Liquid Cartilage
a Note to Health Practitioners

Over the past fifteen years there has been much information made available regarding cartilage. Unfortunately it has been difficult to extract useful information from marketing hype. The reason for this is that while there is no doubt regarding the curative efficacy of cartilage, it is a dynamic and complex material, all the molecular components of which have not yet been fully identified and documented. The two distinct theories currently under research as to how and why cartilage works within the human body further compound the dilemma, creating a highly technical and confusing story.

Following is a brief history of cartilage use and research along with an overview of the two theories on how cartilage achieves the results it does over such a wide range of afflictions.

Immune stimulation or anti-angiogenesis?

There is nothing new about cartilage. In 1954 Dr John Fletcher Prudden, M.D., Med.Sc.D., the originator of cartilage therapy, began documenting case studies when, while studying wound healing, was astounded to see the acceleration of healing bought about by placing chips of cartilage into the wound. In 1972 Dr Prudden used Bovine cartilage to treat a patient suffering from breast cancer that had ulcerated, penetrating the skin over the entire chest wall, creating a very painful ulcer over a large wound of supraclavicular metastasis resulting in paralysis of the left arm. The ulceration healed as per Dr Prudden's expectations. However, the tumor regressed also. The patient experienced complete remission from her cancer and died 12 years later of a non-cancer related cause. Dr Prudden later applied for "Investigative New Drug (IND)" status with the Food & Drug Administration (FDA) and began clinical trials with 31 cancer patients. The trials were a resounding success, with patients achieving a positive response rate of 90%. These results were published in 1985 as "The Treatment of Human Cancer with Agents Prepared from Bovine cartilage" in The Journal of Biological Response Modifiers (4:551-584,1985). He reported that 6 of the original 31 patients were still alive in 1997 and that not all of those that had died actually succumbed to cancer, an outstanding result considering all were considered terminal cases with all possibilities of conventional treatment being exhausted. After confirming the complete non-toxicity of Bovine Cartilage, Dr Prudden began IND phase II clinical trials which he continued up until his death in September 1998.

Dr Prudden and his contemporaries theorize that the mechanism of oral efficacy of Bovine cartilage is immune stimulation. Prudden holds that cartilage closely resembles foetal mesenchyme. This is tissue in its earliest stages of development, from which skin, fat, muscle, bone and bone marrow (the engine room of our immune system) all evolve. The effect of mesenchyme on any tissue is potent normalization, hence the ability of bovine cartilage to modulate the human immune system ie; Stimulation to overcome tumors/modulating to inhibit self-destruction in the case of auto-immune arthritis.

Concurrent to Dr Pruddens research, Dr Judah Folkman was identifying and describing Tumor inhibition known as "anti-angiogenisis". Folkman identified that once tumors reached a size of 2-3 mm they needed to vascularise by eliciting new blood vessels from surrounding tissue in order to enlarge further and/or metastasise. By the mid 1970s Folkman was able to elaborate his hypothesis on the nature of tumor angiogenesis in a series of articles published in the Annals of Internal Medicine, New England Journal of Medicine, and Scientific American. In 1983 Folkman identified a combination of heparin and cortisone as having powerful anti-angiogenic properties. Though this heparinsteroid is now used as the standard when measuring anti-angiogenic activity, its extreme toxicity renders it unsuitable as a therapy.

In 1983 Anne Lee and Robert Langer noted in an article in Science "Cartilage from calves contains a substance that inhibits the vascularisation of solid tumors". In a 1990 issue of Science, Langer and his colleagues Marsha A. Moses and Judith Sudhalter reported the first tissue-derived molecule capable of inhibiting angiogenesis, the molecule was extracted from calf cartilage and was called Cartilage Derived Inhibitor (CDI).

Anti-angiogenisis is now a major field of research in the war against cancer. In a review article published in 1991 in Biologic Therapy of Cancer, Folkman listed CDI as one of 12 substances found to inhibit angiogenisis in mice or tissue culture, many such as heparinsteroid being of little use due to their toxicity. By 1995 this had been revised down to 9. Whilst he does not see cartilage as necessarily the best source of angiogenisis inhibitor, Folkman does however recognize the need for low toxicity levels, as "angiogenisis inhibitors directed against capillary endothelium may need to be administered for prolonged periods". Cartilage certainly meets this criteria. What has not as yet been ascertained is whether in fact these tumor inhibitors actually survive the digestive process in order to reach the tumor site intact.

In later studies Langer was isolating anti-angiogenic material from shark cartilage reasoning that unlike mammals, sharks endoskeletons are composed entirely of cartilage and would therefore be in more plentiful supply. However, as will be pointed out later, this is certainly not an unlimited or renewable resource.

Many firmly believe, particularly shark cartilage proponents, that it is the anti-angiogenic properties of cartilage that is the mechanism of efficacy.

Whichever school of thought is correct is irrelevant in relation to results enjoyed by arthritics and cancer sufferers alike. A multitude of both past and present positive responses to cartilage therapy are nothing short of remarkable, many of which have been well documented. It is clearly and furthermore logically obvious that it is not one single element in cartilage that holds the key to its efficacy. Rather, a natural synergy of a number of different molecules operating together perhaps in conjunction with a combination of both anti-angiogenisis and immuno-stimulation may well explain such achievable results. Since the FDA prefers isolated elements in pure forms and concentrations and does not sanction natural products, funding to study cartilage is difficult to secure. It will take years for researchers to isolate and identify all of the individual molecules involved in cartilage's effectiveness, let alone try to put the jigsaw of interaction together. Australia's own CSIRO are only now gradually beginning to unlock the secrets of the Glycosaminoglycans (Gags) found in cartilage. These include the current "buzz words" Chondroitin and Glucosamine in their natural medium. Though these substances alone have enormous and indisputable merit, they are still but a small piece of the much larger overall cartilage picture.

Shark cartilage or Bovine cartilage

Shark cartilage is available in numerous brands and far easier to find than Bovine cartilage, which at the moment constitutes only around 5% of cartilage sales. Bovine sales will however, catch and outstrip shark over the next few years, for the following reasons:

The research that has been carried out on cartilage has been far better documented in the case of Bovine cartilage.
The research on Bovine has been carried out by well-respected physicians such as Dr Prudden and Dr Durie within the US and as such is more easily verified.
Smaller dosages of bovine are required, so it is therefore easier to consume. There have also been many reports of constipation caused by Shark cartilage consumed in relation to the recommended dosages for cancer treatment.
The often recommended daily 70gram therapeutic dose for Shark cartilage delivers 14 gram of calcium or 13.5 times the USRDA while Bovine contains less than 10% of that allowance.
There has been quite a deal of concern expressed for Shark fishery stocks with the demand created by the cartilage industry, particularly in South American waters. Both the Australian and US. Governments have introduced quotas to protect their Shark stocks.
Taken at the recommended dosages for cancer patients, Shark cartilage therapy is far more expensive than bovine.
Cartilage in liquid form is much easier to take. Hydrolyzed using a completely natural biological process, the only additional ingredients utilized are pH buffers and antioxidants for product stability, allowing both the retention of potency whilst further enhancing the crucial bio-availability. The main reason liquid cartilage makes sense is economic. As cartilage ages it osteofies and becomes more bone like. This older cartilage is not able to be digested by the body and passes straight through but can sometimes comprise up to 50% of cartilage powders. Of course it registers as cartilage components during testing as the cartilage is broken down for analysis using strong acids, something the body cant do.

In conclusion, for those who have not yet looked into cartilage therapy, particularly for the treatment of Arthritis or Cancer, you would be well advised to do so. For your reference and convenience following is a list of books, papers and websites that offer information on Cartilage.

Books
Kirchhof David, DC & Kirchhof Elisabeth, NO "The Successful Use Of Bovine Cartilag in the Treatment of cancer", Kriegel & Associates, 1995.
Lane I. William & Comac Linda; "Sharks Don't Get Cancer" (Garden City, NY: Avery Publishing Group Inc., 1992)
Lane I. William & Comac Linda "Sharks Still Don't Get Cancer ", A very Publishing, 1996
Osbourne Sally E., "Health Benefits of Bovine Cartilage ", Keats Publishing 1998

Papers
Folkman Judah; "Clinical Application of Research on Angiogenisis", New England Journal of Medicine 333(26): 1761 (Dec. 28th 1996)
Harper Greg; "Cattle: Latest Weapon Against Cancer?", CSIRO Media Release, December 1997
Langer Robert, "Isolation of a Cartilage Factor That Inhibits Neovascularization", Science 193:71(July 1976)
Prudden John F.; "The Treatment of Human Cancer with Agents Prepared From Bovine Cartilage", Journal of Biological Response Modifiers4 (6): 551-84(1985).

Websites
CancerGuide, "Bovine Cartilage" Steve Dunn
A Potent Normalisation, From The Cancer Chronicles: 16, 1993 R. W. Moss
Does Cartilage Cure Cancer, Michael Lerner & Don Flint
Shark Cartilage Information Council

Liquid Cartilage a Note to Health Practitioners

Immune stimulation or anti-angiogenesis?

Shark cartilage or Bovine cartilage

Liquid Cartilage
a Note to Health Practitioners