關節炎和結締組織疾病
在美國有4,000萬人患有嚴重的關節炎和結締組織問題被列為美國頭號殘疾，主要區分為骨關節炎和類風濕性關節炎，另外還有許多不同形式，包含痛風、僵直性脊椎炎(AS)和感染性關節炎。導致關節炎的因素包括：關節磨損(過度使用)、受傷而導致損傷、感染、遺傳因素、藥物副作用、營養不足、荷爾蒙因素、年齡有關的退化、免疫系統改變、生物力學因素(姿勢不良)、體重過重。關節炎通常伴隨發炎症狀，其特徵在於關節腫脹、僵硬或疼痛，並且身體的所有關節都會受到影響。但仍有許多形式的關節炎，尚不清楚造成的確切原因。
Arthritic and Musculoskeletal Disorders
Joint and connective tissue problems associated with many forms of arthritis rank as the number one disability disease in the United States. Over 40 million people have severe health problems due to many different forms of arthritis, the major forms being osteoarthritis and rheumatoid arthritis. Other forms include gout, ankylosing spondylitis (AS) and infectious arthritis. Factors that contribute to arthritis include: wear and tear on joints (excessive stress); injuries; infections; genetic factors; drug side effects; nutritional deficiencies; hormonal factors; age-related changes; altered immune system; biomechanical factors; excessive weight.
Arthritis is generally an inflammatory disease characterized by swelling, stiffness and/or pain in the joints. All joints of the body can be affected. Chronic forms of the disease may be associated with deformity and restricted range of motion. The exact cause and progression of many forms of arthritis are not well understood.
骨關節炎：
超過3,000萬美國人患有這種「退化」形式的關節炎，通常伴隨發炎症狀。這種退化性關節病與過度磨損有關，尤其隨著年紀的增長，覆蓋關節骨頂端的軟骨光滑表面會因磨損變得粗糙，磨損過程中會導致關節周圍的結締組織逐漸破裂，關節損傷也會導致軟骨逐漸惡化。在任何一種情況下，關節中的摩擦都可能導致發炎和圍繞關節的肌腱、韌帶和肌肉減弱，導致關節中小骨生長，刺激骨刺和軟囊腫的發展。
Osteoarthritis: Over 30 million Americans have this form of arthritis, which may be accompanied by inflammation. This degenerative joint disease is related to a wear and tear phenomenon. Over time, the smooth surface of cartilage that covers the ends of the joint bones can become rough. This process can lead to a gradual breakdown of the connective tissue surrounding the joint. Injury to a joint can also create a progressive deterioration of the cartilage. In either situation, friction in the joint can lead to inflammation and weakened tendons, ligaments and muscles that surround the joint, causing the development of small bony growths, calcium spurs and soft cysts in the joints.
骨關節炎的特徵在於關節疼痛，滑膜發炎和關節軟骨的消失！這是由於軟骨基質中蛋白多醣被分解所致。隨著退化的持續進展，滑膜炎和關節腫大發生導致關節運動的減少和破壞軟骨的破壞性酶（稱為溶酶體）的釋放。此外，自由基介質的釋放也是導致軟骨退化的主要原因。退化性關節炎的嚴重程度與關節和周圍關節軟骨內醣胺聚醣（GAG）含量的減少有關，「GAG 醣胺聚醣」是軟骨和結締組織的主要成分。由於骨關節炎這種疾病，GAG含量降低，軟骨生產會顯著減緩，甚至完全停止。
Osteoarthritis is characterized by joint pain, inflammation of the synovial membrane and loss of joint cartilage as a result of the increased breakdown of the proteoglycans in the cartilage matrix. As the disease progresses, synovitis and joint enlargement occur leading to a decrease in joint motion and the release of destructive enzymes, called lysosomes, which break down cartilage. Release of free-radical mediators also contributes to major cartilage degradation. The severity of the disease appears to correlate with the loss of glycosaminoglycan (GAG) content within the joint and surrounding articular cartilage." Glycosamino- glycans are a major component of cartilage and connective tissue. Cartilage production can also slow down significantly and even stop entirely as a result of the disease.
類風濕性關節炎：
這種形式的關節炎影響超過300萬人。它是身體免疫系統攻擊其自身關節免疫疾病的一個疾病。這種形式的關節炎是一種全身性炎症性疾病，它會攻擊關節內潤滑液周圍的滑膜，軟骨和骨結構被緩慢地破壞，嚴重時關節可能會沾黏融合。這種情況會影響身體的所有關節，並導致疲勞、體重減輕、關節僵硬和使人衰弱的疼痛。這種形式的關節炎會隨著時間的推移，導致嚴重的關節變形和行動力喪失。
Rheumatoid Arthritis: This form of arthritis affects more than 3 million people. It is an example of an autoimmune disease where the body's immune system attacks its own joints. This form of arthritis is a systemic, inflammatory disease that attacks synovial membranes surrounding the lubricating fluid in the joint. The cartilage, along with the bone structure, is slowly destroyed leading to scar tissue formation. In the extreme form of the disease, the joint may actually fuse. This condition, which can affect any joint in the body, can lead to fatigue, weight loss, joint stiffness and debilitating pain. This form of arthritis can lead to major deformity and loss of motion over time.
傳染性關節炎：
有充分的證據顯示某些形式的關節炎可能由寄生蟲、病毒、真菌和細菌引起，傳染性關節炎的一個這樣的例子是萊姆病。由鹿蜱(吸血蟲)傳播的細菌可以侵入血液並進入關節，在30~40天後出現類風濕性關節炎的症狀。
Infectious Arthritis: There is good evidence that some forms of arthritis can be caused by parasites, viruses, fungi and bacteria. One such example of Infectious Arthritis would be Lyme Disease. Bacteria, which are transmitted by deer ticks, can invade the bloodstream and travel to the joints resulting in arthritis-like symptoms after 30 to 40 days. In many ways, Lyme Disease resembles rheumatoid arthritis.
僵直性脊椎炎(AS)：
這種關節炎疾病影響軀幹的關節，包括脊椎和骨盆。隨著病情的發展，AS可導致持續數月的極度腰痛，隨著時間脊椎會逐漸變僵硬。其他症狀包括無法擴張胸部、劇烈疼痛和眼部炎症。
Ankylosing Spondylitis (AS): This arthritic disease affects the joints of the trunk, including the spine and the pelvis. As it develops, AS can lead to extreme low back pain that persists for many months. Over time, the spine gradually becomes stiffer. Other symptoms include the inability to expand the chest, severe pain and eye inflammation.
軟骨和關節代謝
在討論青邊貽貝幫助改善關節炎之前，提供關節軟骨的簡單介紹會是有用的。
關節軟骨是關節周圍骨骼末端的主要結締組織。軟骨為關節活動時提供了光滑可動的表面，並且在關節受力期間充當主要的避震器。軟骨由4個主要成分組成：膠原蛋白(蛋白質)、蛋白多醣（蛋白質和GAG醣胺聚醣的複合物）、水、軟骨細胞。與身體的所有組成部分一樣，軟骨會不斷被破壞並重建，在這樣的代謝過程中來處理關節活動時所承受的壓力。由軟骨細胞分泌的酶可以分解膠原蛋白然後重建。適當的更新、代謝，是關節靈活、健康的關鍵。
Cartilage and Joint Metabolism
Before discussing the role of Perna canaliculus in helping to improve arthritis, it may be useful to present a short description of articular cartilage, the major connective tissue capping the ends of bones around the joint. Cartilage provides smooth surfaces for unrestricted joint movement and acts as the principle shock absorber during times of stress on the joint. Cartilage is made up of 4 major components: collagen (protein); proteoglycans (complex of protein and glycosaminoglycans); water; and chondrocytes (cells). As with all components of the body, cartilage is continually broken down and rebuilt in response to the stress placed on the joint. Enzymes secreted by the chondrocytes work to degrade collagen, which is then rebuilt. Proper collagen turnover, including adequate synthesis, is key to proper joint health and function.
圖1-蛋白多醣結構
牛軟骨中的蛋白多醣結構（蛋白質和GAG醣胺聚醣的複合物）
（a）蛋白多醣聚集體的電子顯微鏡照片，
（b）相同結構的示意圖。硫酸角質素和硫酸軟骨素與延伸的核心蛋白質分子共價連接。核心蛋白質借助於連接蛋白質沿著透明質酸分子非共價連接。
Figure 1- Proteoglycan Structure
Oredit: Biochemiatry, 2nd Ed. C.K Mathewa and K.E. Van Holde 1998.
Reprinted by perminsion of Addison Wenley Educational Publicationa, Inc. Proteoglycan structure in bovine cartilage. (a) An electron micrograph of a proteoglycan aggregate, (b) A schematic drawing of the same structure. Keratan sulfate and chondroitin sulfate are covalently linked to extended core protein malecules, The core proteins are noncovalently attached to along hyaluronic acid molecule with the aid of a link protein.
在關節中發現的蛋白多醣，由蛋白質核心和幾種複合氨基糖組成，主要三種包含GAG醣胺聚醣(也存在於滑液中)、硫酸角質素和硫酸軟骨素。（參見圖1）。 GAG的主要功能是增加關節的潤滑，並通過將水分子結合到基質中來提供緩衝、減震的能力，對於關節功能正常運作極為重要。由軟骨細胞自行合成的GAG，需要穩定供應葡萄糖胺和其他微量元素，包括硫酸鹽基團的來源。
The proteogyicans are made up of a protein core and several complex amino sugars known as glycosaminoglycans (GAGs). Three principle GAGs found in joints are hyaluronic acid (also found in the synovial fluid), keratin sulfate and chondroitin sulfates (see Figure 1). The principle function of GAGs is to increase lubrication of the joint and provide shock-absorption via incorporation of water molecules into the matrix. Both are essential for proper joint function. GAGs, synthesized by the chondrocytes, require a steady supply of glucosamine and other building blocks including a source of sulfate groups.
GAG的合成是軟骨生成的限制因素(因此GAG含量足夠才能促使軟骨生成)，在維持靈活的關節功能和逆轉關節炎損傷時，應注意三個因素。
首先，需要提供軟骨細胞足夠的原材料(例如GAG)以重建軟骨。
其次，必須將軟骨細胞活性從膠原蛋白分解轉變為更大的修復、重建的代謝模式。
同時，必須減少導致軟骨過度分解的蛋白水解酶的產生，才能控制發炎症狀。
因此軟骨正常代謝的蛋白質結構控制炎症過程，可能是加強關節修復和再生的關鍵。 青邊貽貝提取物提供GAG、硫酸軟骨素和其他構建成份，並管理促炎細胞因子來減少發炎過程。這兩個方面都有助於減少軟骨損失和增加關節修復。
逆轉關節炎破壞的有效方法，應有以下特性：
減少發炎反應和疼痛
強化軟骨細胞、增強軟骨合成
減少酶和自由基降解引起的軟骨破壞
調節免疫反應，以減少自身免疫反應和促炎細胞因子
如上所述，青邊貽貝內的天然成分可維持關節健康。
Synthesis of GAGs is the limiting factor in cartilage generation. There are three factors that should be noted in maintaining proper joint function and reversing arthritic damage. First, adequate raw materials need to be supplied to the chondrocytes to rebuild cartilage. Second, there must be shift in chondrocyte activity from collagen degradation to a greater repair and rebuilding mode. At the same time, production of the proteolytic enzymes that cause cartilage degradation must be reduced and inflammation must be brought under control. It is now believed that protein structures known as cytokines, produced from various immune cells, control the inflammation process. Their regulation may be the key to enhancing joint repair and regeneration. Perna contributes chondroitin sulfates and other building blocks for GAG synthesis and decreases the inflammation process by down- regulating the pro-inflammatory cytokines. Both aspects help to decrease loss of cartilage and increase joint repair . An effective approach to reversing the destruction of arthritis should provide support by:
Decreasing inflammatory response and pain
Enhancing cartilage synthesis by the chondrocytes
Reducing the destruction of cartilage caused by degrading enzymes and free radicals
Modulating the immune responses to reduce autoimmune response and pro-inflammatory cytokines
Natural components within the Perna mussel potentially support joint health in all of these areas as discussed below.
紐西蘭特有種青邊貽貝，提取出的成分中以 GAG 醣胺聚醣最為矚目，因為一般的葡萄糖胺（Glucosamine）經過食用後大約6~8週才能轉換成 GAG，成為關節可用的營養，但是青邊貽貝提取物穩定存在豐富的 GAG可直接被關節使用，當然青邊貽貝提取物中含有與人體相似的天然礦物質與其他成分也有助於關節炎的整體改善。
圖片來源 My Swiss Life
青邊貽貝在生長曲線的高峰期(大約18個月)收成，以急速冷凍乾燥的方式加工成細粉，這種方式不會破壞營養與活性，因此完整保存蛋白質、複合碳水化合物、脂質、天然礦物質、氨基酸和粘多醣（GAG 醣胺聚醣），為身體尤其是關節提供營養。符合潔淨海域、保存完整營養的青邊貽貝提取物，就會有「ORIGINAL PERNA EXTRAKT」的驗證標章。
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