Punicalagin from pomegranate: a polyphenolic modulator of inflammation and cartilage homeostasis in knee and joint pain

Aavrati Rastogi; Roop B. Kalia; Pradeep K. Meena; Mukesh Bairwa

doi:10.18203/2394-6040.ijcmph20262774

Authors

Aavrati Rastogi Department of Orthopedics, AIIMS Rishikesh, Uttarakhand, India https://orcid.org/0000-0002-8985-3143
Roop B. Kalia Department of Orthopedics, AIIMS Rishikesh, Uttarakhand, India https://orcid.org/0000-0002-3418-5942
Pradeep K. Meena Department of Orthopedics, AIIMS Rishikesh, Uttarakhand, India https://orcid.org/0000-0001-7278-3671
Mukesh Bairwa Department of Internal Medicine, AIIMS Rishikesh, Uttarakhand, India https://orcid.org/0000-0002-8974-5775

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20262774

Keywords:

Punicalagin, Pomegranate, Cartilage homeostasis

Abstract

Knee osteoarthritis is increasingly recognized as a multifactorial disorder rather than simple “wear and tear.” Pain and cartilage degradation are caused by oxidative stress, metabolic imbalance, and chronic low-grade inflammation. NF κB is a significant therapeutic target because it is a key regulator of inflammation which promotes the production of cytokines and matrix breakdown.

References

Shukla M, Gupta K, Rasheed Z, Khan KA, Haqqi TM. Consumption of hydrolyzable tannin-rich pomegranate extract suppresses inflammation and improves clinical symptoms in patients with knee osteoarthritis. Nutrition. 2008;24(7–8):733 43. PMID: 18547657.

Rasheed Z, Akhtar N, Khan A, Haqqi TM. Anti inflammatory effects of pomegranate extract on human osteoarthritis chondrocytes. Arthritis Res Ther. 2009;11(2):R47. PMID: 19344515.

Ismail T, Sestili P, Akhtar S. Pomegranate peel and fruit extracts: A review of potential anti inflammatory and antioxidant properties. J Ethnopharmacol. 2012;143(2):397 405. PMID: 22819520.

Xu J, Cao K, Liu X, et al. Punicalagin regulates NF κB, MAPK, and PI3K/Akt pathways in chronic inflammation. Antioxidants (Basel). 2021;11(1):29. PMID: 35052533.

Rafraf M, Khadem Haghighian M, Molani Gol R, et al. Effects of pomegranate peel extract on inflammation and MMP 1 in women with knee osteoarthritis: a randomized controlled trial. Nutr Metab Insights. 2024;17:11786388241243266. PMID: 38827464.

Rafraf M, Hemmati S, Jafarabadi MA, et al. Pomegranate peel hydroalcoholic extract reduces pain and improves symptoms in knee osteoarthritis: randomized controlled trial. Iran Red Crescent Med J. 2017;19(1):e38577. doi:10.5812/ircmj.38577.

Haghighian MK, Rafraf M, Hemmati S, et al. Pomegranate peel extract supplementation improves lipid profile and antioxidant status in obese women with knee osteoarthritis. Adv Integr Med. 2021;8(2):107 13. doi:10.1016/j.aimed.2020.05.001.

Li H, Li Q, Wan T, et al. Punicalagin attenuates inflammatory osteolysis via Brd4 mediated chromatin remodeling. Sci Rep. 2026;16:12948. PMID: 41807492.

Bone. Punicalagin attenuates osteoarthritis progression via Foxo1/Prg4/HIF3α axis. Bone. 2021;152:116070. doi:10.1016/j.bone.2021.116070.