-inflammatory Activity of Cucumis sativus L. Br J Pharm Res. 2015; 8(2): 1-8.

6 Kumar D, Kumar S, Singh J, et al. Free Radical Scavenging and Analgesic Activities of Cucumis sativus L. Fruit Extract. J Young Pharm. 2010;2(4): 365-368.

Gene Bruno, MS, MHS, the dean of academics for Huntington College of Health Sciences, is a nutritionist, herbalist, writer and educator. For more than 30 years he has educated and trained natural product retailers and health care professionals, has researched and formulated natural products for dozens of dietary supplement companies, and has written articles on nutrition, herbal medicine, nutraceuticals and integrative health issues for trade, consumer magazines and peer-reviewed publications. He can be reached at gbruno@hchs.edu.