Resveratrol and the treatment of osteoarthritis | The research

Marion Hauser, MS, RD

Resveratrol, in simple terms, is a chemical compound found in some plants that provides that plant a super antioxidant protector from oxidative stress and infections. What stresses a plant, you may ask? Disease, fungus, environmental pollutants to name a few.

The remarkable nature of Resveratrol has made this chemical compound somewhat of a “researcher’s darling.” In October 2018 alone, there were at least 25 new studies published on Resveratrol and its impact on cancer, oxidative stress, heart disease, obesity, and diabetes to name a few of the main topics covered. There have also been a handful of studies throughout the last few years that have focused solely on Resveratrol’s impact on inflammation and osteoarthritis. For our purpose, we will focus on the research that centers on joint pain.

Resveratrol is most famous for the “French Paradox.” Red wine and reduced risk of cardiovascular disease

Resveratrol has been studied extensively for supplementation in humans. Many of you will remember that Resveratrol was first brought to the attention of the public in a series of studies and news stories in the late 1980s surrounding the “French Paradox.” Here doctors wanted to know why there was such a low incidence rate of cardiovascular disease in the French population who regularly consumed high saturated fat diets.

The answer some researchers brought forward? Red Wine. Resveratrol is found in the skins of wine grapes.

It should be noted that the theory was promoted and sponsored by winemakers and has since had numerous studies promoting and questioning the “French Paradox” theory that red wine consumption is beneficial. However, research in Resveratrol continues to show benefits and the interest in Resveratrol could not be stronger as attested to by the numerous ongoing studies.

Foods that are rich in Resveratrol other than red wine include Peanuts, pistachios, cranberries, strawberries, almonds, and berries.

The research on Resveratrol and joint pain

University researchers publishing in the medical journal Molecular Medicine Reports (1) had a lot of good things to say about Resveratrol.

Besides the anti-cancer, cholesterol-lowering, anti-aging effects: “Resveratrol. . . improves the plant’s resistance against pathogens and environmental deterioration, and performs important functions beneficial to human health, such as anti‑cancer, anti‑oxidation, regulating blood lipid levels and prolonging lifespan,” the researchers also examined the effects of resveratrol in laboratory rats with osteoarthritis. They noted that Resveratrol reversed inflammatory damage and protected the rat joints from osteoarthritis damage.

Understanding inflammation and healing so you can understand how Resveratrol can help.

In our practice inflammation is THE tool to fix damaged joints. We control the inflammation through our regenerative injection techniques. We create healing inflammation that stimulates the body’s natural healing response of quick, powerful inflammation bursts that heal damaged joints. Once the healing job is done, the inflammation shuts down. The most obvious clue that healing has occurred is that the swelling goes away.

Inflammation becomes bad when the swelling does not go away. Healing is not occurring. Yet the body continues to try to heal the only way it knows how, with inflammation and swelling. When swelling becomes chronic, the inflammatory factors that are beneficial to quickly heal, become corrosive over the long term, eroding joints.

Chronic inflammation is your body’s attempt to try to heal something it may not be able to, such as advanced degenerative joint disease. The swelling of inflammation, once a protective tool, now becomes painful and typically sends the person off to chronic anti-inflammatory pain medications.

Resveratrol can act as a natural anti-inflammatory.

Resveratrol helps by acting as an anti-inflammatory. It should be noted however that it does not repair damaged tissue, its beneficial claim is that it helps stop the erosion.

How?

Resveratrol significantly inhibited tumor necrosis factor‑α,
- Tumor-Necrosis factor (TNF‑α) is a cell-signaling protein (cytokine), which communicates the commands to create inflammation in arthritis joint swelling. The medical thinking is if you can block TNF and other inflammatory factor production or at least inhibit it, joint swelling will be reduced and hopefully, the amount of articular cartilage breakdown resulting from a toxic, over the inflamed joint environment will be slowed.
Resveratrol significantly inhibited interleukin (IL)‑1β, IL‑6, and IL‑18 expression levels. These are the serum biomarkers of inflammation and cartilage degradation.
Decreased caspase‑3/9 activity. Caspase is responsible for damage cell breakdown. When cartilage is damaged and the body cannot heal itself, it gets rid of the damaged cartilage. The problem with osteoarthritis is that this cartilage is not replaced.
Resveratrol altered the inflammation messages. It sent chemical messages to stop chronic inflammation
- Effect on nitric oxide.
  - Nitric Oxide is another of our body’s Dr. Jeykll/Mr. Hyde molecules. In a normal joint environment, nitric oxide regulates inflammation as a healing agent. In an abnormal toxic non-healing joint environment, nitric oxide production gets stuck in the “open,” position creating chronic damaging inflammation.
- Effect on the nuclear factor (NF)‑κB, receptor activator for nuclear factor‑κB (regulates and creates messages to begin inflammation)
Resveratrol cut the energy source of chemicals involved in oxidative breakdown and stress
- oxidative stress phosphorylated‑(p)‑AMP‑activated protein kinase and sirtuin 1 protein expression were significantly suppressed
Resveratrol enlisted chemicals involved in providing anti-oxidant activities
- heme oxygenase 1 (HO‑1) and nuclear factor erythroid 2‑related factor 2 (Nrf‑2) protein expression was stimulated in rats with osteoarthritis treated with resveratrol.

Resveratrol can reduce tissue damage

In the Journal of the Science of Food and Agriculture,(2) doctors at the University of Padova, (yes that Padova in Italy known for its vineyards that produce several high-quality red wines), examined several animal studies that measured the effects of Resveratrol on rheumatoid arthritis, osteoarthritis, and gout. They noted interesting results in terms of reduced tissue damage, restored cartilage homeostasis (cartilage stability), and decreased levels of uric acid (the problems with gout).

Of course, the French make great wine as well. Leading French researchers, writing in the journal Nutrients,(3) found that in rheumatoid arthritis, evidence suggests that resveratrol displayed anti-inflammatory, anti-catabolic (prevents breakdown), anti-apoptotic (prevents cell death) in various articular (cartilage) cell types, including chondrocytes (cartilage building blocks) and synoviocytes (the cells that regulate inflammation in the synovial fluid of joints). In preclinical models of osteoarthritis and rheumatoid arthritis, resveratrol has shown joint protective effects, mainly mediated by decreased production of pro-inflammatory and pro-degradative factors.

A May 2020 study in the journal Cells (4) comes to us from Italy. It confirmed the benefits of the resveratrol I mentioned above. Here are the summary learning points:

Resveratrol has a chondroprotective (cartilage protective) characteristic that helps limit cartilage matrix loss (the cartilage ingredients) during the early stages of the disease.
Resveratrol has an anti-apoptotic effect (an anti-oxidant characteristic of prevention of cell death, in this case, cartilage cell death), by shutting off harmful inflammation.
The chondroprotective activity of resveratrol was shown that resveratrol might be responsible for both anti-inflammatory effects and anticatabolic (stops cartilage breakdown)
Animal studies suggest that inflammation linked to obesity could be shut off by Resveratrol.
Taken together, all these studies provide a wide range of evidence of resveratrol-mediated biological activities with potentially beneficial outcomes in osteoarthritis.

Why your doctor may recommend Resveratrol and meloxicam

Your doctor or health care provider may recommend that you consider 500mg of Resveratrol with your meloxicam (anti-inflammatory) prescription.

Before I tell you why first a reminder that this type of recommendation is a pain management technique usually given to people to manage them along until they are ready for knee replacement surgery.
This type of recommendation is one we would not make to our patients receiving regenerative medicine injections.

In August 2018, doctors published research in the Journal of Medicinal Foods, where they measured the beneficial response of taking 500 mg per day resveratrol against placebo as an adjuvant or companion medication to make the meloxicam work better. An examination of one hundred ten men and women (45-75 years old) diagnosed with mild to moderate knee osteoarthritis found that resveratrol may be an effective “add-on” option as the resveratrol-treated group experienced a time-dependent (gradual but) significant decrease in pain severity. (5)

Why your doctor may recommend Resveratrol and other nutrients

Resveratrol and curcumin

The Curcumin family (curcuminoids), compounds of the spice turmeric, display an ability to alleviate and possibly stop osteoarthritis progression.

European researchers publishing in the medical journal Springerplus noted that the combination treatment of curcumin and resveratrol produced a synergistic effect. The two nutraceuticals worked in collaboration to shut off chronic destructive inflammation. (6)

For more about Turmeric/Curcumin please see my article curcumin and osteoarthritis.

Resveratrol and ginger

Researchers at Appalachian State University wrote in the Nutrition Journal of the effect of resveratrol, ginger root, and curcumin in a combined supplement. (7) Please see my article Ginger and Joint Pain | Research says it does help.

Resveratrol in strawberries

Resveratrol is found in high concentrations in the strawberry’s seeds. Strawberries are among the foods called super anti-inflammatory, super anti-oxidant, even super antibiotic. Please see my article Strawberries improve pain and reduce inflammation in obese adults with knee osteoarthritis

Please see my other articles on nutrition and chronic joint pain

Do you have questions about obesity and osteoarthritis? You can get help and information from our Caring Medical staff.

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This article was update January 17, 2021