Asthma Exacerbation Associated With Glucosamine-Chondroitin Supplement

Alfred F. Tallia, MD, MPH, Dennis A. Cardone, DO

Disclosures

J Am Board Fam Med. 2002;15(6) 

In This Article

Literature Search

A MEDLINE electronic literature search was performed using the MeSH terms "glucosamine," "chondroitin sulfate," "alternative medicine," and "dietary supplements," which were combined with the term "asthma" for articles published from 1980 through 2002. Six articles were found using the terms "glucosamine" and "asthma," and five were found using the terms "chondroitin" and "asthma." Thirteen articles were found using "dietary supplements" and "asthma," and 72 were found combining "alternative medicine" and "asthma." A total of 117 articles on glucosamine therapy alone and 110 on chondroitin therapy alone were also found. A review of all these articles found no case reports of asthma or asthma exacerbation with either of these dietary supplements alone or combined. It did find, however, a possible biochemical linkage between both substances and the respiratory tree of asthmatic patients, as described below.

Antibodies to chondroitin sulfate are found in higher concentrations in the airways of persons with asthma than in those without, even in the face of steroid administration.[9] In a study by Huang and colleagues,[10] deposition of chondroitin sulfate proteoglycan in the airways was increased significantly in asthmatic patients when compared with control subjects. Furthermore, the degree of proteoglycan immunoreactivity was significantly correlated with airway responsiveness in persons with asthma, suggesting proteoglycans such as chondroitin might play a role in airway wall remodeling and mechanics in asthma.

Glucosamine-containing antigen preparations have been found to be allergenic in asthmatic patients who have sea squirt allergy.[11] Whether glucosamine itself is responsible for the allergic response is unknown, but the possibility is plausible. These studies collectively provide a biochemical link to a possible immune response in asthmatic patients. Elucidation of the immunology of asthma is rapidly advancing.[12]

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