Collagen and gelatin

General information

Collagen is a natural fibrous protein found in human cartilage, connective tissue, and bone. Glutaraldehyde cross-linked bovine collagen is a sterile, biocompatible, biodegradable, purified bovine dermocollagen cross-linked with glutaraldehyde, mixed in a phosphate buffered saline solution.

Purified solubilized bovine collagen is used as bio-material for the treatment of soft tissue defects and has been used for the treatment of stress urinary incontinence since the late 1980s [ ]. Injected material precipitates at body temperature, forming a matrix allowing fibroblastic infiltration and formation of new tissue. It has been used for cosmetic purposes by injection in the dermis to correct scars and other contour deformities of the skin.

Urethral injection of bovine collagen under local anesthesia is considered safe and effective, with minimal complications [ , ]. It has low antigenicity and is associated with a minimal inflammatory response, although foreign body reactions have occasionally been reported [ ]. However, antibody formation is not impossible [ ]. Patients with a history of allergic reactions to bovine collagen-derived products should be investigated because of the widespread use of collagen-derived therapeutic devices, the potential for immunological cross-reactivity with dietary collagen (gelatin), and the potential for anaphylaxis.

Artecoll® is a permanent synthetic cosmetic filler substance, composed of 80% bovine collagen and 20% polymethylacrylate. It is used for augmentation of deep wrinkles and is injected subdermally. The collagen is biodegradable with 2–4 months; however, the polymethylacrylate microspheres are non-biodegradable and long-lasting cosmetic effects are achieved.

Gelatin is an important constituent of many drug formulations, including capsules and suppositories. It is also found in some volume replacement solutions (for example Gelofusine). Gelofusine is a colloidal plasma volume expander used in the treatment of hypotension. It is prepared from bovine collagen. Severe non-IgE-mediated anaphylactic (anaphylactoid) reactions after gelofusine occur with an incidence that has been reported at between 0.066% and 0.345% of cases. They are more common in those with known drug allergy and in men. The mechanism may be triggering of non-immune complement C3 activation by colloid particles in the gelatine formulation or by combination with components in the patient’s blood [ ].

Organs and systems