• Citer

LES ANTI-INFLAMMATOIRES NON STEROIDIENS DANS LE TRAITEMENT DE L'ARTHROSE

par Famaey, Jean Pierre ;Colinet, E.
Référence Acta rhumatologica, 1, 1-2, page (65-74)
Publication Publié, 1977

Article révisé par les pairs

• Détails
• Contenu

Résumé :

More and more non steroidal antiinflammatory drugs are used to-day in the treatment of osteoarthritis. Their use in the treatment of inflammatory rheumatic disease is well documented. Their clinical effectiveness is statistically demonstrated. Moreover their mode of action is now better understood. They inhibit the prostaglandins biosynthesis by acting at the level of the dioxygenase while steroids probably act on the prostaglandins production and release by intact entire cells. In addition their stabilizing effect on lysosomes, their uncoupling action on oxidative phosphorylation and a few other well established biochemical properties contribute to their favorable as well as side-effects. But on the other hand the reason of their use in osteoarthritis is still not very well understood and even quite controversial. A few clinical studies seem to demonstrate that they could have some indication in the treatment of various osteoarthritic conditions and they are surely usefull to releave the inflammation frequently associated to osteoarthritis. However, we have now more and more evidences indicating that they could exert in addition some protective actions on cartilage structures, probably related to their most fundamental modes of action. They inhibit various collagenases or proteases and prevent the release of several damaging lysosomal enzymes thanks to their membrane stabilizing properties. The discovery of their inhibitory effect on superoxide anions production is a new and most interesting approach and explantation of such properties. This could be the basis of their actions on prostaglandins. As superoxides could contribute to cartilage and collagen maturation and degradation, it seems that this biochemical property could be also very important for their antiarthrotic actions. Catalases and superoxide dismutases play probably a key role in the pathogenesis of both inflammation and osteoarthritis and could have a therapeutic action.