Experimental Intervertebral Discolysis with Collagenase

Sussman, Bernard J.; Mann, Marion

doi:10.3171/jns.1969.31.6.0628

Cited by 31 publications

(11 citation statements)

References 3 publications

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“…With respect to the systemic biochemical and hematological response to local tissue injection of CHCs, Sussmann and Mann69,70,95,96 demonstrated no adverse changes in red blood cell, white blood cell, or platelet counts in rats receiving >100 times the effective dose required for intervertebral disc lysis. Hurst et al5 reported no clinically meaningful changes in hematological or biochemical variables following CHC injection in DD cords.…”

Section: Discussionmentioning

confidence: 98%

“…To date, CHCs have been investigated for clinical use in the treatment of herniated intervertebral discs,69–71 retained placenta,72 frozen shoulder adhesive capsulitis,73 DD (see section “CHC and fibrotic disease”), PD,11,17,74 wound healing, 75–77 in the debridement of burns,76,77 and in the preparation of pancreatic islet cells for transplantation 16,78. It has also been suggested that CHC could be used in the treatment of keloid scars,16 for recannalization of chronically occluded arterial vessels or stents within peripheral arterial angioplasty procedures79 and in the amelioration of plantar fasciitis,7 lateral epicondylitis,7 and cellulite removal 10.…”

Section: Collagenase C Histolyticummentioning

confidence: 99%

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The emerging role of <em>Clostridium histolyticum</em> collagenase in the treatment of Dupuytren disease

Thomas

Bayat

2010

TCRM

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Dupuytren disease (DD) is a common fibroproliferative disease of unknown etiopathogenesis affecting the palmar aponeurosis, causing reduced hand function and resulting in fixed flexion contractures of the digits. Current gold standard treatment for the management of DD is surgical excision involving removal of the affected palmar fascial tissue. However, there are potential complications associated with surgery as it is costly and a positive surgical outcome is often short-lived because the disease tends to recur. Therefore, there is growing interest in nonsurgical, outpatient-based treatments that could be quicker, cheaper, reduce morbidity, show a decreased rate of recurrence, and give DD patients an improved quality of life when compared with traditional surgical management. Of the available nonsurgical options, injectable Clostridium histolyticum collagenase (CHC) has received recent clinical interest. In this article, a brief overview of DD surgical and nonsurgical treatments utilized is given, followed by a detailed examination of the nine papers published to date on the use of CHC in DD (and similar fibrotic disorders). These papers have investigated safe and efficacious doses for the injection of CHC to treat palpable DD cords in adult patients and have shown significant short- to mid-term results for correction to near-full digital extension (≤5° extension) following CHC injection of DD cords. CHC has been shown to target the collagen-based DD cords while sparing surrounding neurovasculature, with a complication profile that appears comparable to that of the surgical methods currently utilized. In conclusion, clostridial collagenase is a novel nonsurgical treatment option of considerable potential in the management of DD when administered by specialist hand surgeons with detailed knowledge of the disease and the relevant anatomy. Nonetheless, there is a need for further data on long-term results, complications, and rate of recurrence with the use of this emerging treatment option.

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Section: Discussionmentioning

confidence: 98%

Section: Collagenase C Histolyticummentioning

confidence: 99%

The emerging role of <em>Clostridium histolyticum</em> collagenase in the treatment of Dupuytren disease

Thomas

Bayat

2010

TCRM

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“…The safety of CCH was assessed in several early animal studies evaluating the applications of collagenase in intervertebral discolysis to treat herniation. These studies found no adverse hematologic effects on erythrocytes, leukocytes, or platelets and no other adverse systemic effects when administered to dogs at 100 times the prospective therapeutic dose [Sussman and Mann, 1969]. Rat studies at high doses similarly found no adverse systemic effects of CCH, including fertility and harm to fetus, when administered up to 11 times the maximum recommended human dose (MRHD).…”

Section: Collagenase Clostridium Histolyticummentioning

confidence: 99%

Collagenase Clostridium histolyticum in the management of Peyronie’s disease: a review of the evidence

Traore

Wang

Yafi

2016

Therapeutic Advances in Urology

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“…1,23,25 After successful animal experiments, collagenase (Nukleolysin) was used in a chemically purified preparation for clinical studies. 7,8,28,[67][68][69] In a double-blind study, 80% of the patients treated with collagenase showed good and excellent results, as compared with 30% in the placebo group. 9 There were no reports about allergic reactions or sensitivity to collagenase, but endplate erosions of the adjacent vertebra, mimicking the picture of discitis, were reported.…”

mentioning

confidence: 96%

“…10,12,36,39,40 Even 7 to 10 times the therapeutic dose injected into the disc or intravenously in dogs and monkeys caused no toxic effects. 8,69 After intrathecal injections of lower doses in dogs, anterior horn cell degenerations were seen. Hemorrhage and paraplegia occurred only after a high dose of 2000 U.…”

mentioning

confidence: 97%