Chondroitin sulfate

Identification

Generic Name
Chondroitin sulfate
DrugBank Accession Number
DB09301
Background

Chondroitin sulfate is a glycosaminoglycan considered as a symptomatic slow-acting drug for osteoarthritis (SYSADOA).1 The SYSADOA status suggested a pain relief and increased joint mobility after a relative long regular administration, as well as a long-lasting effect after the end of the treatment. Chondroitin sulfate is composed of alternating 1,3-N-acetyl-β-d-galactosamine and 1,4-β-d-glucuronic acid units which bear 4-O- and/or 6-O-sulfations at the N-acetylgalactosamine units disposed of in specific patterns. Depending on the predominating disaccharide unit, it will present different biological activities.2 Chondroitin sulfate is sold as an OTC dietary supplement in North America and it is a prescription drug under the EMA in Europe.4

Type
Small Molecule
Groups
Approved, Investigational, Nutraceutical
Synonyms
  • Chondroitin sulfates
  • Condroitín sulfato

Pharmacology

Indication

Chondroitin sulfate, used with glucosamine, is indicated to alleviate pain and inflammation from primary osteoarthritis.7 This supplement is reported to improve joint function and slow disease progression.8 Osteoarthritis is characterized by progressive structural and metabolic changes in joint tissues, mainly cartilage degradation, subchondral bone sclerosis and inflammation of synovial membrane.4

Studies have proposed the potential use of chondroitin sulfate as a nutraceutical in dietary supplements.3

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Symptomatic treatment ofArthritis••• •••••
Symptomatic treatment ofBackache••• •••••
Symptomatic treatment ofMuscle pain••• •••••
Symptomatic treatment ofMuscle strain••• •••••
Symptomatic treatment ofMuscle ache••• •••••
Associated Therapies
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Pharmacodynamics

In clinical trials, chondroitin sulfate has been reported a significant pain relief. Some reports have shown no slow in joint damage. The effects of chondroitin sulfate have been very controversial.8 One of the characteristics of chondroitin is a slow onset of action with a maximal effect attained after several months.4 Chondroitin sulfate has been reported to have anti-inflammatory properties by reducing the synovitis and prevent proinflammatory cytokine up-regulation in arthritis models.4

It is also registered an anabolic effect of chondroitin sulfate in which it induces the synthesis of hyaluronate in synovial cells, it increases type II collagen and proteoglycan synthesis.4

Mechanism of action

Chondroitin sulfate functions as a major component of the intricate extracellular matrix. It is proposed that chondroitin sulfate supply can provide new building blocks for the synthesis of new matrix components.4

The anti-inflammatory effect of chondroitin sulfate is thought to be caused by the inhibition of the synthesis of inflammatory intermediates such as the inhibition of nitric oxide synthase, COX-2, microsomal prostaglandin synthase 1 and prostaglandin E2. It is reported also an inhibitory activity in the toll-like receptor 4 which will later inhibit inflammatory cytokines, NFkB and MyD88. This activity suggests a modulation of the MAP kinase pathway. On the other hand, some reports have pointed out an induction on the PKC/PI3K/Akt pathway in neuroblastoma.4

The anabolic effect of chondroitin sulfate is suggested to be caused by the inhibition of metalloproteinases such as MMP-1, -3 and -13 as well as ADAMTS-4 and -5.4

TargetActionsOrganism
UBrain-derived neurotrophic factorNot AvailableHumans
UGlial cell line-derived neurotrophic factorNot AvailableHumans
UVascular endothelial growth factor ANot AvailableHumans
UC-C motif chemokine 2Not AvailableHumans
Absorption

Chondroitin sulfate is absorbed from the gastrointestinal tract.2 The absorbed portion reaches a ratio of 10% as unchanged chondroitin sulfate and 90% as depolymerized low-molecular-weight derivatives. This absorption depends on the sulfation status. The bioavailability of chondroitin sulfate ranges from 10-20% following oral administration. Reports have shown a consistent accumulation of the compound in joint tissue. The steady-state is attained after 3-4 days and it takes around 3-6 months to obtain the maximal effect.4

After intramuscular administration of chondroitin sulfate, the peak plasma level of 3.8 mcg/ml was reached after 90 min. When given orally, the peak plasma concentration of 4.6 mcg/ml was reached after 240 min.5

Volume of distribution

After intramuscular administration of chondroitin sulfate, the apparent volume of distribution was 0.40 ml/g. When administered orally, the apparent volume of distribution changed to 0.44ml/g.5

Protein binding

Chondroitin sulfate protein binding reports have shown a very low percentage of protein binding of only 0.23% of the total protein.6

Metabolism

Chondroitin sulfate is not metabolized by cytochrome P450.4 Reports have indicated the presence in plasma of mono-, oligo- and polysaccharides with a molecular weight of less of 5 kDa which are derived from the partial digestion of exogenous chondroitin sulfate.5 The reported degradation of chondroitin sulfate seems to be very complex and led by the formation of smaller digestion derivatives of the original form.9

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Route of elimination

Chondroitin sulfate is excreted in the urine as intact polymers and as partial degradation products.2 After intramuscular administration, about 37% of the administered dose is excreted by urine during the first 24 hours as high- and low-molecular-weight derivatives.5

Half-life

The approximate half-life of chondroitin sulfate and its derivative metabolites is 15 hours.4 After intramuscular administration of chondroitin sulfate in humans, the elimination half-life of the chondroitin sulfate was of 275 min. When administered orally, the elimination half-life was presented at 310 min.5

Clearance

Not Available

Adverse Effects
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Toxicity

Chondroitin sulfate does not present a carcinogenic potential.7 On tolerability assays, it has been shown to present great safety and good tolerability without significant severe side effects.4

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbacavirAbacavir may decrease the excretion rate of Chondroitin sulfate which could result in a higher serum level.
AceclofenacAceclofenac may decrease the excretion rate of Chondroitin sulfate which could result in a higher serum level.
AcemetacinAcemetacin may decrease the excretion rate of Chondroitin sulfate which could result in a higher serum level.
AcenocoumarolChondroitin sulfate may increase the anticoagulant activities of Acenocoumarol.
AcetazolamideAcetazolamide may increase the excretion rate of Chondroitin sulfate which could result in a lower serum level and potentially a reduction in efficacy.
Food Interactions
No interactions found.

Products

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Product Ingredients
IngredientUNIICASInChI Key
Chondroitin sulfate (bovine)6IC1M3OG5Z9007-28-7Not applicable
Chondroitin sulfate (chicken)7VZ9466BABNot AvailableNot applicable
Chondroitin sulfate (porcine)V5E8ELO4W9Not AvailableNot applicable
Chondroitin sulfate (shark)2ZAJ1K50XHNot AvailableNot applicable
Chondroitin sulfate sodium (bovine)8QTV3DTT8W39455-18-0Not applicable
Chondroitin sulfate sodium (chicken)4T078B3Z6VNot AvailableNot applicable
Chondroitin sulfate sodium (porcine)R27OH35FYQNot AvailableNot applicable
Chondroitin sulfate sodium (shark)Q75WVO004LNot AvailableNot applicable
Over the Counter Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
CONSULF CAPSULESCapsule400 mgOralAV MANUFACTURING SDN.BHD2013-12-262017-01-19Malaysia flag
THERAFLEX Glucosamine Plus MaxCapsule500 mg/1OralBayer Healthcare Llc.2015-07-01Not applicableUS flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
AdaxilChondroitin sulfate sodium (bovine) (600 mg) + Glucosamine sulfate (750 mg)PowderOralMYLAN HEALTHCARE SDN. BHD.2020-09-08Not applicableMalaysia flag
Appeton Essentials Glucosamine 500 + Chondroitin 400 TabletChondroitin sulfate sodium (bovine) (400 mg) + Glucosamine sulfate potassium chloride (500 mg)TabletOralKOTRA PHARMA (M) SDN. BHD.2020-09-08Not applicableMalaysia flag
Arthro CapsuleChondroitin sulfate sodium (bovine) (200 mg) + Glucosamine sulfate (375 mg)CapsuleOralSTERILINE SDN. BHD.2020-09-08Not applicableMalaysia flag
ARTHRO-S Powder for Oral SolutionChondroitin sulfate sodium (bovine) (1200 mg) + Glucosamine sulfate potassium chloride (1500 mg)PowderOralNoripharma Sdn. Bhd.2020-09-08Not applicableMalaysia flag
ARTROFORT(R) COMPLEXChondroitin sulfate (bovine) (600 mg) + Glucosamine (750 mg)PowderOralบริษัท เมด้า ฟาม่าร์ (ประเทศไทย) จำกัด2011-11-04Not applicableThailand flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
Medi-flexx Rx Joint Support FormulaChondroitin sulfate (chicken) (400 mg/1) + Dimethyl sulfone (200 mg/1) + Glucosamine sulfate (500 mg/1)TabletOralTwo Hip Consulting, Llc2014-12-052016-04-11US flag
Remaxazon External PatchChondroitin sulfate sodium (bovine) (3 g/100g) + Capsaicin (.0285 g/100g) + Glucosamine (5 g/100g) + Lidocaine (4 g/100g)PatchTopicalHome Aide Diganostics, Inc.2015-03-09Not applicableUS flag

Categories

ATC Codes
M01AX25 — Chondroitin sulfate
Drug Categories
Classification
Not classified
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
Not Available
CAS number
24967-93-9
InChI Key
Not Available
InChI
Not Available
IUPAC Name
Not Available
SMILES
Not Available

References

General References
  1. Monfort J, Pelletier JP, Garcia-Giralt N, Martel-Pelletier J: Biochemical basis of the effect of chondroitin sulphate on osteoarthritis articular tissues. Ann Rheum Dis. 2008 Jun;67(6):735-40. Epub 2007 Jul 20. [Article]
  2. da Cunha AL, de Oliveira LG, Maia LF, de Oliveira LF, Michelacci YM, de Aguiar JA: Pharmaceutical grade chondroitin sulfate: Structural analysis and identification of contaminants in different commercial preparations. Carbohydr Polym. 2015 Dec 10;134:300-8. doi: 10.1016/j.carbpol.2015.08.006. Epub 2015 Aug 8. [Article]
  3. Volpi N: Quality of different chondroitin sulfate preparations in relation to their therapeutic activity. J Pharm Pharmacol. 2009 Oct;61(10):1271-80. doi: 10.1211/jpp/61.10.0002. [Article]
  4. Henrotin Y, Mathy M, Sanchez C, Lambert C: Chondroitin sulfate in the treatment of osteoarthritis: from in vitro studies to clinical recommendations. Ther Adv Musculoskelet Dis. 2010 Dec;2(6):335-48. doi: 10.1177/1759720X10383076. [Article]
  5. Ronca G, Conte A: Metabolic fate of partially depolymerized shark chondroitin sulfate in man. Int J Clin Pharmacol Res. 1993;13 Suppl:27-34. [Article]
  6. Saito A, Munakata H: Analysis of plasma proteins that bind to glycosaminoglycans. Biochim Biophys Acta. 2007 Feb;1770(2):241-6. doi: 10.1016/j.bbagen.2006.10.015. Epub 2006 Nov 7. [Article]
  7. Chemical selection summary [Link]
  8. Arthritis foundation [Link]
  9. Metafishnet [Link]
KEGG Drug
D00080
KEGG Compound
C00607
PubChem Substance
347910430
RxNav
2473
Wikipedia
Chondroitin_sulfate
MSDS
Download (143 KB)

Clinical Trials

Clinical Trials

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
Drug delivery systemOral
CapsuleOral
TabletOral500 mg
Granule, for solutionOral800 MG
Powder, for solutionOral
CapsuleOral
Granule, for solutionOral
TabletOral800.000 mg
TabletOral800 mg
GelOral1200 MG
CapsuleOral400 mg
Powder, for suspensionOral
Tablet, coatedOral
Capsule, liquid filledOral
Powder, for solutionOral1200 mg
PowderOral1200.000 mg
GranuleOral
Capsule, coatedOral
GelTopical0.445 %
CreamTopical40 g
CapsuleOral150 MG
CapsuleOral300 MG
SolutionOral
Tablet, effervescentOral
PowderOral
Tablet, film coated
Granule, for solutionOral400 MG
Injection, solutionIntramuscular100 MG/4ML
TabletOral
SolutionOphthalmic1.0000 mg
TabletOral400 mg
Tablet, delayed releaseOral
PowderOral1500.000 mg
PatchTopical
Tablet, film coatedOral
SolutionOphthalmic
SolutionOphthalmic; Topical
CapsuleOral500 mg
CapsuleOral500 mg/1
CapsuleOral400.00 mg
TabletOral300.000 mg
Capsule
CreamTopical
CapsuleOral450 mg
Prices
Not Available
Patents
Not Available

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)190-194ºCLipowitz A. and Newton C. Degenerative joint disease and traumatic arthritis.
water solubilitySoluble'MSDS'
pKa1.5-2Chandran P. and Horkay F. (2012). Acta Biomater.
Predicted Properties
Not Available
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
Not Available
Chromatographic Properties
Collision Cross Sections (CCS)
Not Available

Targets

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Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Neurotrophin trkb receptor binding
Specific Function
During development, promotes the survival and differentiation of selected neuronal populations of the peripheral and central nervous systems. Participates in axonal growth, pathfinding and in the m...
Gene Name
BDNF
Uniprot ID
P23560
Uniprot Name
Brain-derived neurotrophic factor
Molecular Weight
27817.72 Da
References
  1. Nandini CD, Mikami T, Ohta M, Itoh N, Akiyama-Nambu F, Sugahara K: Structural and functional characterization of oversulfated chondroitin sulfate/dermatan sulfate hybrid chains from the notochord of hagfish. Neuritogenic and binding activities for growth factors and neurotrophic factors. J Biol Chem. 2004 Dec 3;279(49):50799-809. Epub 2004 Sep 22. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Receptor binding
Specific Function
Neurotrophic factor that enhances survival and morphological differentiation of dopaminergic neurons and increases their high-affinity dopamine uptake.
Gene Name
GDNF
Uniprot ID
P39905
Uniprot Name
Glial cell line-derived neurotrophic factor
Molecular Weight
23719.85 Da
References
  1. Nandini CD, Mikami T, Ohta M, Itoh N, Akiyama-Nambu F, Sugahara K: Structural and functional characterization of oversulfated chondroitin sulfate/dermatan sulfate hybrid chains from the notochord of hagfish. Neuritogenic and binding activities for growth factors and neurotrophic factors. J Biol Chem. 2004 Dec 3;279(49):50799-809. Epub 2004 Sep 22. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Vascular endothelial growth factor receptor binding
Specific Function
Growth factor active in angiogenesis, vasculogenesis and endothelial cell growth. Induces endothelial cell proliferation, promotes cell migration, inhibits apoptosis and induces permeabilization of...
Gene Name
VEGFA
Uniprot ID
P15692
Uniprot Name
Vascular endothelial growth factor A
Molecular Weight
27042.205 Da
References
  1. Nandini CD, Mikami T, Ohta M, Itoh N, Akiyama-Nambu F, Sugahara K: Structural and functional characterization of oversulfated chondroitin sulfate/dermatan sulfate hybrid chains from the notochord of hagfish. Neuritogenic and binding activities for growth factors and neurotrophic factors. J Biol Chem. 2004 Dec 3;279(49):50799-809. Epub 2004 Sep 22. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
General Function
Not Available
Specific Function
Not Available
Gene Name
CCL2
Uniprot ID
P13500
Uniprot Name
C-C motif chemokine 2
Molecular Weight
11024.87 Da
References
  1. Distler JH, Jungel A, Caretto D, Schulze-Horsel U, Kowal-Bielecka O, Gay RE, Michel BA, Muller-Ladner U, Kalden JR, Gay S, Distler O: Monocyte chemoattractant protein 1 released from glycosaminoglycans mediates its profibrotic effects in systemic sclerosis via the release of interleukin-4 from T cells. Arthritis Rheum. 2006 Jan;54(1):214-25. [Article]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Receptor binding
Specific Function
Plays an important role in the degradation of dermatan and keratan sulfates.
Gene Name
GUSB
Uniprot ID
P08236
Uniprot Name
Beta-glucuronidase
Molecular Weight
74731.46 Da
References
  1. Metafishnet [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Protein homodimerization activity
Specific Function
Responsible for the degradation of GM2 gangliosides, and a variety of other molecules containing terminal N-acetyl hexosamines, in the brain and other tissues.
Gene Name
HEXB
Uniprot ID
P07686
Uniprot Name
Beta-hexosaminidase subunit beta
Molecular Weight
63110.745 Da
References
  1. Metafishnet [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Sulfuric ester hydrolase activity
Specific Function
Not Available
Gene Name
GALNS
Uniprot ID
P34059
Uniprot Name
N-acetylgalactosamine-6-sulfatase
Molecular Weight
58025.575 Da
References
  1. Metafishnet [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Required for the lysosomal degradation of heparan sulfate and dermatan sulfate.
Specific Function
Iduronate-2-sulfatase activity
Gene Name
IDS
Uniprot ID
P22304
Uniprot Name
Iduronate 2-sulfatase
Molecular Weight
61872.405 Da
References
  1. Metafishnet [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Not Available
Specific Function
L-iduronidase activity
Gene Name
IDUA
Uniprot ID
P35475
Uniprot Name
Alpha-L-iduronidase
Molecular Weight
72669.19 Da
References
  1. Metafishnet [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Removes sulfate groups from chondroitin-4-sulfate (C4S) and regulates its degradation (PubMed:19306108). Involved in the regulation of cell adhesion, cell migration and invasion in colonic epithelium (PubMed:19306108). In the central nervous system, is a regulator of neurite outgrowth and neuronal plasticity, acting through the control of sulfate glycosaminoglycans and neurocan levels (By similarity).
Specific Function
Arylsulfatase activity
Gene Name
ARSB
Uniprot ID
P15848
Uniprot Name
Arylsulfatase B
Molecular Weight
59686.71 Da
References
  1. Metafishnet [Link]

Drug created at November 11, 2015 19:54 / Updated at February 13, 2021 11:02