Nutrients & Science Rheumatoid Arthritis and Osteoarthritis · This has now changed with undenatured type II collagen Undenatured type II collagen is the first natural food supplement

NUTRIENCENutrients & Science

Rheumatoid Arthritis

and Osteoarthritis

Five good reasons why you can safely recommend undenatured type ll collagen

A report by Peter Jackson

Collasense booklet.indd 1 12/18/2013 4:32:21 PM

Foreward

Those of you who have read my reports before will know that I am passionate about tackling chronic disease by natural means whenever possible.

It is nearly two years since my last report, but I was compelled to put pen to paper again when I saw the recent research that has been carried out on undenatured type ll collagen and its undoubtable benefits for osteoarthritis and rheumatoid arthritis.

Those of us in the naturopathic world understand how chronic diseases can build up over time due to imbalances in our diet. There have been a number of supplements over the years which have helped to relieve the symptoms of osteoarthritis which is considered a chronic disease resulting from years of wear and tear.

But, when it came to RA (an auto-immune disease), no supplements were considered to be effective.

However, this all changed when scientists noticed that something as simple as chicken broth (made from chicken bones) could have an anti- inflammatory effect and reduce the auto-immune response responsible for RA.

How about that? Could something as simple as chicken broth seriously reduce the symptoms of rheumatoid arthritis? It seems so.

Following these findings, there have been a number of studies that have shown how a natural extract from the sternum of chickens, known as undenatured type ll collagen, can significantly reduce the symptoms of both osteoarthritis and rheumatoid arthritis.

These are covered briefly in this report. I think you will find them interesting as I did when I started to look into them. At long last you have something that is safe and easy to take for customers suffering from these two debilitating conditions.

Peter Jackson



Main Points

1. New research has revealed undenatured type II collagen as the only natural food supplement ingredient that can help stop the immune attack of arthritis - something that normal collagen, glucosamine and chondroitin are unable to do.

2. Some studies have shown the effectiveness of undenatured type II collagen in reducing the symptoms of both OA and RA.

3. Undenatured type II collagen is proven to be twice as effective

as glucosamine and chondroitin in reducing the symptoms of OA of the knee.

4. Undenatured type II collagen has been proven to help

active sports people whose performance is affected by joint discomfort with physical activity.

5. Undenatured type ll collagen is convenient, natural and totally safe to take.

Abbreviations used in this report:

RA = Rheumatoid Arthritis OA = Osteoarthritis


Main Points in Detail

1. New research has revealed undenatured type II collagen as the only natural food supplement ingredient that can help stop the immune attack of arthritis - something that normal collagen, glucosamine and chondroitin are unable to do.

This new research shows how the presence of undenatured collagen type II stops your immune system from attacking its own natural collagen stores in the joints.

This is why undenatured type II collagen is effective in reducing the symptoms of OA and RA significantly whereas normal collagen and glucosamine and chondroitin are not.

To explain this, it is necessary to understand why your own immune system attacks and destroys collagen in your joint tissues in the first place.

A new understanding of osteoarthritis

Up until recently it was considered that OA was simply the result of age related wear and tear whereas RA results from an auto-immune attack on joints.

However, that has now changed and OA – in addition to being caused by age related wear and tear - is also subject to an auto-immune attack like RA. It is the activation of ‘killer’ T-cells by exposed collagen, which leads to the destruction of joint surfaces and the accompanying pain and impaired function. [1,2]

To explain a little more

Your joints take a beating over time, with those in the weight bearing lower half of your body taking the heaviest punishment. Small traumas to cartilage occur at all ages, but go unnoticed when you are young. In time, these traumas can result in bits of cartilage breaking away (known



as exposed fibres of collagen), and these exposed fibres can be recognised by your immune system as ‘foreign invaders’

When this happens, the body’s alarm system goes off indicating that a foreign invasion has taken place and this triggers a cascade of events that leads to the release of T killer cells, your immune system watchdogs, and other chemicals and enzymes that proceed to degrade not only the exposed fibres of collagen floating around in your system, but also the collagen in your joints. [3, 4]

But the attack doesn’t end there

Researchers found that as cartilage is destroyed by the immune system, the destroyed cells release various by-products which drive a vicious and continuing cycle of joint-tissue damage. [4]

This eats away at your healthy cartilage within the joints – creating pain, friction, and grinding known as OA. [5]

So, OA may be started by wear and tear, but it is this wear and tear that sets up an immune response which may in fact be the main cause of the problems.

Although OA is not considered to be a true auto-immune disease like RA, there are more similarities than once thought in that they are both the result of substantial immune reactions triggered by exposed collagen.

RA occurs when your immune system mistakenly identifies exposed cartilage, or other joint contents such as synovial fluid or the synovial membrane, as enemies.

In the past, food supplements have not been considered useful in reducing the symptoms of RA because this disease is influenced by an auto-immune attack on the joints.

This has now changed with undenatured type II collagen

Undenatured type II collagen is the first natural food supplement ingredient that has been shown to reduce the symptoms of RA by its influence on the immune system in the gut.


How undenatured type II collagen reduces symptoms in OA and RA

Earlier, I mentioned how T cells released by the immune system can attack exposed cartilage which sets off a chain of events that eats away at the collagen matrix in your joints.

However, following this recent research, scientists have learned that it is possible to teach T cells that the exposed collagen in the blood stream - that has been released through wear and tear - is a friend rather than a foe.

To explain. 70% of your immune systems is in your gut. In the lower end of the small intestine, we have an area called ‘Peyer’s patches’ which act as ‘training centres’ for the immune system, exposing T-cells to a vast variety of natural components in the food we eat. This exposure desensitises T-cells to new foods to avoid constant inflammatory or allergic reactions. In other words, this is the area that induces tolerance. [6] This is a role of the immune system which cannot be overstated when considering auto-immune diseases.

If natural collagen is eaten in the form of food or a food supplement, it can educate T killer cells (through the Peyer’s patches) to ignore collagen fibres when they are encountered in the joints. [7]

That is provided the structure of the collagen food or food supplement you consume is the same, natural structure as the collagen found in your joints.

The result of this ‘education’ of the T Killer cells, in scientific terms, is known as ‘induced specific oral tolerance ‘. [8,9]

But to achieve this tolerance to exposed joint collagen, the orally introduced product must be undenatured collagen type ll, which is different to normal collagen supplements.

The reason for this is that undenatured collagen type ll is a natural protein that consists of a triple helix structure of three cross-linked collagen fibres (as found in nature). During oral consumption, specific parts of the structure – the epitopes’ are recognised by Peyer’s patches and the T-cells of the immune system and this builds up, quite quickly, ‘induced specific oral tolerance’ ,which I mentioned earlier.

This tolerance will result in a state of absent or minimal auto-immune response to the collagen found in your joints. [10]



In this way, undenatured type ll collagen stops cartilage erosion, reduces pain and inflammation and helps to repair and rebuild cartilage.

Why normal collagen will not achieve the same results

During the manufacturing process, due to the heat that is generated, this triple helix and its epitopes are destroyed and this means it does not get recognised by the Peyer’s patches. That means that no ‘induced specific oral tolerance’ is developed over time and this, in turn, means that ‘exposed cartilage’ can be seen as a foreign invader rather than a ‘friend’ and this leads, in some individuals, to arthritis.

With undenatured type ll collagen this triple helix is preserved. This is achieved by a patented low-temperature manufacturing process, which preserves the triple helix structure and epitopes.

That is why undenatured type ll collagen is the only natural ingredient that can reduce the symptoms of OA and RA through the effect it has on the immune system and this has now been confirmed in clinical studies.

2. Recent studies have shown the effectiveness of undenatured type ll collagen in reducing the symptoms of both OA and RA.

Now that I have explained how undenatured type ll collagen works, in this section I will summarise some recent studies that relate to it.

References are made if you require further reading.

Int. J. Med. Sci. 2009, 6

http://www.medsci.org

312

IInntteerrnnaattiioonnaall JJoouurrnnaall ooff MMeeddiiccaall SScciieenncceess 2009; 6(6):312-321

© Ivyspring International Publisher. All rights reserved Research Paper

Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial David C. Crowley1, Francis C. Lau2, Prachi Sharma1, Malkanthi Evans1, Najla Guthrie1, Manashi Bagchi2, Debasis Bagchi2,3, Dipak K. Dey4, Siba P. Raychaudhuri 5,6, 1. KGK Synergize Incorporated, London, ON, Canada 2. Department of Research and Development, InterHealth Research Center, Benicia, CA, USA 3. Department of Pharmacology and Pharmaceutical Sciences, University of Houston College of Pharmacy, Houston, TX,

USA 4. Department of Statistics, University of Connecticut, Storrs, CT, USA 5. Department of Medicine, Division of Rheumatology, Allergy and Immunology, School of Medicine, University of

California Davis, Davis, CA, USA 6. VA Medical Center Sacramento, Hospital Way, Mather, CA, USA

Correspondence to: Siba P. Raychaudhuri, [email protected]

Received: 2009.07.14; Accepted: 2009.10.08; Published: 2009.10.09

Abstract

Previous studies have shown that undenatured type II collagen (UC-II) is effective in the treatment of rheumatoid arthritis, and preliminary human and animal trials have shown it to be effective in treating osteoarthritis (OA). The present clinical trial evaluated the safety and efficacy of UC-II as compared to a combination of glucosamine and chondroitin (G+C) in the treatment of OA of the knee. The results indicate that UC-II treatment was more efficacious resulting in a significant reduction in all assessments from the baseline at 90 days; whereas, this effect was not observed in G+C treatment group. Specifically, although both treatments reduced the Western Ontario McMaster Osteoarthritis Index (WOMAC) score, treatment with UC-II reduced the WOMAC score by 33% as compared to 14% in G+C treated group after 90 days. Similar results were obtained for visual analog scale (VAS) scores. Although both the treatments reduced the VAS score, UC-II treatment decreased VAS score by 40% after 90 days as compared to 15.4% in G+C treated group. The Lequesne’s functional index was used to determine the effect of different treatments on pain during daily activities. Treatment with UC-II reduced Lequesne’s functional index score by 20% as compared to 6% in G+C treated group at the end of 90-day treatment. Thus, UC-II treated subjects showed significant enhancement in daily activities suggesting an improvement in their quality of life.

Key words: undenatured type II collagen, osteoarthritis, glucosamine, chondroitin, WOMAC, vis-ual analog scale, Lequesne’s Functional Index

INTRODUCTION Arthritis afflicts approximately 43 million

Americans or approximately 16.6% of the US popula-tion. The two most common types of arthritis are os-teoarthritis (OA) and rheumatoid arthritis (RA). OA of the knee and hip is a growing health concern and is the most common forms of arthritis (1-3). Pain and

disease can range from very mild to very severe (3). Patients with OA have pain that typically worsens with weight bearing, including walking and standing, and improves with rest (4). Other symptoms include morning stiffness and gelling of the involved joint after periods of inactivity. Currently, OA affects


Osteoarthritis in Joint Pain

Five women (58-78) with OA and severe pain in their joints participated in a study in which they received 10mg of undenatured collagen type II daily. [2] The participants observed a significant reduction in pain, such as morning stiffness, stiffness after rest, and pain with movement. In addition, an improvement in the mobility of the joint was observed. The intake of 10mg of undenatured collagen type II showed an average pain reduction in the joints of 26% in 42 days.

Patient case

This involved a patient with degenerated cartilage and a bone spur which caused immobility and severe pain in the knee joint. The treating physician had recommended knee replacement surgery.

An X-ray image – after three years of supplementation with 10 mg of undenatured type ll collagen per day – showed a clear reduction of the bone spur and a thickening of the cartilage.

Rheumatoid Arthritis

274 patients with an average of eleven years of active RA were given a placebo, or 20, 50 500 or 2500 micrograms of undenatured type ll collagen before breakfast every day over the course of 24 weeks (11).

The patients had at least six swollen joints and nine painful joints, and endured the disease for at least six months. 83% of the patients completed the entire study.

A significant improvement was seen in the group starting at 20 micrograms undenatured type ll collagen compared with the placebo group.

This was seen in the number of swollen and painful joints and the evaluation by



the patient and treating physician. Patients who demonstrated anti-bodies against collagen (please refer back to section 1 of this report) were significantly more responsive to the treatment with undenatured type ll collagen [11].

Another group of 60 people with severe RA were given undenatured type ll collagen or a placebo over the course of three months. The number of swollen and painful joints decreased in the collagen group, but not in the placebo group.

Four patients in the collagen group had a complete remission of rheumatoid arthritis. [12]

Juvenile Rheumatoid Arthritis

Ten youngsters with RA were treated for 12 months with undenatured type ll collagen. A reduction in painful and swollen joints was seen in eight patients. Swelling decreased by 61% and pain by 54%. Other parameters, such as grip strength, the time a certain distance was covered, duration of morning stiffness also significantly improved. This was observed by both the treating physicians and the patients themselves (13).

3. Undenatured type ll collagen is proven to be twice as effective as glucosamine and chondroitin in reducing the symptoms of OA of the knee.

According to a randomised, double-blind study, undenatured type ll collagen is more than twice as effective as glucosamine/chondroitin in OA of the knee. The study compared 10mg of undenatured type ll collagen with 1500mg glucosamine and 1200mg of chondroitin (14).

52 people with OA in the knee participated in this 90 day study.

In only 30 days the group that received undenatured type ll collagen noticed a reduction by 20% in pain and stiffness. In the glucosamine/chondroitin group pain decreased by only 6%.

To measure the symptoms of OA, the WOMAC score was used. This is a score to determine the level of OA and measures pain, stiffness and knee joint functioning. At the end of the study this was reduced by 33% in the undenatured type ll group, compared with 14% in the glucosamine/ chondroitin group.


The visual analog scale (VAS) score is a method to determine subjective pain levels. After 90 days, this decreased by 40% in the undenatured type ll collagen group compared with 15.4% in the glucosamine/chondroitin group.

According to the Lequesne index, a functional index for the impact of pain on daily activities, undenatured type ll collagen was more than three times as effective as glucosamine/chondroitin.



4. Undenatured type ll collagen has been proven to help active sports people whose performance is affected by joint discomfort with physical activity.

You don’t have to be a sufferer of RA or OA to benefit from undenatured type ll collagen. Sports people whose performance is adversely affected by joint pain can benefit.

In a randomised, double-blind, placebo-controlled study, healthy subjects who had no prior history of osteoarthritic disease or

joint pain at rest, but who experienced joint discomfort with physical activity, were included in the study.

Research showed benefits for knee extension, exercise duration and recovery. According to the lead study researcher, Dr. Jay Udani, ‘Loss of knee extension has been shown to negatively impact the function of the lower extremity. For example, loss of knee extension can cause altered gait patterns affecting ankles and the hip, which could result in difficulty with running and jumping.’

5. Undenatured type ll collagen is convenient, natural and totally safe to take.

Undenatured type ll collagen is a naturally occurring collagen that is extracted from the sternum of chicken. As I mentioned earlier, due to a patented low-temperature manufacturing process, the main structure of the natural collagen remains intact, and this is what gives undenatured type ll collagen its unique benefits.

Both glucosamine and chondroitin and normal collagen require taking 3-4 large capsules daily to achieve therapeutic levels.

It is not surprising that – when you consider the natural source of undenatured type ll collagen – it was found to be totally safe to take in both human and animal studies with no recorded side effects.

What’s more, undenatured type ll collagen was found to be effective in just 10mg per day.

This means taking just one small capsule daily.


References

1. Trenthham DE, Dynesius-Trentham RA, Orav EJ, et al, Effects of oral administration of type ll collagen on rheumatoid arthritis. Science. 1993 Sep 24;261(5129):1727-30

2. Bagchi D, Misner B, Bagchi M, et al. Effects of orally administered undenatured type II collagen against arthritic inflammatory diseases: a mechanistic exploration. Int J Clin Pharmacol Res. 2002;22(3-4):101-10.

3. Cohen ES, Bodmer HC. Cytotoxic T lymphocytes recognize and lyse chondroctyes under inflammatory, but not non-inflammatory conditions. Immunology. 2003 May;109(1):8-14.

4. Wang Q, Rozelle AL, Lepus CM, et al. Identification of a central rol(6)e for complement in osteoarthritis. Nature Medicine. Nov 6 2011

5. Adatia A, Rainsford KD, Kean WF, Osteoarthrities of the knee and hip. Part 1: aetiology and pathogenesis as a basis for pharmacotherapy. J Pharm Pharmacol. 2012 May;64(5):617-25.

6. Park KS, Park MJ, Cho ML, et al. Type ll collagen oral tolerance; mechansism and role in collagen-induced arthritis and rheumatoid arthritis. Mod Rheumatol. 2009;19 (6):581-9

7. Min SY, Park KS, Cho ML, et al. Antigen-induced, tolerogenic CDllc+, CDllb+dendritic cells are abundant in Peyer’s patches during the induction of oral tolerance to type ll collagen and suppress experimental collagen-induced arthritis. Arthritis Rheum. 2006 Mar;54(3):887-98

8. Weiner HL. Oral tolerance: immune mechanisms and treatment of autoimmune diseases. Immunol Today. 1997 Jul;18(7):335-43

9. Zhu P, Li XY, Wang HK, et al. Oral administration of type-ll collagen peptide 250-270 suppresses specific cellular and humoral immune response in collagen-induced arthritis. Clin Immunol, 2007 Jan;12(1):75-84

10. Shamir L, Ling SM, Scott WW Jr, et al. Knee x-ray image analysis method for automated detection of osteoarthritis.IEEE Trans Biomed Eng. 2009 Feb;56.

11. Barnett ML, Kremer JM, St Clair EW, et al. Treatment of rheumatoid arthritis with oral type ll collagen. Results of a multicentre, double-blind, placebo-controlled trial. Arthritis Rheum. 1998 Feb;41 (2):290-7

12. Trentham D, et al. Effects of Oral Administration of Type-II Collagen on Rheumatoid Arthritis. Science. 261:1727-1730, 1993.

13. Barnett ML, Combitchi D, Trentham DE. A pilot trial or oral type ll collagen in the treatment of juvenile rheumatoid arthritis. Arthritis Rheum. 1996 Apr;39(4):623-8

14. Crowley DC, Lau FC, Sharma P, et al. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int J Med Sci. 2009 Oct 9;6(6):312-21.


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Nutrients & Science Rheumatoid Arthritis and Osteoarthritis · This has now changed with undenatured type II collagen Undenatured type II collagen is the first natural food supplement