Intradermal Implantation of Bovine Collagen: Humoral Immune Responses Associated With Clinical Reactions

A special collagen implant (Zyderm) (ZCI) is a biomaterial used for the correction of dermal contour deformities. Although infrequent, reactions believed to be of an immunologic nature have followed treatment. To investigate whether humoral immunity is associated with these reactions, we studied 40 patients for the presence of anti-ZCI antibodies using an enzyme-linked immunosorbent assay. Ten patients who had had adverse treatment reactions uniformly exhibited circulating anti-ZCI antibodies. Twenty-nine of 30 control patients, including nine who had received ZCI without adverse reaction, failed to produce the high levels of antibodies found in all clinical reactors. This difference was statistically significant. Additional investigations confirmed that the antibodies studied were directed primarily against the bovine collagen component of the ZCI. These data suggest that the humoral immune system is capable of recognizing ZCI and that the presence of antibodies to the ZCI correlates with the occurrence of adverse reactions.