水解胶原蛋白对骨骼和关节疾病的作用（中英）

目的：为了检查水解胶原蛋白在关节炎和骨质疏松症治疗上的目前状况。  方法：通过回顾过去和目前有关水解胶原蛋白代谢的文献，并且评估其对关节炎，骨质疏松病上的治疗试验的临床研究。  结果：水解胶原已被长期使用于药物和食物中，这些产品通常被监督部门评定为安全食物。医药使用级别的水解胶原蛋白从药物水解胶原中获取。临床研究建议每天服用10克水解胶原蛋白有助减少患关节炎病人膝部和臂部的疼痛，并且提升血液中的羟脯氨酸浓度。在临床性使用上伴有稍许不良反应，主要表现为肠胃饱胀或口感不佳。我们在美国，英国和德国的诊所进行了一个多中心，随意性，双盲无效对照剂测试，结果从数据上显示，所有研究组（所有实验场地）的平均疼痛评分差别没有明显区别。然而，在德国使用水解胶原蛋白代替安慰剂有着显著治疗效果优势。此外，对比起安慰剂，我们从研究开始就观察到水解胶原蛋白在整个研究严重症候病人人群中有着加强效用。对比标注14C的脯氨酸，我们发现标为14C的水解胶原在软骨中更容易聚集。容易被软骨吸收表明药用水解胶原蛋白对软骨组织代谢起着有益作用。考虑到胶原蛋白在骨骼中的重要角色，药用水解胶原蛋白对患骨质疏松人群的骨骼代谢作用已被评估。服用降钙素同时摄取含或不含水解胶原蛋白的餐食作用研究已确实服用降钙素加上胶原蛋白比单单使用降钙素在防止骨骼骨胶原分解方面有着更好的作用。其特点显示在尿液吡啶诺林交联键的下降水平。对单独使用降钙素而言，药用胶原蛋白对其有着加强作用。  结论：水解胶原蛋白作为治疗媒介在关节炎和骨质疏松治疗上的可能性使用引起我们的关注。它的高度安全性作为长期使用治疗严重失调症状的媒介对大众特别有吸引力。

Role of collagen hydrolysate in bone and joint disease.  OBJECTIVES:To review the current status of collagen hydrolysate in the treatment of osteoarthritis and osteoporosis.  METHODS:Review of past and current literature relative to collagen hydrolysate metabolism, and assessment of clinical investigations of therapeutic trials in osteoarthritis and osteoporosis.  RESULTS:Hydrolyzed gelatin products have long been used in pharmaceuticals and foods; these products are generally recognized as safe food products by regulatory agencies. Pharmaceutical-grade collagen hydrolysate (PCH) is obtained by hydrolysis of pharmaceutical gelatin. Clinical studies suggest that the ingestion of 10 g PCH daily reduces pain in patients with osteoarthritis of the knee or hip; blood concentration of hydroxyproline is increased. Clinical use is associated with minimal adverse effects, mainly gastrointestinal, characterized by fullness or unpleasant taste. In a multicenter, randomized, doubleblind, placebo-controlled trial performed in clinics in the United States, United Kingdom, and Germany, results showed no statistically significant differences for the total study group (all sites) for differences of mean pain score for pain. There was, however, a significant treatment advantage of PCH over placebo in German sites. In addition, increased efficacy for PCH as compared to placebo was observed in the overall study population amongst patients with more severe symptomatology at study onset. Preferential accumulation of 14C-labeled gelatin hydrolysate in cartilage as compared with administration of 14C-labeled proline has been reported. This preferential uptake by cartilage suggests that PCH may have a salutary effect on cartilage metabolism. Given the important role for collagen in bone structure, the effect of PCH on bone  metabolism in osteoporotic persons has been evaluated. Studies of the effects of calcitonin with and without a collagen hydrolysate-rich diet suggested that calcitonin plus PCH had a greater effect in inhibiting bone collagen breakdown than calcitonin alone, as characterized by a fall in levels of urinary pyridinoline cross-links. PCH appeared to have an additive effect relative to use of calcitonin alone.  CONCLUSIONS:Collagen hydrolysate is of interest as a therapeutic agent of potential utility in the treatment of osteoarthritis and osteoporosis. Its high level of safety makes it attractive as an agent for long-term use in these chronic disorders.