From ancient sutures to 3D-printed tissues: How nature's structural protein is revolutionizing regenerative medicine
Imagine a material strong enough to support bones, flexible enough to form tendons, and transparent enough for the cornea of the eye. This wonder material already exists in our bodies: collagen. As the main structural protein of the human body, collagen makes up about 30% of total body protein and forms the framework that gives our tissues shape and strength 8 .
But only in the last 50 years have we learned to process collagen specifically for implantable medical devices. Today, collagen-based biomaterials are revolutionizing regenerative medicine - from artificial skin for burn victims to woven blood vessels and 3D-printed tissues 1 4 9 .
Provides framework for bones, tendons, and skin
Used in wound care, surgery, and tissue engineering
Ongoing innovations in processing and applications
Collagen is not a simple, uniform protein but a diverse protein family with at least 28 different types, each performing specific functions in different tissues 4 8 . This diversity allows collagen to absorb immense compressive forces in bones as well as form flexible networks in the skin.
The foundation is a repetitive amino acid sequence that repeats as a (Gly-X-Y) pattern. Glycine (Gly) is the smallest amino acid and enables the dense packing of the structure. Proline (Pro) and hydroxyproline (Pro-OH) are frequently found at positions X and Y 4 9 .
Three of these amino acid chains wind into a unique left-handed helix 4 .
Three left-handed helices form together a stable right-handed superhelix, the so-called tropocollagen. This molecule is about 300 nm long and 1.5 nm in diameter 4 8 .
Tropocollagen molecules assemble in a staggered arrangement to form collagen fibrils, which in turn bundle into collagen fibers. This staggered arrangement creates the characteristic cross-striated patterns visible under the electron microscope 4 .
| Collagen Type | Main Occurrence | Significance and Function |
|---|---|---|
| Type I | Skin, tendons, bones, teeth | Provides tensile strength; most common collagen type (≈90%) 4 9 |
| Type II | Cartilage, vitreous body of the eye | Resists periodic compressive loading 8 |
| Type III | Skin, blood vessels, internal organs | Often associated with Type I; gives tissue elasticity 8 |
| Type IV | Basement membranes | Forms mesh-like filter structures 4 |
Collagen for biomedical applications is obtained from various sources, each with advantages and disadvantages:
Obtained from fish skin and scales. An interesting alternative for better waste utilization and fewer religious concerns 9 .
Produced using genetically modified microorganisms or plants. This bypasses the risk of disease transmission and batch variations but is currently associated with high costs and low yields 9 .
The extraction of pure, biocompatible collagen from animal tissue is a multi-stage process that either preserves or specifically modifies the complex natural architecture of the protein 1 .
Starting materials such as skin, tendons, or intestines undergo intensive cleaning and digestion processes. Non-collagenous proteins, fats, and cell debris are removed. The purification can be carried out so gently that the complex tissue-specific architecture is essentially preserved - this is referred to as decellularized ECM (decellularized extracellular matrix) 1 . More intensive chemical and enzymatic treatments, however, completely dissolve the collagen in soluble form.
The collagen solution obtained in this way can be processed into various product forms:
By casting and drying, thin, flexible films are created that are used in dentistry or for wound covering 5 .
Freeze-drying (lyophilization) creates highly porous sponges that absorb liquids and serve as scaffolds for cell growth, for example in the treatment of burn wounds 1 .
In aqueous solution, collagen forms a soft, three-dimensional gel at certain temperatures and pH values, which is ideal for cell culture or as an injection material 9 .
Using special processes such as wet spinning with the addition of crosslinkers, stable, fibrous structures can be produced that are suitable for tendon replacement .
Native collagen often does not have the required mechanical strength and degradation resistance for implants. Through crosslinking, additional stable bonds between the collagen molecules are created. This significantly strengthens the material and slows its degradation in the body 9 .
| Crosslinking Method | Principle | Advantages and Disadvantages |
|---|---|---|
| Physical (e.g., irradiation, UV light) | Generation of reactive species that form crosslinks 9 | Simple; no foreign substance input / Lower stability |
| Chemical (e.g., glutaraldehyde, EDC) | Chemical bridges between amino acid residues of the collagen chains 1 9 | Very stable / Potential cytotoxicity of chemical residues |
| Enzymatic (e.g., transglutaminase) | Use of natural enzymes to form crosslinks 9 | Biocompatible / Higher costs |
Tendons are masterpieces of nature that transmit mechanical loads between muscles and bones. Their enormous tear strength is due to a strict parallel alignment of collagen fibrils in a hierarchical structure . Reproducing this structure in the laboratory is one of the greatest challenges in biomaterials research.
The goal is to produce a biomimetic material - that is, a material that mimics the natural structure and function. Specifically, an acellular tendon scaffold made of collagen is to be created that, after implantation, can be colonized and remodeled by the body's own cells, a process referred to as ligamentization . Such a scaffold must exhibit high tensile strength and mimic the uniaxial fibril alignment of a real tendon to encourage cells to migrate in an orderly manner and form new tissue.
One of the most promising mechanical methods is wet extrusion with shearing . The following step-by-step description illustrates this process:
A highly purified collagen powder, typically from bovine or rat tendons, is dissolved in an acidic aqueous solution (e.g., acetic acid) at 4°C. At this pH and temperature, the collagen is in dissolved, monomeric form.
The viscous collagen solution is forced through a nozzle into a neutral precipitation bath (often a phosphate buffer solution). The pH change and the presence of ions initiate the immediate self-assembly of the collagen molecules into fibrils.
Crucial for the alignment is that the forming fibrils are subjected to shear forces on their way through the precipitation bath. This can be achieved by the movement of the precipitation medium (flow shear layer) or by pulling the emerging thread. These forces force the fibrils to align in the flow direction.
The fibrous strand is then removed from the bath, often fixed in a stretched state, and chemically (e.g., with EDC) or physically crosslinked to stabilize the structure. Finally, it is carefully dried.
Microscopic analyses (scanning electron microscopy) show that fibers produced with this shearing method exhibit a high linear alignment of the collagen fibrils in the fiber direction, which strongly resembles that of natural tendons . Mechanical tensile tests demonstrate that these artificial fibers have significantly higher tensile strength and stiffness than disordered collagen sponges or gels.
| Material | Tensile Strength (MPa) | Elastic Modulus (MPa) | Notes |
|---|---|---|---|
| Human Achilles Tendon | 54 ± 20 | 212 ± 109 | Natural reference tissue |
| Anterior Cruciate Ligament | 24 ± 9 | 113 ± 45 | Natural reference tissue |
| Non-aligned Collagen Sponge | < 1 | Very low | Soft, for soft tissue repair |
| Collagen Fiber (Sheared) | Up to ~80 (theoretical) | Significantly increased | Mimicry of tendon structure |
This experiment demonstrates that the natural hierarchy of collagen structures can be replicated through controlled physical processes. It provides the basis for the development of load-bearing artificial tendons that could ultimately replace autologous transplants, thus sparing patients a second harvesting site .
Research on collagen biomaterials requires a range of special reagents and techniques. The following table provides insight into the scientists' "toolbox".
| Tool / Reagent | Function in the Research Process |
|---|---|
| Acid Solution (e.g., acetic acid) | Dissolution of collagen powder at low temperatures to preserve the native structure . |
| Phosphate Buffered Saline (PBS) | Serves as a precipitation bath; neutral pH induces fibril formation . |
| N-Hydroxysuccinimide (NHS)/EDC | Biocompatible chemical pair for chemical crosslinking; avoids toxic residues 9 . |
| Electron Microscope (SEM/TEM) | Visualization of fibril structure, diameter, and alignment at the nano level 4 . |
| Tensile Testing Machine | Quantification of mechanical properties such as tensile strength and elongation . |
The future of collagen biomaterials is extremely promising and is being driven by several innovative technologies:
With collagen-containing bioinks, complex, patient-specific tissue structures such as skin, cartilage, or even parts of organs can be built up layer by layer. The major challenge is to preserve the native structure and strength of collagen during the printing process 1 7 .
Through advances in recombinant protein technology, customized collagen could be produced in the future that is precisely tailored to the needs of a specific patient or tissue type - without the risk of incompatibilities 9 .
From the ancient suture to 3D-printed tissue - the journey of collagen as a biomaterial is an impressive example of the translation of biological knowledge into medical progress. We have understood that the unique hierarchical structure of collagen is not only responsible for its mechanical properties in nature but also provides the blueprint for modern biomaterials. Through targeted processing, crosslinking, and structuring, we are now able to give this natural building block new, life-saving forms. The future promises to place collagen even further in the service of health to repair damaged tissues, treat diseases, and perhaps someday rebuild entire organs.
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