Dupuytren’s disease cords are weakened ex vivo by injection of recombinant collagenase G – A proof-of-concept study

Objectives Dupuytren’s disease is a fibroproliferative disorder that is characterized by collagen-rich cords that cause progressive flexion contractures. Collagenase from Clostridium histolyticum is an established nonsurgical therapy. Herein, we evaluated whether a recombinant form of collagenase G (ColG), expressed in Escherichia coli , weakens Dupuytren’s cords ex vivo. Methods Cords from Dupuytren’s disease patients were excised during surgery. Using a 30G needle, 0.5 mL of 4 mg/ml ColG or phosphate buffer Saline (PBS) was injected into the cord center. Samples were incubated in saline at 37 °C and mounted via size-1 Prolene Krackow sutures on an Instron tensile testing system. Force vs. displacement curves were recorded. Results Six cords from five patients were tested (ColG n = 4; PBS n = 2). Representative force–displacement curves showed a reduced slope and lower peak force prior to rupture in ColG-treated samples compared with vehicle. The mean maximum rupture force was lower with ColG than with PBS (0.047 kN vs 0.069 kN), corresponding to ~32% reduction in the force required to tear the cord in this series. Conclusions Recombinant ColG weakens the tensile strength of Dupuytren’s cords ex vivo, consistent with potent collagenolytic activity. These proof-of-concept pilot data support further studies to define dose–response, optimize formulation and exposure time, and evaluate safety and clinical performance relative to current collagenase-based treatments.