Anticoagulant and antiplatelet effects of chondroitin sulfate
Molecules of chondroitin sulphate (CHS), from which the gel-based proteoglycans of connective tissue are synthesized, are important for the restoration of cartilage and have a marked anti-inflammatory effect. Osteoarthritis (OA) is accompanied by chronic inflammation and, therefore, refers to diseases with an increased risk of thrombosis. Systematic analysis results of experimental and clinical studies presented in this paper indicate the prospects for the use of standardized CHS extracts to achieve anticoagulant and antiplatelet effects. Anticoagulant CHS mechanisms are implemented by inhibiting the activation of coagulation factor X, antiaggregant mechanisms - by activating the CD44 receptor, which leads to inactivation of NF-kB signalling cascades of platelets. Thus, the use of chondroprotectors based on CHS in patients with OA can be considered simultaneously as a means of cardioprophylaxis, as the anticoagulant and antiplatelet effects of standardized CHS contribute to reducing the thromboembolic risk. Polypragmasia may be observed in patients with OA and comorbid diseases, due to the need for prescription of various anti-inflammatory, antithrombotic and chondroprotective agents. The use of CHS-based chondroprotective agents a with a high pharmaceutical standardization is pathogenetically substantiated to avoid adverse events in the treatment of patients with OA receiving antithrombotic therapy or NSAIDs.