Status of iron during radon-sulfide balneotherapy in osteoarthritis patients

Jadwiga Kuciel-Lewandowska, Sylwia Płaczkowska, Lilla Pawlik-Sobecka, Agnieszka Piwowar


Osteoarthritis and other arthropathies are still one of the most debilitating musculoskeletal disorders among the elderly population. Pathogenesis of these diseases is multifactorial and mainly connected with increasing of oxidative stress. Pharmacotherapy, physico- and balneotherapy are the most commonly used methods of treatment. The mechanism of action balneotherapy in arthropathies is not fully understood. Probably it is a combined effect of used forms of biological interactions which influence different metabolic pathways. One of the potential factor connected with decreasing oxidative stress status during balneotherapy can be iron bioavailability and changes its concentration during this therapy. The aim of this study was assessing change of iron blood status during the routine 21 days’ radon-sulfide balneotherapy course in patients with osteoarthritis. The study group consisted of 35 osteoarthritis patients without impediment to comprehensive treatment at spa. The age of patients ranged 32-67 years (average 53.5). The blood samples were collected before the therapy and after 21 days of treatment at a spa. The levels of iron, transferrin, total iron binding capacity and transferrin saturation percent were assessed. Within statistical comparison before and after spa course reveled decreasing trend for all iron status parameters after 21 days’ spa treatment, but the observed changes were significant only for TIBC. In the course of spa therapy Osteoarthritis patients, the level of the systemic iron components is not affected and changes in blood oxidative status during this therapy probably are not influenced by iron status and vice versa.


Balneotherapy; Iron; Osteoarthritis; Oxidative stress; Radon-sulfide water

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Gonçalves RS, Cabri J, Pinheiro JP. Evaluation of patient characteristics as predictors of health status in knee osteoarthritis patients referred for physical therapy. Acta Reumatol Port. 2011; 36(2): 137-144.

Vasilic-Brasnjevic S, Marinkovic J, Vlajinac H, Vasiljevic N, Jakovljevic B, Nikic M. Association of body mass index and waist circumference with severity of knee osteoarthritis. Acta Reumatol Port. 2016; 41: 226-231.

Chojnacki M, Kwapisz A, Synder M, Szemraj J. Osteoarthritis: etiology, risk factors, molecular mechanisms [in Polish]. Postepy Hig Med Dosw. 2014; 68: 640-652.

Kuciel-Lewandowska J. Balneofizjoterapia a przemiany wolnorodnikowe i ogólnoustrojowe. Piel Zdr Publ. 2014; 4(4): 377-382.

Czyzewska A, Glinkowski WM, Walesiak K, Krawczak K, Cabaj D, Gorecki A. Effects of preoperative physiotherapy in hip osteoarthritis patients awaiting total hip replacement. Arch Med Sci. 2014; 10(5): 985-991.

Kuciel-Lewandowska J, Paprocka-Borowicz M. The impact of the spa therapy on reduction of the perception of pain intensity in patients with degenerative joints and disc disease [in Polish]. Pomeranian J Life Sci. 2015; 61(3): 257-262.

Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M. Mechanisms of action of spa therapies in rheumatic diseases: what scientific evidence is there? Rheumatol Int. 2011; 31(1): 1-8.

Kloesch B, Liszt M, Krehan D, Broell J, Kiener H, Steiner G. High concentrations of hydrogen sulphide elevate the expression of a series of pro-inflammatory genes in fibroblast-like synoviocytes derived from rheumatoid and osteoarthritis patients. Immunol Lett. 2012; 141(2): 197-203.

Branco M, Rego NN, Silva PH, Archanjo IE, Ribeiro MC, Trevisani VF. Bath thermal waters in the treatment of knee osteoarthritis: a randomized controlled clinical trial. Eur J Phys Rehabil Med. 2016; 52(4): 422-430.

Fioravanti A, Giannitti C, Cheleschi S, Simpatico A, Pascarelli NA, Galeazzi M. Circulating levels of adiponectin, resistin, and visfatin after mud-bath therapy in patients with bilateral knee osteoarthritis. Int J Biometeorol. 2015; 59(11): 1691-1700.

Lipiński P, Starzyński RR, Styś A, Gajowiak A, Staroń R. Heme metabolism as an integral part of iron homeostasis [in Polish]. Postepy Hig Med Dosw. 2014; 68: 557-570.

Ziskoven C, Jager M, Zilkens C, Bloch W, Brixius K, Krauspe R. Oxidative stress in secondary osteoarthritis: from cartilage destruction to clinical presentation? Orthop Rev (Pavia). 2010; 2(2): e23.

Baskol G, Demir H, Baskol M , Kilic E, Ates F, Karakukcu C, Ustdal M. Investigation of protein oxidation and lipid peroxidation in patients with rheumatoid arthritis. Cell Biochem Funct. 2006;24(4):307-311.

Karagülle M, Kardeş S, Karagülle O, Dişçi R, Avcı A, Durak I, et al. Effect of spa therapy with saline balneotherapy on oxidant/antioxidant status in patients with rheumatoid arthritis: a single-blind randomized controlled trial. Int J Biometeorol. 2016; 61(1): 169-180.

Jokic A, Sremcevic N, Karagulle Z, Pekmezovic T, Davidovic V. Oxidative stress, hemoglobin content, superoxide dismutase and catalase activity influenced by sulphur baths and mud packs in patients with osteoarthritis. Vojnosanit Pregl. 2010; 67(7): 573-578.

Bender T, Balint G, Prohaszka Z, Geher P, Tefner IK. Evidence-based hydro- and balneotherapy in Hungary - a systematic review and meta-analysis. Int J Biometeorol. 2014; 58(3): 311-323.

Olah M, Koncz A, Feher J, Kalmanczhey J , Kálmánczhey J, Oláh C, Nagy G, Bender T. The effect of balneotherapy on antioxidant, inflammatory, and metabolic indices in patients with cardiovascular risk factors (hypertension and obesity)--a randomised, controlled, follow-up study. Contemp Clin Trials. 2011; 32(6): 793-801.

Ekmekcioglu C, Strauss-Blasche G, Holzer F, Marktl W. Effect of sulfur baths on antioxidative defense systems, peroxide concentrations and lipid levels in patients with degenerative osteoarthritis. Forsch Komplementarmed Klass Naturheilkd. 2002; 9(4): 216-220.

Costantino M, Giuberti G, Caraglia M, Lombardi A, Misso G, Abbruzzese A, et al. Possible antioxidant role of SPA therapy with chlorine-sulphur-bicarbonate mineral water. Amino Acids. 2009; 36(2): 161-165.


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