# Seareed Exhibits Therapeutic Properties against Chronic Diseases: An Overview
## 6 Pharmacological Properties of Seaweed to Overcome Chronic Disease
### Arthritis  
Arthritis is the most common chronic inflammatory disease; it is characterized by structural and biochemical changes in major joint tissues, including cartilage matrix degradation and insufficient extracellular matrix synthesis (ECM), resulting in pain, stiffness, and joint failure [203; 204]. Arthritis consists of several types, such as juvenile idiopathic arthritis (JIA) [205], psoriatic arthritis [206], gouty arthritis [207], rheumatoid arthritis (the most common form) [208], and osteoarthritis (OA) [209]. Previous studies on the potential of seaweed compounds for arthritis treatment are reported in Table 7. \begin{table}
\begin{tabular}{c c c c c} \hline \hline
**Algal Source** & **Constituents** & **Study Type** & **Biological Effects** & **Ref.** \\ \hline \multicolumn{5}{c}{Brown Seaweed (Phaeophycae)} \\ \hline _Ecklonia cava_ & Phlorotannins & In vitro & Downregulated pro-inflammatory & [13] \\ _Undaria pinnatifida_ & Fucoidan & In vitro and in vivo & Cytokines & [75] \\ _Lobophora variegata_ & Fucan & In vitro and in vivo & Reduced articular inflammation & [210] \\ _Sargassum wigthiti_ & Alginic acid & In vivo & Downregulated pro-inflammatory & [211] \\ _Sargassum wigthiti_ & Alginic acid & In vivo & Downloaded pro-inflammatory & [34] \\ _Fucus vesiculis_ & Fucoidan & Clinical study & Reduced the symptoms of osteoarthritis & [12] \\ _Macrocystis pyrifera_, & Fucoidan & Clinical study & Reduced the symptoms of osteoarthritis & [12] \\ \hline _Laminaria_ & Fucoidan & Clinical study & Reduced the symptoms of osteoarthritis & [12] \\ _japonica_ & Fucoidan & Clinical study & in a dose-dependent manner & [12] \\ \hline \hline \end{tabular}
\end{table} 
Table 7: The effect of seaweed-derived compounds on arthritis. Among several types of arthritis, seaweed bioactivity against OA is the most widely reported. OA is a common type of arthritis that primarily affects the knee [104]. A previous study suggested that OA joint degeneration results from a combination of mechanical stresses and biochemical factors, such as ROS and MMPs, which act as precursors to pro-inflammatory cytokines, including IL-1\(\alpha\), IL-1\(\beta\), and TNF-\(\alpha\)[204; 214]. As a result, cartilage degradation was attenuated in the model tested [190]. Previous studies have reported that phlorotannin-rich extracts isolated from _Eckonia cava_ reduce inflammation by downregulating pro-inflammatory cytokines [13]. Moreover, _Lobophora variegate_ fucan reduced articular inflammation by downregulating paw edema and serum TNF-\(\alpha\)[210]. Meanwhile, _Laurencia glandulifera_ and _Codium fragile_ exhibited anti-OA effects by inhibiting NF-\(\kappa\)B activity and COX-2 expression in RAW264.7 cells in vitro, and reduced carrageenanan-induced rat edema in vivo [212; 213]. A study by [PERSON] et al. [112] reported that _Caulerpa cupressoides_ lectin may reduce leukocyte influx and the expression levels of pro-inflammatory cytokines, including IL-1\(\beta\) and TNF-\(\alpha\), in the temporomandibular joint. The mechanism of OA is shown in Figure 4g. Research on the benefits of seaweed for the treatment of OA was conducted in a clinical study by combining Phase I and II trials [12]. The formulation used contained Maritech(r) fucoidan-rich extracts of _Fucus vesiculosis_, _Macrocystis pyrifera_, and _Laminaria japonica_, with additional vitamin B6, zinc, and manganese taken daily. The study was conducted for 12 weeks in 11 participants, and for 10 weeks in one participant. A multilevel linear model revealed a decrease of 18% for the 100 mg treatment and of 52% for the 1000 mg dose in the average COAT score at the end of the study. This result suggests that treatment should be conducted for more than 12 weeks in a dose-dependent manner to reduce the symptoms of OA. A phase III randomized controlled trial (RCT) must be conducted to ensure its safety. Rehunatiod arthritis is a chronic joint disorder affecting the cartilage and subchondar bone, affecting approximately 1% of the world's population.