Resumen de Mechanism of action of collagenase clostridium histolyticum for clinical application

R. Sanjuan Cerveró, D. Gómez Herrero, Francisco Javier Carrera Hueso

• Introduction: Bacterial collagenases are a group of enzymes with wide uses in industry and medicine. In recent years a new interest has emerged as the result of their use as novel treatment for Dupuytren and Peyronie diseases, two fibroproliferative diseases. Their mechanism of action remains unclear for most pharmacists and clinicians due to the lack of information provided in the literature.

  Objectives: Systematic review of the literature to understand and explain the mechanisms of action of collagenases used in the treatment of fibroproliferative diseases.

  Method: The search conducted in PubMed using descriptors «Collagenase» AND «Clostridium histolyticum», not establishing limits of search by date, language or type of study, completed with other databases and excluding the terms «Dupuytren» AND «Peyronie» to avoid revisions and articles with clinical results.

  Discussion: There are two kinds of collagenase codified by one gen each other: ColG and ColH. Both collagenases act to different levels in the collagen: ColG or type I acts at the N-terminal level of the triple helix of collagen and ColH or type II develops its enzymatic action inside the molecule of collagen. This first step as collagenases is followed by the loosening of the C-terminal structure of the enzyme converting them as gelatinases that degrades the results of the initial digestion of the collagen, obtaining little oligopeptides. This process explains the six classes of collagenases described in literature. Impact of this process is crucial to understand the secondary effects of the collagenase in the treatment of fibroproliferative diseases, starting a cascade of reactions that activates the wound healing response and an inflammatory process