REVIEW
Collagen hydrolysate for the treatment of osteoarthritis and
other joint disorders: a review of the
literatureAlfonsoe.belloaandsteffenOesserbaUniversity of Illinois
College of Medicine at Chicago, Chicago, IL, USAbCollagen Research
Institute, Kiel, Germany
Address for correspondence:
AlfonsoE.Bello,MD,MHS,FACP,FACR,DABPM,ClinicalAssociateProfessorofMedicine,UniversityofIllinoisCollegeofMedicineatChicago,1801WestTaylorStreet,Chicago,IL60612,USA.Tel.:+13124133631;Fax:+13123553133;email:[email protected]
Key words:
ArticularcartilageCollagenhydrolysateNutritionalsupplementsOsteoarthritisProteoglycansTypeIIcollagen
0300-7995
doi:10.1185/030079906X148373
Allrightsreserved:reproductioninwholeorpartnotpermitted
CurrentMediCAlreseArChAndOpiniOn
VoL. 22, No. 11, 2006, 22212232
2006librAphArMliMited
Paper 3580 2221
Background: There is a need for an effective treatment for the
millions of people in the United States with osteoarthritis (OA), a
degenerative joint disease. The demand for treatments, both
traditional and non-traditional, will continue to grow as the
population ages.
Scope: This article reviews the medical literature on the
preclinical and clinical research on a unique compound, collagen
hydrolysate. Articles were obtained through searches of the PubMed
database (www.pubmed.gov) through May 2006 using several pairs of
key words (collagen hydrolysate and osteoarthritis; collagen
hydrolysate and cartilage; collagen hydrolysate and chondrocytes;
collagen hydrolysate and clinical trial) without date limits. In
addition, other sources of information, such as abstracts presented
at scientific congresses and articles in the German medical
literature not available on PubMed, were reviewed and included
based on the authors judgment of their relevance to the topic of
the review.
Findings: According to published research, orally administered
collagen hydrolysate has
been shown to be absorbed intestinally and to accumulate in
cartilage. Collagen hydrolysate ingestion stimulates a
statistically significant increase in synthesis of extracellular
matrix macromolecules by chondrocytes ( p < 0.05 compared with
untreated controls). These findings suggest mechanisms that might
help patients affected by joint disorders such as OA. Four
open-label and three double-blind studies were identified and
reviewed; although many of these studies did not provide key
information such as the statistical significance of the findings
they showed collagen hydrolysate to be safe and to provide
improvement in some measures of pain and function in some men and
women with OA or other arthritic conditions.
Conclusion: A growing body of evidence provides a rationale for
the use of collagen hydrolysate for patients with OA. It is hoped
that ongoing and future research will clarify how collagen
hydrolysate provides its clinical effects and determine which
populations are most appropriate for treatment with this
supplement.
A B S T R A C T
Introduction
Osteoarthritis(OA)affectsmillionsofpeopleintheUnitedStates,andthenumberofpeoplewithOAispredictedtoincreaseasthepopulationages1.Currently,
thereisnocureforOA,somanagementofthediseaseis focusedon
reducingpain,maintainingmobility,andminimizingdisability. In recent
years,
severalinvestigatorshavesuggestedthatsomesubstancesmaybecapableofrepairingdamagedarticularcartilageor
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2222 Collagen hydrolysate and osteoarthritis
2006librAphArMltdCurrMedresOpin2006;22(11)
atleastdeceleratingitsprogressivedegradation2.Onesuchagentthathasbeeninvestigatedisthenutritionalsupplementcollagenhydrolysate3.The
purpose of this article is to review the
epidemiologyandriskfactorsforOAandreviewsomeofthecurrentmanagementoptionsforthisdisorder.ItsummarizesclinicalresearchwithcollagenhydrolysateanddiscussestheclinicalsignificanceofthisresearchandthepotentialofthissupplementforthetreatmentofpatientswithOA.ArticleswereobtainedthroughsearchesofthePubMeddatabase(www.pubmed.gov)throughMay2006usingthefollowingkeywordpairs,withoutdate
limits:
collagenhydrolysateandOA;collagenhydrolysateandcartilage;collagenhydrolysateandchondrocytes;collagenhydrolysateandclinicaltrial.Inaddition,othersourcesofinformation,suchasabstractspresentedatscientificcongressesandarticlesin
theGermanmedical literaturenot
availableonPubMed,werereviewedandincludedbasedontheauthorsjudgmentoftheirrelevancetothetopicofthisreview.
osteoarthritis: epidemiology and risk factors
OA is themost common formof arthritis amongtheelderlyanda
leadingcauseofdisability in
thispopulation46.Thediseaseaccountsfor25%ofvisitstoprimarycarephysicians7.OAaccounts
formoretroublewithclimbingstairsandwalkingthananyotherdisease8.The
prevalence of arthritis and chronic joint
symptoms increaseswith age (Table 1)6,9. In
onecommunity-basedsurvey,theincidenceandprevalenceofOAincreased2-to10-foldfrom30to65yearsof
age,anditincreasedfurtherbeyond65years1.Duetothegeneralincreaseinlifeexpectancyandtheagingofthebabyboomgeneration,thenumberofAmericanswhoare50yearsofageandolderisexpectedtodoubleby2020,aswilltheprevalenceofOA,underscoringtheneedforeffectivetreatment10.Besidesage,otherriskfactorsforOAincludemajor
traumaand repetitive jointuse6.Obesity is also
ariskfactorforOA(Table1)11.TherearedatawhichsuggestthatobesityplaysanevenlargerroleinthedevelopmentofkneeOA12.OtherconditionsthatmaybeinvolvedinthedevelopmentofOAaresystemic,metabolic,orendocrinedisorders,neurologicdiseases,anddysplasia.
Pathophysiology of cartilage
degenerationthestructureofarticularcartilage
Articularcartilage,alsoknownashyalinecartilage,isaspecialized,tough,flexibletissuewithalow-frictioncoefficientandasmootharticulatingsurfacethatmakesitideallysuitableforloaddistributionandabsorbingtheshockofmovement13.Itiscomprisedofchondrocytes(about210%ofthevolumeofarticularcartilage)andanextracellularmatrix,whichismaintainedbythechondrocytes14.Thematrixofthearticularcartilageconsistsoftwocomponents:thetissuefluidandtheframeworkofstructuralmacromoleculesthatgivethetissueitsformandstability15.Sixtytoeightypercentofthematrixiswater1618.Themacromolecularframeworkofarticularcartilage
consistsofcollagens(predominantlytypeIIcollagen),proteoglycans,andnon-collagenousproteins13,15.Thesestructuralmacromoleculescontribute2040%ofthe
Table 1. Persons with arthritis and chronic joint symptoms in
the United States9
Characteristic Number* Percent (95%CI)
Agegroup,years 1844 20610 19.0 (18.519.4)4564 27112 42.1
(41.542.8)65 21704 58.8 (58.059.7)
Sex Male 28926 28.4 (27.928.9)Female 41008 37.3 (36.937.8)
Bodymassindex(BMI) BMI
