DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20183386

Undenatured collagen type II for the treatment of osteoarthritis: a review

Ram Prabhoo, Gauri Billa

Abstract


Osteoarthritis is a prevalent musculoskeletal condition worldwide with rising rates in elderly people. Both mechanical and immunological factors are implicated in the pathogenesis of osteoarthritis resulting in destruction of the articular cartilage. Non-steroidal anti-inflammatory drugs (NSAIDs) commonly used for the treatment of osteoarthritis, are associated with several adverse events and also do not affect the underlying disease process. Clinicians and patients both seek options which are safe and effective in the treatment of osteoarthritis. Collagen derivatives represent a suitable option in such cases. Collagen is the most abundant component of the cartilage. Collage derivatives have shown to have disease modifying action in osteoarthritis. Depending on the degree of hydrolysis and molecular weight, collage derivatives are classified into undenaured collagen, gelatin and collage hydrolysate. Collagen derivatives are well tolerated without major safety concerns. Undenatured type II collagen has shown to provide significant improvement in patients with osteoarthritis. In this article we discuss, the pathophysiology of osteoarthritis with focus on immunological factors and evidence for the use of undenatured collagen type II in osteoarthritis.

 


Keywords


Efficacy, Osteoarthritis, Undenatured collagen type II

Full Text:

PDF

References


Pal CP, Singh P, Chaturvedi S, Pruthi KK, Vij A. Epidemiology of knee osteoarthritis in India and related factors. Indian J Orthop. 2016;50:518-22.

Van Vijven JPJ, Luijsterburg PAJ, Verhagen AP, van Osch GJVM, Kloppenburg M, Bierma-Zeinstra SMA. Symptomatic and chondroprotective treatment with collagen derivatives in osteoarthritis: a systematic review. Osteoarthritis Cartilage. 2012;20:809-21.

Poole AR, Kobayashi M, Yasuda T, Laverty S, Mwale F, Kojima T, et al. Type II collagen degradation and its regulation in articular cartilage in osteoarthritis. Ann Rheum Dis 2002;61(2):78–81.

Diab M. The role of type IX collagen in osteoarthritis and rheumatoid arthritis. Orthop Rev. 1993;22:165-70.

Yuan Q-H, Masuko-Hongo K, Kato T, Nishioka K. Immunologic intervention in the pathogenesis of osteoarthritis. Arthritis Rheumatism. 2003;48:602-11.

Shoulders MD, Raines RT. Collagen structure and stability. Annu Rev Biochem. 2009;78:929–58.

Franchi M, Trire A, Quatanta M, Orsini E, Ottani V. Collagen structure of tendon relates to function. The Scientific World J. 2007;7:404–20.

An B, Abbonante V, Yigit S, Balduini A, Kaplan DL, Brodsky DL. Definition of the native and denatured type II collagen binding site for fibronectin using a recombinant collagen system. The J Biological Chem. 2014;289:4941-51.

Ricard-Blum S. The collagen family. Cold Spring Harb Perspect Biol. 2011;3:a004978.

Eyre DR, Weis MA, Wu J-J. Articular cartilage collagen: An irreplaceable framework? European Cells and Materials. 2006;12:57-63.

Fernandes JC, Martel-Pelletier J, Pelletier JP. The role of cytokines in osteoarthritis pathophysiology. Biorheology. 2002;39:237-46.

Jasin HE. Autoantibody specificities of immune complexes sequestered in articular cartilage of patients with rheumatoid arthritis and osteoarthritis. Arthritis Rheum. 1985;28:241–8.

Asnagli H, Martire D, Belmonte N, Quentin J, Bastian H, Boucard-Jourdin M. Type 1 regulatory T cells specific for collagen type II as an efficient cell-based therapy in arthritis. Arthritis Res Therapy. 2014;16:115.

Lugo JP, Saiyed ZM, Lau FC, Molina JPL, Pakdaman MN, Shamie AN. Undenatured type II collagen (UC-II®) for joint support: a randomized, double-blind, placebo-controlled study in healthy volunteers. J Int Society Sports Nutr. 2013;10:48.

Lugo JP, Saiyed ZM, Lane NE. Efficacy and tolerability of an undenatured type II collagen supplement in modulating knee osteoarthritis symptoms: a multicenter randomized, double-blind, placebo-controlled study. Nutrition J. 2016;15:14.

Bagchi D, Misner B, Bagchi M, Kothari SC, Downs BW, Fafard RD, et al. Effects of orally administered undenatured type II collagen against arthritic inflammatory diseases: A mechanistic exploration. Int J Clin Pharm Res. 2002;22:101-10.

Weiner HL, da Cunha AP, Quintana F, Wu H. Oral tolerance. Immunol Rev. 2011;241:241–59.

Kraus TA, Mayer L. Oral tolerance and inflammatory bowel disease. Curr Opin Gastroenterol. 2005;21(6):692-6.

Astry B, Venkatesha SH, Moudgil KD. Temporal cytokine expression and the target organ attributes unravel novel aspects of autoimmune arthritis. Indian J Med Res. 2013;138:717-31.

Broere F, Wieten L, Koerkamp EIK, van Roon JAG, Guichelaar T, Lafeber FPJG. Oral or nasal antigen induces regulatory T cells that suppress arthritis and proliferation of arthritogenic T cells in joint draining lymph nodes. The J Immunol. 2008;181:899–906.

Di Cesare Mannelli L, Micheli L, Zanardelli M, Ghelardini C. Low dose native type II collagen prevents pain in a rat osteoarthritis model. BMC Musculoskeletal Disorders. 2013;14:228.

Ju JH, Cho ML, Jhun JY, Park MJ, Oh HJ, Min SY, et al. Oral administration of type-II collagen suppresses IL-17-associated RANKL expression of CD4+ T cells in collagen-induced arthritis. Immunol Lett. 2008;117:16–25.

Bagi CM, Berryman ER, Teo S, Lane NE. Oral administration of undenatured native chicken type II collagen (UC-II) diminished deterioration of articular cartilage in a rat model of osteoarthritis (OA). Osteoarthritis and Cartilage. 2017;25:2080-90.

Crowley DC, Lau FC, Sharma P, Evans M, Guthrie N, Bagchi M. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int J Med Sci. 2009;6:312-21.