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The effect of plant extracts on the management and progression of osteoarthritis (Master thesis)

Κουβάτσου, Αικατερίνη/ Kouvatsou, Aikaterini/ Τρόφιμα, Διατροφή και Μικροβίωμα

Introduction: Osteoarthritis is a highly prevalent chronic joint disorder characterized by pain, functional limitation and progressive whole-joint pathology. In recent years, plant-derived compounds and selected adjunctive biological interventions have attracted increasing interest as complementary approaches for osteoarthritis symptom management. Methods: This dissertation provides a literature review of clinical studies evaluating plant-derived compounds, nutraceutical formulations, food-derived bioactives and selected adjunctive biological interventions in adult populations with osteoarthritis. The synthesis focused primarily on symptomatic outcomes, including pain, physical function, stiffness, inflammatory biomarkers and safety. Due to heterogeneity in interventions, formulations, comparators, study designs and outcome measures, findings were synthesized narratively and tabulated rather than pooled quantitatively. Results: The available clinical evidence suggests that curcumin-based preparations and Boswellia-related interventions provide the most consistent signals for symptomatic improvement, although methodological and formulation heterogeneity limit the strength of conclusions. Dextrose prolotherapy was considered as a selected non-plant adjunctive intervention and showed generally favorable findings compared with saline or exercise controls, but its relative benefit appeared less consistent against other biological injectables such as platelet-rich plasma or autologous conditioned serum. Evidence for botulinum toxin type A and capsaicin/trans-capsaicin was mixed, as larger or more confirmatory studies did not consistently demonstrate superiority over controls. Crocin was interpreted as preliminary evidence based on one small randomized clinical base with secondary immunological and molecular analyses, while resveratrol evidence remained limited and was considered only in relation to osteoarthritis-specific findings. Conclusion: Overall, the available evidence supports a complementary, symptomfocused role for selected plant-derived and adjunctive biological interventions in osteoarthritis management. However, current evidence remains insufficient to support established disease-modifying effects. Larger, well-designed randomized controlled trials with standardized formulations, clinically relevant comparators and longer follow-up are needed to clarify efficacy, safety and potential structural effects.