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IntroductionChicken type II collagen (CCII) is a protein extracted from the cartilage of chicken breast and exhibits intriguing possibilities for the treatment of autoimmune diseases by inducing oral tolerance. A 24-week, double-blind, double-dummy, randomized, methotrexate (MTX)-controlled study was conducted to evaluate the efficacy and safety of CCII in the treatment of rheumatoid arthritis (RA).MethodsFive hundred three RA patients were included in the study. Patients received either 0.1 mg daily of CCII (n = 326) or 10 mg once a week of MTX (n = 177) for 24 weeks. Each patient was evaluated for pain, morning stiffness, tender joint count, swollen joint count, health assessment questionnaire (HAQ), assessments by investigator and patient, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) by using the standard tools at baseline (week 0) and at weeks 12 and 24. Additionally, rheumatoid factor (RF) was evaluated at weeks 0 and 24. Measurement of a battery of biochemical parameters in serum, hematological parameters, and urine analysis was performed to evaluate the safety of CCII.ResultsFour hundred fifty-four patients (94.43%) completed the 24-week follow-up. In both groups, there were decreases in pain, morning stiffness, tender joint count, swollen joint count, HAQ, and assessments by investigator and patient, and all differences were statistically significant. In the MTX group, ESR and CRP decreased. RF did not change in either group. At 24 weeks, 41.55% of patients in the CCII group and 57.86% in the MTX group met the American College of Rheumatology 20% improvement criteria (ACR-20) and 16.89% and 30.82%, respectively, met the ACR 50% improvement criteria (ACR-50). Both response rates for ACR-20 and ACR-50 in the CCII group were lower than those of the MTX group, and this difference was statistically significant (P < 0.05). The DAS28 (disease activity score using 28 joint counts) values of the two treatment groups were calculated, and there was a statistically significant difference between the two treatment groups (P < 0.05). Gastrointestinal complaints were common in both groups, but there were fewer and milder side effects in the CCII group than in the MTX group. The incidence of adverse events between the two groups was statistically significant (P < 0.05).ConclusionsCCII is effective in the treatment of RA and is safe for human consumption. CCII exerts its beneficial effects by controlling inflammatory responses through inducing oral tolerance in RA patients.Trials RegistrationClinical trial registration number: ChiCTR-TRC-00000093.

Functionalized and monodisperse nanoshells have attracted significant attention owing to their well-defined structure, unique properties, and wide range of potential applications. Here, the synthesis of cross-linked organic-inorganic hybrid nanoshells with strong fluorescence properties was reported via a facile precipitation polymerization of hexachlorocyclotriphosphazene (HCCP) and fluorescein on silica particles used as templates. The resulting poly(cyclotriphosphazene-co-fluorescein) (PCTPF) nanoshells were firm cross-linked shells with ∼2.2 nm mesopores that facilitated the transport of drug molecules. The fluorescent nanoshells also exhibited excellent water dispersibility and biocompatibility; thus, they can be considered as ideal drug vehicles with high doxorubicin storage capacity (26.2 wt %) and excellent sustained release (up to 14 days). Compared to doxorubicin (DOX) alone, the PCTPF nanoshells more efficiently delivered DOX into and killed cancer cells. Moreover, the PCTPF nanoshells also exhibited remarkable fluorescent emission properties and improved photobleaching stability in both suspension and solid state owing to the covalent immobilization of fluorescein in the highly cross-linked organic-inorganic hybrids. The exceptional fluorescent properties enabled the release of DOX as well as the distribution of nanoshells and DOX to be monitored.

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