Gnaw Those Bones
Long ago, my parents explained that polite people don't chew up chicken bones. At dinner, one should whittle off solely what discreet maneuverings of knife and fork permitted. I could gnaw away at the delicious morsels only when we dined with my mother's parents.
"The best meat," my grandfather always declared, "lies closest to the bone." Then he'd pick up a drumstick and chomp down, chewing up skin, cartilage and all. No one dared scold Grandpa, so I was safe too. Let the others mince about with cutlery. He and I were eating chicken as it should be eaten.
The image of those family dinners came back when I read in a recent issue of the journal Science about a study that offers hope for easing rheumatoid arthritis.
Rheumatoid arthritis is one of the so-called autoimmune diseases. In such diseases, the body's immune system seems to lose its ability to distinguish between friend and enemy. A normal immune system attacks invading organisms and carries off alien substances. Once in a while a system malfunctions, and the defender cells begin attacking the body itself. In rheumatoid arthritis, the immune system attacks cartilage in the joints.
No one understands what triggers this sudden inability to tell self from nonself, and no one has yet found a cure for the problem. Treatments to ease symptoms usually involve painkillers, steroids, or drugs to suppress the output of defender cells, but even these palliatives can have unpleasant or dangerous side effects.
However, foreign substances enter the body all the time without triggering an immune reaction---as long as they come in via the digestive system. A team of scientists at Harvard University decided to see if that natural pathway could be used to train the immune systems of arthritis patients to leave their joints alone.
Led by rheumatologist David Trentham, the group hypothesized that alien proteins entering through the stomach and intestines somehow suppress immune responses to similar proteins. The researchers decided to try feeding rheumatoid arthritis patients a substance as close to their own attacked protein as could be found. Theoretically, the patients' systems should learn toleration by ingestion.
Trentham's team selected a protein known as type II collagen, which is common in the cartilage found in joints and is thought to be one of the substances destroyed by confused immune system cells. After testing collagen derived from chicken joints for safety and efficacy with arthritic rats, they enlisted 60 human volunteers to take part in a clinical trial. All the volunteers had been undergoing treatment for rheumatoid arthritis, and all had to forgo their usual medications during the trial. Half of the test group received daily doses of collagen, and half received an inert placebo. Neither the patients nor their doctors, who performed monthly exams, knew who got which treatment.
The trial lasted 90 days. During the course of the study, only 7 percent of the volunteers who received collagen got worse--they had less joint mobility and more pain and swelling than when the trial began--compared to 35 percent of the patients receiving the placebo. Nearly all the other collagen recipients showed various degrees of improvement, and four of them enjoyed complete remission of their symptoms.
Please note that collagen is clearly not a magic bullet against rheumatoid arthritis. The trial was brief, and the trial participants few. Most of the experimental subjects felt only some improvement, and a few actually got worse. Even collagen's proponents warn against blindly trying to alleviate arthritis by popping collagen pills. Dosage is likely to be critical, and attempting self-medication is more likely to produce frustration than relief.
But still, the preliminary evidence is tantalizing. And, when I think back to those chicken dinners with my mother's family, I can remember my grandfather's strong if weathered old hands holding a drumstick. My grandmother's hands, holding the fork that pursued bits of meat around her plate, were knobbed and swollen with arthritis.
