Similar to the DNA’s double-helix structure, collagen is composed of three strands, or polypeptide chains, forming a triple-helix. Each of these chains is composed of three amino acids, usually glycine, proline, and hydroxyproline.

Cartilage is composed of proteoglycans, collagen, chondrocytes (cartilage cells), and water. Glucosamine (an amino-sugar composed of glucose and glutamine) is found in much larger molecules, known as glycosaminoglycans (GAGs). Chondroitin sulfate, which has found great popularity today in treating osteoarthritis, is a glycosaminoglycan. These GAGs are polysaccharides that form long chains. After they are formed they are attached to a core protein to make a proteoglycan subunit. These proteoglycan subunits are then attached by a link protein to a hyaluronic acid molecule (another, much larger glycosaminoglycan) to create a proteoglycan aggregate, which then takes on a bottlebrush-like appearance. These GAGs are highly electro-negatively charged and attract large numbers of positively charged ions, such as sodium (Na+ ), and being osmotically active, cause large amounts of water to be attracted to these tissues

Chondrocytes are responsible for creating, forming, and repairing cartilage. Although they have a very poor oxygen and food supply, they seem to produce large amounts of collagen and proteoglycans^III.

Recently there have been many gelatin products available today that claim to help restore damaged joint materials. However, most of these gelatin products are typically derived from skin and not from cartilage, thus most of the collagen available is type I. As of today, there has been no research to show that collagen type I is effective in treating any forms of arthritis.

Research on collagen type II is another story, however. In the first Harvard trial, Dr. Trentham administered very small doses of collagen type II (derived from chicken sternal cartilage) to ten of his patients who had been diagnosed with rheumatoid arthritis. Prior to beginning the study, he had all of his patients discontinue their immune suppressive and disease-modifying drugs (methotrexate, mercaptopurine, azathioprine, or auranofin). These patients were then given 0.1 mg of collagen daily for one month, and then 0.5 mg for the next two months. Clinical response was defined as a 50% or greater improvement in the number of swollen and tender joints, accompanied by a 50% or greater improvement in two additional measures (morning stiffness, 15-meter walking time, grip strength, Westergren erythrocyte sedimentation rate, or physician or patient global assessment), lasting for two months after the treatment period. Six of the ten patients showed substantial clinical response, and one showed a complete response lasting 26 months. There were no adverse effects^IV.

Following this study, and because of the favorable results of Dr. Trentham’s research, a 90-day double-blind, phase II placebo study was performed involving 60 patients with severe active rheumatoid arthritis. These patients received either the placebo or solubilized type II collagen at 0.1 mg for one month and then 0.5 mg for two months. At the end of the study, 59 of the patients were evaluated. Twenty eight of these had received the collagen type II and thirty one had received the placebo.

There are two schools of thought as to how collagen type II seems to have this positive effect. The first theory speaks of a process known as oral tolerization in which small quantities of antigens cause biological processes that suppress inflammation at the cellular level, suppress response to delayed-hypersensitivity antigens, and eliminate the cells that respond to antigens. As of today, other studies using chicken sternal cartilage as a source of collagen type II offer conflicting results. My feeling is that because this quite unique matrix, derived from chicken sternal cartilage, containing collagen, glucosamine (15%), and chondroitin sulfate (15%), it provides a very comprehensive formula of nutrients required to re-construct damaged tissues and also provide wonderful anti-inflammatory qualities.