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  1. Fulltext 2019 revised algorithm for the management of knee osteoarthritis: the Southeast Asian viewpoint
    Yeap SS, Tanavalee A, Perez EC, Tan MP, Reyes BHM, Lee JK, et al.
    Aging Clin Exp Res, 2021 May;33(5):1149-1156.
    PMID: 33774784 DOI: 10.1007/s40520-021-01834-x
    BACKGROUND: Since 2014, the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) algorithm for the management of knee osteoarthritis (OA) is available worldwide.

    AIM: Based on this document, a Southeast Asia Working Group (SEAWG) wished to see how the new ESCEO algorithm developed in 2019 was perceived by Southeast Asian experts and how it was integrated into their clinical practice.

    METHODS: A SEAWG was set up between members of the international ESCEO task force and a group of Southeast Asian experts.

    RESULTS: Non-pharmacological management should always be combined with pharmacological management. In step 1, symptomatic slow-acting drugs for osteoarthritis are the main background therapy, for which high-quality evidence is available only for the formulations of patented crystalline glucosamine sulfate and chondroitin sulfate. In step 2, oral NSAIDs are a useful option, considering the cardiovascular/renal/gastrointestinal profiles of the individual patient. Intra-articular hyaluronic acid and corticosteroids are a possible alternative to oral NSAIDs, but limited evidence is available. If steps 1 and 2 do not give adequate relief of symptoms, tramadol can be used, but its safety is debated. In general, the indications of the ESCEO algorithm are important in Southeast Asian countries, but the reimbursement criteria of local health systems are an important aspect for adherence to the ESCEO algorithm.

    CONCLUSION: This guidance provides evidence-based and easy-to-follow advice on how to establish a treatment algorithm in knee OA, for practical implementation in clinical practice in Southeast Asian countries.

    Matched MeSH terms: Chondroitin Sulfates/therapeutic use
  2. Fulltext A pilot study to Assess Serum Potassium Levels and Haemolysis in Red Cell Units
    Nurimatussolehah Sarijan, Sabariah Md Noor, Tun Maizura Mohd Fathullah, Malina Osman, Zainina Seman
    Malaysian Journal of Medicine and Health Sciences, 2018;14(103):1-5.
    MyJurnal
    Percentage of haemolysis is widely used as a quality parameter to assess red blood cell viability in blood banking. In certain blood banks, serum potassium level is used due to the unavailability of the former test. The relationship between these two tests, however, is still unclear. The objective of this study is to determine the association between haemolysis measured using two different methods for quality control. Methods: A total of forty-four samples of packed red cell in citrate-phosphate-dextrose with optisol were randomly selected from donation drives. Nine millilitres of blood was collected weekly starting from day-2 of storage, followed by day-7, 14, 21, 28, 35 and 42 for assessment of red blood cell haemolysis by measuring serum potassium level and percentage of haemolysis.Results: These two parameters were correlated significantly with a positive moderate linear relationship on day 7, 21 and 28 with r = 0.393, 0.448 and 0.425, respectively and p-values less than 0.01. The linear regression analysis showed there was a significant regression equation which could be used to predict the serum potassium level from the percentage of haemolysis. Conclusion: There were significant increases in the percentage of haemolysis and serum potassium level in the packed red cell units with storage. The serum potassium level would be able to be predicted from the percentage of haemolysis using the regression equations on day 7, 21 and 28. The serum potassium measurement could be used as an alternative test to the percentage of haemolysis before issuing blood.
    Matched MeSH terms: Chondroitin Sulfates
  3. Use of dermal regeneration template (INTEGRA) in reconstructive burn surgery
    Sasidaran R, Dorai AA, Sulaiman WA, Halim AS
    Med J Malaysia, 2008 Jul;63 Suppl A:29.
    PMID: 19024967
    We present our two year experience with a dermal regeneration template (INTEGRA) in burn reconstructive surgery for contracture release as well as a reconstructive tool for management of soft tissue loss.
    Matched MeSH terms: Chondroitin Sulfates*
  4. Chondroitin 6-sulfate and dextran sulfate promote hypochlorite-induced peroxidation of phosphatidylcholine liposomes
    Vakhrusheva T, Panasenko O
    Chem Phys Lipids, 2006 Apr;140(1-2):18-27.
    PMID: 16458872
    In this work, we studied whether chondroitin sulfates and dextran sulfates (DXSs) can influence hypochlorite-induced peroxidation of phosphatidylcholine (PC) liposomes. Multilamellar liposomes (2 mg lipid/ml) were prepared in phosphate buffer, pH 7.4, with NaCl or not and exposed to reagent HOCl/ClO- (1mM) at 37 degrees C in the presence of different concentrations of chondroitin 6-sulfate (C6S), chondroitin 4-sulfate (C4S), DXS 8000, DXS 40,000, and DXS 500,000. Lipid peroxidation was assessed by thiobarbituric acid-reactive substance (TBARS) production. DXSs and C6S enhanced TBARS production in a dose-dependent manner. The decline in TBARS production at the relatively high C6S concentrations may be attributed to C4S present in C6S, since in contrast to C6S, C4S is known to react with hypochlorite. Dextrans, nonsulfated analogues of DXS, failed to modulate TBARS production. This fact indicates the important role of negatively charged sulfate groups for DXS to facilitate hypochlorite-induced peroxidation of PC liposomes. The electrostatic nature of the mechanism providing for the pro-oxidative effect of DXS was also supported by the influence of liposome surface charge and solution ionic strength on the extent of liposome peroxidation. The addition of calcium ions to the incubation mixture did not prevent the pro-oxidative action of DXS. The relevance of the results to atherogenesis is discussed.
    Matched MeSH terms: Chondroitin Sulfates/chemistry*
  5. The Combined Effect of Substrate Stiffness and Surface Topography on Chondrogenic Differentiation of Mesenchymal Stem Cells
    Wu Y, Yang Z, Law JB, He AY, Abbas AA, Denslin V, et al.
    Tissue Eng Part A, 2017 01;23(1-2):43-54.
    PMID: 27824280 DOI: 10.1089/ten.TEA.2016.0123
    Stem cell differentiation is guided by contact with the physical microenvironment, influence by both topography and mechanical properties of the matrix. In this study, the combined effect of substratum nano-topography and mechanical stiffness in directing mesenchymal stem cell (MSC) chondrogenesis was investigated. Three polyesters of varying stiffness were thermally imprinted to create nano-grating or pillar patterns of the same dimension. The surface of the nano-patterned substrate was coated with chondroitin sulfate (CS) to provide an even surface chemistry, with cell-adhesive and chondro-inductive properties, across all polymeric substrates. The surface characteristic, mechanical modulus, and degradation of the CS-coated patterned polymeric substrates were analyzed. The cell morphology adopted on the nano-topographic surfaces were accounted by F-actin distribution, and correlated to the cell proliferation and chondrogenic differentiation outcomes. Results show that substratum stiffness and topographical cues affected MSC morphology and aggregation, and influenced the phenotypic development at the earlier stage of chondrogenic differentiation. Hyaline-like cartilage with middle/deep zone cartilage characteristics was generated on softer pillar surface, while on stiffer nano-pillar material MSCs showed potential to generate constituents of hyaline/fibro/hypertrophic cartilage. Fibro/superficial zone-like cartilage could be derived from nano-grating of softer stiffness, while stiffer nano-grating resulted in insignificant chondrogenesis. This study demonstrates the possibility of refining the phenotype of cartilage generated from MSCs by manipulating surface topography and material stiffness.
    Matched MeSH terms: Chondroitin Sulfates/chemistry*
  6. XPS study of sulfur and phosphorus compounds with different oxidation states
    Leanne Britcher, Sunil Kumar, Hans J. Griesser, Kim S. Siow
    Sains Malaysiana, 2018;47:1913-1922.
    In this report, we demonstrate that continuous improvement in XPS instruments and the calibration standards as well
    as analysis with standard component-fitting procedures can be used to determine the binding energies of compounds
    containing phosphorus and sulfur of different oxidation states with higher confidence. Based on such improved XPS
    analyses, the binding energies (BEs) of S2p signals for sulfur of increasing oxidation state are determined to be 166-167.5
    eV for S=O in dimethyl sulfoxide, 168.1 eV for S=O2
    in polysulfone, 168.4 eV for SO3
    in polystyrene sulfonate and 168.8
    eV for SO4
    in chondroitin sulfate. The BEs of P2p signals show the following values: 132.9 eV for PO3
    in triisopropyl
    phosphite, 133.3 eV for PO4
    in glycerol phosphate, 133.5 eV for PO4
    in sodium tripolyphosphate and 134.0 eV for PO4
    in sodium hexametaphosphate. These results showed that there are only small increases in the binding energy when
    additional oxygen atoms are added to the S-O chemical group. A similar result is obtained when the fourth oxygen or
    poly-phosphate environment is added to the phosphorus compound. These BE values are useful to researchers involved
    in identifying oxidation states of phosphorus and sulfur atoms commonly observed on modified surfaces and interfaces
    found in applications such as biomaterials, super-capacitors and catalysis.
    Matched MeSH terms: Chondroitin Sulfates
  7. A preliminary study of the effects of glucosamine sulphate and chondroitin sulphate on surgically treated and untreated focal cartilage damage
    Kamarul T, Ab-Rahim S, Tumin M, Selvaratnam L, Ahmad TS
    Eur Cell Mater, 2011 Mar 15;21:259-71; discussion 270-1.
    PMID: 21409755
    The effects of Glucosamine Sulphate (GS) and Chondroitin Sulphate (CS) on the healing of damaged and repaired articular cartilage were investigated. This study was conducted using 18 New Zealand white rabbits as experimental models. Focal cartilage defects, surgically created in the medial femoral condyle, were either treated by means of autologous chondrocyte implantation (ACI) or left untreated as controls. Rabbits were then divided into groups which received either GS+/-CS or no pharmacotherapy. Three rabbits from each group were sacrificed at 12 and 24 weeks post-surgery. Knees dissected from rabbits were then evaluated using gross quantification of repair tissue, glycosaminoglycan (GAG) assays, immunoassays and histological assessments. It was observed that, in contrast to untreated sites, surfaces of the ACI-repaired sites appeared smooth and continuous with the surrounding native cartilage. Histological examination demonstrated a typical hyaline cartilage structure; with proteoglycans, type II collagen and GAGs being highly expressed in repair areas. The improved regeneration of these repair sites was also noted to be significant over time (6 months vs. 3 months) and in GS and GS+CS groups compared to the untreated (without pharmacotherapy) group. Combination of ACI and pharmacotherapy (with glucosamine sulphate alone/ or with chondroitin sulphate) may prove beneficial for healing of damaged cartilage, particularly in relation to focal cartilage defects.
    Matched MeSH terms: Chondroitin Sulfates/pharmacology*
  8. Fulltext Hybrid Collagen Hydrogel/Chondroitin-4-Sulphate Fortified with Dermal Fibroblast Conditioned Medium for Skin Therapeutic Application
    Maarof M, Mohd Nadzir M, Sin Mun L, Fauzi MB, Chowdhury SR, Idrus RBH, et al.
    Polymers (Basel), 2021 Feb 08;13(4).
    PMID: 33567703 DOI: 10.3390/polym13040508
    The current strategy for rapid wound healing treatment involves combining a biomaterial and cell-secreted proteins or biomolecules. This study was aimed at characterizing 3-dimensional (3D) collagen hydrogels fortified with dermal fibroblast-conditioned medium (DFCM) as a readily available acellular skin substitute. Confluent fibroblasts were cultured with serum-free keratinocyte-specific medium (KM1 and KM2) and fibroblast-specific medium (FM) to obtain DFCM. Subsequently, the DFCM was mixed with collagen (Col) hydrogel and chondroitin-4-sulphate (C4S) to fabricate 3D constructs termed Col/C4S/DFCM-KM1, Col/C4S/DFCM-KM2, and Col/C4S/DFCM-FM. The constructs successfully formed soft, semi-solid and translucent hydrogels within 1 h of incubation at 37 °C with strength of <2.5 Newton (N). The Col/C4S/DFCM demonstrated significantly lower turbidity compared to the control groups. The Col/C4S/DFCM also showed a lower percentage of porosity (KM1: 35.15 ± 9.76%; KM2: 6.85 ± 1.60%; FM: 14.14 ± 7.65%) compared to the Col (105.14 ± 11.87%) and Col/C4S (143.44 ± 27.72%) constructs. There were no changes in both swelling and degradation among all constructs. Fourier transform infrared spectrometry showed that all groups consisted of oxygen-hydrogen bonds (O-H) and amide I, II, and III. In conclusion, the Col/C4S/DFCM constructs maintain the characteristics of native collagen and can synergistically deliver essential biomolecules for future use in skin therapeutic applications.
    Matched MeSH terms: Chondroitin Sulfates
  9. Fulltext Cell-based therapy for the treatment of focal articular cartilage lesions: a review of six years od studies in a Malaysian University Medical Centre
    Samsudin EZ, Kamarul T
    JUMMEC, 2014;17(2):1-11.
    MyJurnal
    Autologous chondrocyte implantation (ACI) is a significant technique that has gained widespread use for the treatment of focal articular cartilage damage. Since its inception in 2004, the Tissue Engineering Group (TEG) of the Faculty of Medicine, University Malaya has been dedicated to carrying out extensive research on this cell-based therapy. The objective of this report, comprising one clinical case report, six animal studies and one laboratory study, is to summarise and discuss TEG’s key findings. On the whole, we observed that the ACI technique was effective in regenerating hyaline-like cartilage in treated defects. Autologous chondrocytes and mesenchymal stem cells (MSC) were found to produce comparable tissue repair irrespective of the state of MSC differentiation, and the use of alginate-based scaffolding and oral pharmacotherapy (Glucosamine and Chondroitin Sulphate) was shown to enhance ACI-led tissue repair. ACI is suggested to be an efficient therapeutic option for the treatment of articular cartilage defects of the knee.
    Matched MeSH terms: Chondroitin Sulfates
  10. The effect of tocotrienol-rich fraction on the expression of glutathione s-transferase isoenzymes in mice liver
    Ahmed Atia, Nadia Salem Alrawaiq, Azman Abdullah
    Sains Malaysiana, 2018;47:2799-2809.
    Glutathione S-transferase isoenzymes (GSTs) catalyze the conjugation reaction between glutathione and electrophilic
    compounds. GSTs are involved in the detoxification of toxic and carcinogenic compounds, thus protecting the body from
    toxic injuries. Tocotrienols are part of the vitamin E family and is believed to possess potent antioxidant activity. The
    objective of this study was to determine the effect of increasing doses of tocotrienol rich fraction (TRF) supplementation
    on liver GSTs gene and protein expression. A total of 30 male ICR white mice were divided into five groups (n=6 for each
    group) and given treatment for 14 days through oral supplementation. Groups were divided as follows: - three groups
    administered with TRF at doses of 200, 500 and 1000 mg/kg, respectively, a positive control group administered with 100
    mg/kg butylated hydroxyanisole (BHA) and a control group administered with only the vehicle (corn oil). At day 15, the
    mice were sacrificed and their livers isolated. Total RNA was extracted from the liver and quantitative real-time polymerase
    chain reaction (qPCR) assays were performed to analyze GSTs gene expression. Total liver protein was also extracted
    and the protein expression of GSTs was determined by Western blotting. The results showed that TRF oral supplementation
    caused a significant dose-dependent increase in liver GST isoenzymes gene and protein expression, compared to controls.
    In conclusion, TRF oral supplementation for 14 days resulted in increased gene and protein expression of GST isoenzymes
    in mice liver dose-dependently, with the highest expression seen in mice treated with 1000 mg/kg TRF.
    Matched MeSH terms: Chondroitin Sulfates
  11. The role of specific Smad linker region phosphorylation in TGF-β mediated expression of glycosaminoglycan synthesizing enzymes in vascular smooth muscle
    Rostam MA, Kamato D, Piva TJ, Zheng W, Little PJ, Osman N
    Cell Signal, 2016 08;28(8):956-66.
    PMID: 27153775 DOI: 10.1016/j.cellsig.2016.05.002
    Hyperelongation of glycosaminoglycan chains on proteoglycans facilitates increased lipoprotein binding in the blood vessel wall and the development of atherosclerosis. Increased mRNA expression of glycosaminoglycan chain synthesizing enzymes in vivo is associated with the development of atherosclerosis. In human vascular smooth muscle, transforming growth factor-β (TGF-β) regulates glycosaminoglycan chain hyperelongation via ERK and p38 as well as Smad2 linker region (Smad2L) phosphorylation. In this study, we identified the involvement of TGF-β receptor, intracellular serine/threonine kinases and specific residues on transcription factor Smad2L that regulate glycosaminoglycan synthesizing enzymes. Of six glycosaminoglycan synthesizing enzymes, xylosyltransferase-1, chondroitin sulfate synthase-1, and chondroitin sulfotransferase-1 were regulated by TGF-β. In addition ERK, p38, PI3K and CDK were found to differentially regulate mRNA expression of each enzyme. Four individual residues in the TGF-β receptor mediator Smad2L can be phosphorylated by these kinases and in turn regulate the synthesis and activity of glycosaminoglycan synthesizing enzymes. Smad2L Thr220 was phosphorylated by CDKs and Smad2L Ser250 by ERK. p38 selectively signalled via Smad2L Ser245. Phosphorylation of Smad2L serine residues induced glycosaminoglycan synthesizing enzymes associated with glycosaminoglycan chain elongation. Phosphorylation of Smad2L Thr220 was associated with XT-1 enzyme regulation, a critical enzyme in chain initiation. These findings provide a deeper understanding of the complex signalling pathways that contribute to glycosaminoglycan chain modification that could be targeted using pharmacological agents to inhibit the development of atherosclerosis.
    Matched MeSH terms: Chondroitin Sulfates/metabolism
  12. Cultured epidermal autografts in combination with MEEK Micrografting technique in the treatment of major burn injuries
    Dorai AA, Lim CK, Fareha AC, Halim AS
    Med J Malaysia, 2008 Jul;63 Suppl A:44.
    PMID: 19024976
    The treatment of major burn injuries are a formidable challenge to the burn surgeon. Early aggressive surgery for deep to full thickness burn injuries is vital in the prevention of infection. The ultimate goal in major burn injuries is to prevent the onset of multi-resistant organisms and achieve early wound cover. The field of tissue engineering can help to expedite the healing of these burn wounds. The development of keratinocyte culture delivery system can be used clinically to fasten the healing process and save many lives.
    Matched MeSH terms: Chondroitin Sulfates
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