What does B1 have to do with osteoarthritis? Many patients have heard me discuss the importance of a balanced inflammatory system and the difference between acute and chronic inflammation. Chronic inflammation is a degenerative process while acute inflammation is a regenerative process. The difference between these two processes lies in the types of chemical signals present in the tissue as well as the concentration at which these signals are expressed.
In medicine, physiological substances are rarely “all good” or “all bad.” The innate wisdom of the body is such that there is a time and a place for every process— what tends to create pathology is when there is an imbalance in the process or the system.
What is CCL2?
One such example is the chemical substance known as CCL2. In an acute inflammatory process, such as the type we promote with PRP/PRF or Micro-fragmented Adipose Tissue, the CCL2 acts to facilitate communication of the mesenchymal stem cells to promote connective tissue regeneration.1 However, when that concentration of CCL2 persists at too high of a concentration for too long of a period, it actually promotes degenerative changes such as those seen in osteoarthritis.
The relationship between CCL2 and Vitamin B1
In a recent study in mice, it was found that fluid samples from joints with osteoarthritis after a meniscus injury had a marked reduction of vitamin B1. This reduced Vitamin B1 level coincided with increased levels of CCL2.2 When Vitamin B1 was added to the diet, the levels of CCL2 were decreased. They found that reduced CCL2 resulted in decreased instances of joint degeneration. Conversely, if CCL2 was reintroduced into the joint, the result was decreased vitamin B1 and an increase in joint degeneration.
Ultimately, this study was able to demonstrate that by reducing CCL2, vitamin B1 supplementation helped to significantly prevent cartilage loss and there was a significant reduction in osteophytes in subjects with osteoarthritis. That is why at ORM, we emphasize the importance of maintaining a balanced inflammatory response which often involves the addition of supplements including B vitamin complex. After an acute inflammatory response, we want the levels of inflammation to reduce back to “normal levels.” Many of the supplements we recommend help to re-balance the inflammatory system to prevent ongoing joint degeneration.
Dr. Kristian Flores, MD, ND, began his medical journey as a Naturopathic Doctor. He then earned his Medical Degree, completing an Internal Medicine internship as well as a residency in Physical Medicine and Rehabilitation (also known as Physiatry). As a Board Certified Physiatrist, Dr. Flores specializes in the prevention, diagnosis, and rehabilitation of people disabled by disease, disorder, or injury. He works extensively with patients suffering from acute and chronic pain conditions such as spine pain and sports injuries. His practice also includes helping patients with disabling conditions such as brain injury, long-covid, and hypermobility disorders.
Sources
1. CCL2 promotes osteogenesis by facilitating macrophage migration during acute inflammation. Goodman et al. Front. Cell Dev. Biol., 29 June 2023 Sec. Molecular and Cellular Pathology. Volume 11 – 2023 | https://doi.org/10.3389/fcell.2023.1213641
2. Dietary supplementation of vitamin B1 prevents the pathogenesis of osteoarthritis. Xiao et al. Proc Natl Acad Sci USA. 2024 Jul 23;121(30):e2408160121. doi: 10.1073/pnas.2408160121. Epub 2024 Jul 18
