[Effect of mud therapy on the state of blood coagulation and lipid metabolism in rabbits with experimental atherosclerosis].
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The trend in the aerobic reserve obtained from maximal oxygen utilization and other clinicophysiological indices was investigated for children with scoliosis stage I, II and III on pelotherapy and hydrokinesitherapy in the pool. The aim was to design therapeutic regiments differentiated by the patients' initial functional condition. Baseline reduction of the aerobic reserve was recorded in 35% of the examinees. The response to balneopelotherapy appeared more pronounced when the treatment was adjusted to initial functional condition of the child. Functional classes of scoliosis were defined to justify dosing of balneotherapy and peloids by temperature of water, mud, duration of the procedure and the whole course.
One hundred and ninety-nine children aged 7-14 and 177 adolescents in remission and minimal manifestations of rheumatoid arthritis (RA) were examined before and after fangotherapy with allowance for activity of the process, age-related reactivity. The comparison involved sympathetic-adrenal function (by urine excretion of epinephrine and norepinephrine), specific and nonspecific immune reactivity (by the level of IgA, IgM, IgG, circulating immune complexes, T and B lymphocytes; RF titers, leukocyte migration inhibition test), platelet components of hemostasis (number of platelets, adhesion induced by ADP and epinephrine).
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BACKGROUND: Mud pack therapy (MPT) influences the serum levels of several cytokines involved in chondrocyte metabolism and in the pathogenesis of osteoarthrosis. In fact, we have observed decreases of IL-1 and TNF-alpha, involved in cartilage inflammation and destruction, and increases of IGF-1 that have a protective influence on the cartilage. It is known that in osteoarthrosis MPT is also able to decrease pain, largely attributable to the inflammatory response. METHODS: We enrolled 31 subjects undergoing MPT and collected blood samples before and after the therapy to assay serum levels of prostaglandin (PGE2) and leukotriene (LTB4) compounds with potent inflammatory and algesic properties. RESULTS: The study shows a decrease in PGE2 and LTB4 serum levels in all the samples after MPT with no correlation between the PGE2 and LTB4 decreases. CONCLUSIONS: Mud pack therapy exerts a protective effect on the cartilage and is able to induce pain relief by reducing the inflammatory reaction.
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Mud pack therapy is an alternative mode of treatment for rheumatic diseases. It is based on the application of heated mud packs to the entire body or to specific areas, such as over joints. The aim of the current study was to evaluate the efficacy of treatment with mud compresses at patients' homes for osteoarthritis of the knee. Fifty-eight patients with osteoarthritis of the knee were enrolled in a prospective, double-blinded, controlled study. Forty patients were treated with natural mineral-rich mud compresses and 18 patients were treated with mineral-depleted mud compresses. Mud compresses were applied 5 times each week during 3 weeks for a total of 15 treatments. Patients were assessed at baseline, at completion of the 3-week treatment period, and twice after the conclusion of the treatment period-after 1 month and after 3 months. The main outcome measures were the Lequesne Index of severity of knee osteoarthritis, patient self-assessment of pain, and severity of knee pain on a visual analog scale. A reduction of 20% or more in the pain scores was considered clinically significant. In the group treated with natural mud compresses, a significant reduction in knee pain was observed at all assessments. Similarly, improvement in the Lequesne Index was seen at the end of therapy and a month after treatment. In the control group, given mineral-depleted mud compresses, no significant change in knee pain was seen at any assessment. Improvement in the Lequesne Index was seen 1 and 3 months after completion of the therapy, but not at the end of therapy. Seventy-two percent of the patients in the treatment group had an improvement of >20% in self-assessment of knee pain, compared with 33% in the control group (p = 0.005). The data suggest that treatment with mud compresses, but only in their natural form, temporarily relieves pain in patients with osteoarthritis of the knees. We believe that treatment with mud compresses might augment conventional medical therapy in these patients.
We have previously shown that thermal mud therapy is able to influence chondrocyte activity of osteoarthrosic patients by modulating the production of serum cytokines, such as interleukin 1, and this was related to the presence of an anti-inflammatory principle in mature thermal mud. Mud therapy influences many biochemical processes of the body, independently of the thermic stimulation alone and the present paper documents specific increases of insulin growth factor 1 and decreases of tumor necrosis factor alpha in serum of osteoarthrosic patients after 12 days of mud pack application.
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Several studies have demonstrated that matrix metalloproteinases (MMPs) are frequently implicated in the destruction of articular cartilage in arthritis. The control of MMP activity is dependent on the local concentration of tissue inhibitors of metalloproteinases (TIMPs), and the imbalance of the enzyme-to-inhibitor ratios plays an important role in the remodeling of articular tissues. Some cytokines such as interleukin (IL)-1 and tumor necrosis factor (TNF)-alpha which regulate leukocyte activities, promote MMP secretion and, as a consequence, cartilage degradation. The aim of the present study was to investigate whether a natural treatment is effective in reducing cartilage inflammation and degradation by influencing MMP and TIMP serum levels. Eighty patients with osteoarthritis (OA) were enrolled in the trial and were divided into group A (30 patients who did not undergo mud bath therapy), group B (28 patients repeating mud bath therapy more than 5 times and less than 10) and group C (22 patients repeating mud bath therapy more than 10 times). Blood samples were obtained from all the patients for assay of MMP-1, -2, -3, -8 and -9 and TIMP-1 and -2. The parameters were determined by an ELISA technique. Statistical indexes were calculated for each parameter and mean values were compared. The differences between mean values of MMP-3, -8 and -9 were statistically significant between group A and the treated groups (B and C). Analysis of variance established a significant difference (p < 0.05) between groups A and C in mean serum levels of MMP-8, MMP-9 showed a statistically significant difference (p < 0.05) in mean serum concentration between groups A and B. Regression analysis showed a very high R2 between MMP-2 and TIMP-2. One of the most interesting findings in this study was that MMP-3 serum levels were significantly lower in the treated groups, since this enzyme plays an important role in cartilage degradation, suggesting that mud bath therapy contributes to matrix integrity in OA cartilage. In contrast, MMP-8 and -9 were higher in the treated subjects and no correlation with TIMPs was evident. One possible explanation is that these enzymes are required for the efficient degradation and removal of already compromised cartilage matrix and that they operate as part of a matrix turnover and repair process. In conclusion, our data suggest that mud bath therapy alone is not able to influence chondrocyte metabolic activity in the advanced phases of OA. There could be a synergic and sequential association with pharmacologic therapy and/or interventions.