DOI QR코드

DOI QR Code

Application of purified porcine collagen in patients with chronic refractory musculoskeletal pain

  • Seong, Hyunyoung (Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital) ;
  • Kim, Raing Kyu (Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital) ;
  • Shin, Youngjae (Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital) ;
  • Lee, Hye Won (Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital) ;
  • Koh, Jae Chul (Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital)
  • Received : 2020.04.27
  • Accepted : 2020.08.17
  • Published : 2020.09.30

Abstract

Background: This study aimed to assess the potential efficacy of purified porcine atelocollagen (PAC) for the management of refractory chronic pain due to suspected connective tissue damage. Methods: Patients treated with PAC were retrospectively evaluated. Patients with chronic refractory pain, suspected to have originated from musculoskeletal damage or defects with the evidence of imaging studies were included. Pain intensity, using the 11-point numerical rating scale (NRS), was assessed before the procedure, and 1 month after the last procedure. Results: Eighty-eight patients were finally included for investigation. The mean NRS score was decreased from 5.8 to 4.1 after 1 month of PAC injection (P < 0.001). No independent factor was reported to be directly related to the decrease in NRS score by more than half. Conclusions: Application of PAC may have potential as a treatment option for refractory chronic musculoskeletal pain. PAC might promote tissue recovery, act as a scaffold for repair, or directly reduce inflammation.

Keywords

References

  1. Fayaz A, Croft P, Langford RM, Donaldson LJ, Jones GT. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open 2016; 6: e010364. https://doi.org/10.1136/bmjopen-2015-010364
  2. Velly AM, Mohit S. Epidemiology of pain and relation to psychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 2018; 87(Pt B): 159-67. https://doi.org/10.1016/j.pnpbp.2017.05.012
  3. Oh IH, Yoon SJ, Seo HY, Kim EJ, Kim YA. The economic burden of musculoskeletal disease in Korea: a cross sectional study. BMC Musculoskelet Disord 2011; 12: 157. https://doi.org/10.1186/1471-2474-12-157
  4. Yelin E, Weinstein S, King T. The burden of musculoskeletal diseases in the United States. Semin Arthritis Rheum 2016; 46: 259-60. https://doi.org/10.1016/j.semarthrit.2016.07.013
  5. Killian ML, Cavinatto L, Galatz LM, Thomopoulos S. The role of mechanobiology in tendon healing. J Shoulder Elbow Surg 2012; 21: 228-37. https://doi.org/10.1016/j.jse.2011.11.002
  6. Hauser RA, Lackner JB, Steilen-Matias D, Harris DK. A systematic review of dextrose prolotherapy for chronic musculoskeletal pain. Clin Med Insights Arthritis Musculoskelet Disord 2016; 9: 139-59.
  7. Squadrito F, Bitto A, Irrera N, Pizzino G, Pallio G, Minutoli L, et al. Pharmacological activity and clinical use of PDRN. Front Pharmacol 2017; 8: 224. https://doi.org/10.3389/fphar.2017.00224
  8. Suh DS, Lee JK, Yoo JC, Woo SH, Kim GR, Kim JW, et al. Atelocollagen enhances the healing of rotator cuff tendon in rabbit model. Am J Sports Med 2017; 45: 2019-27. https://doi.org/10.1177/0363546517703336
  9. Kim M, Choi YS, You MW, Kim JS, Young KW. Sonoelastography in the evaluation of plantar fasciitis treatment: 3-month follow-up after collagen injection. Ultrasound Q 2016; 32: 327-32. https://doi.org/10.1097/RUQ.0000000000000233
  10. Hanai K, Kojima T, Ota M, Onodera J, Sawada N. Effects of atelocollagen formulation containing oligonucleotide on endothelial permeability. J Drug Deliv 2012; 2012: 245835. https://doi.org/10.1155/2012/245835
  11. Lynn AK, Yannas IV, Bonfield W. Antigenicity and immunogenicity of collagen. J Biomed Mater Res B Appl Biomater 2004; 71: 343-54.
  12. Sheikh Z, Qureshi J, Alshahrani AM, Nassar H, Ikeda Y, Glogauer M, et al. Collagen based barrier membranes for periodontal guided bone regeneration applications. Odontology 2017; 105: 1-12. https://doi.org/10.1007/s10266-016-0267-0
  13. Dunn MG, Tria AJ, Kato YP, Bechler JR, Ochner RS, Zawadsky JP, et al. Anterior cruciate ligament reconstruction using a composite collagenous prosthesis. A biomechanical and histologic study in rabbits. Am J Sports Med 1992; 20: 507-15. https://doi.org/10.1177/036354659202000504
  14. Lee HS, Oh KJ, Moon YW, In Y, Lee HJ, Kwon SY. Intra-articular injection of type I atelocollagen to alleviate knee pain: a double-blind, randomized controlled trial. Cartilage 2019. doi: 10.1177/1947603519865304.
  15. Astrom M, Rausing A. Chronic achilles tendinopathy. A survey of surgical and histopathologic findings. Clin Orthop Relat Res 1995; (316): 151-64.
  16. Kane SF, Olewinski LH, Tamminga KS. Management of chronic tendon injuries. Am Fam Physician 2019; 100: 147-57.
  17. Kim SH, Jeon YH, Park JW. Effects of prolotherapy on chronic musculoskeletal disease. Korean J Pain 2002; 15: 121-5.
  18. Andia I, Abate M. Platelet-rich plasma: combinational treatment modalities for musculoskeletal conditions. Front Med 2018; 12: 139-52. https://doi.org/10.1007/s11684-017-0551-6
  19. Clark D, Nakamura M, Miclau T, Marcucio R. Effects of aging on fracture healing. Curr Osteoporos Rep 2017; 15: 601-8. https://doi.org/10.1007/s11914-017-0413-9
  20. Oliveira SM, Ringshia RA, Legeros RZ, Clark E, Yost MJ, Terracio L, et al. An improved collagen scaffold for skeletal regeneration. J Biomed Mater Res A 2010; 94: 371-9.
  21. Matsushita R, Nakasa T, Ishikawa M, Tsuyuguchi Y, Matsubara N, Miyaki S, et al. Repair of an osteochondral defect with minced cartilage embedded in atelocollagen gel: a rabbit model. Am J Sports Med 2019; 47: 2216-24. https://doi.org/10.1177/0363546519854372
  22. Stopak D, Wessells NK, Harris AK. Morphogenetic rearrangement of injected collagen in developing chicken limb buds. Proc Natl Acad Sci U S A 1985; 82: 2804-8. https://doi.org/10.1073/pnas.82.9.2804
  23. Chang SW, Flynn BP, Ruberti JW, Buehler MJ. Molecular mechanism of force induced stabilization of collagen against enzymatic breakdown. Biomaterials 2012; 33: 3852-9. https://doi.org/10.1016/j.biomaterials.2012.02.001
  24. Bayarsaikhan O, Kawai N, Mori H, Kinouchi N, Nikawa T, Tanaka E. Co-administration of myostatin-targeting siRNA and ActRIIB-Fc fusion protein increases masseter muscle mass and fiber size. J Nutr Sci Vitaminol (Tokyo) 2017; 63: 244-8. https://doi.org/10.3177/jnsv.63.244
  25. Lee KI, Moon SH, Kim H, Kwon UH, Kim HJ, Park SN, et al. Tissue engineering of the intervertebral disc with cultured nucleus pulposus cells using atelocollagen scaffold and growth factors. Spine (Phila Pa 1976) 2012; 37: 452-8. https://doi.org/10.1097/BRS.0b013e31823c8603
  26. Covey CJ, Sineath MH Jr, Penta JF, Leggit JC. Prolotherapy: can it help your patient? J Fam Pract 2015; 64: 763-8.

Cited by

  1. 족부족관절 질환에서 주사 치료는 얼마나 효과가 있는가? vol.25, pp.1, 2020, https://doi.org/10.14193/jkfas.2021.25.1.10
  2. 3D bioprinting of a trachea-mimetic cellular construct of a clinically relevant size vol.279, 2020, https://doi.org/10.1016/j.biomaterials.2021.121246