Collagen Types I and III Propeptides as Markers of Healing in Chronic Leg Ulcers A Noninvasive Method for the Determination of Procollagen Propeptides in Wound Fluid—Influence of Growth Hormone

Abstract

A noninvasive method allowing measurements of the propeptides of collagen type III (PIIINP) and type I (PICP) in ulcer washings was developed. The response to topical human growth hormone was examined. Fourteen patients with venous ulcers were treated sequentially with human growth hormone (0.1, 0.25, and 1 IU/cm2/day), each dose for 1 week, followed by 1 week washout. On alternate days, three and two times during treatment and washout periods, respectively, the ulcers were washed and incubated for 30 minutes with sterile water. No changes in healing rates in relation to growth hormone application were observed. In contrast, PIIINP increased significantly to 168% (154% to 184%) (mean, 95% confidence interval) and 195% (179% to 218%) 5 and 9 days, respectively, after start of treatment, (p < 0.01). Propeptides of collagen type I reached a significant increase, to 196% (172% to 232%), in the fourth week, (p < 0.01). The areas under the curves of PICP and PIIINP correlated significantly with the healing rates (r = 0.57, p = 0.04; and r = 0.64, p = 0.01, respectively). The authors conclude that propeptide measurements may be useful markers of healing in clinical studies.

Expression patterns of collagen types I and III in the capsule of a rat knee contracture model

“…It is not only a major constituent of normal synovial membrane,23 but also present in inflamed24 and proliferative rheumatoid synovial membrane 25. Further, it is synthesized during wound healing26 and replaced by collagen type I 27. The determination of collagen types I and III expression levels is of value in assessing whether the changes in the capsule of a joint developing a contracture are of a proliferative/secretive or a degenerative/ catabolic nature 18…”

Prognostic value of markers of collagen remodeling in venous ulcers

“…These proteases may also be regarded as markers of inflammatory and connective tissue cell activity, respectively 11,12 . On the synthetic side, it has been shown that levels of the propeptide markers of collagen synthesis are modulated during healing 13‐15 . All of these components may be collected noninvasively from wound exudates.…”

Noninvasive device readouts validated by immunohistochemical analysis enable objective quantitative assessment of acute wound healing in human skin

“…This trend was also demonstrated by collagen III immunohistochemical analysis, although collagen I results showed an increase from day 0 to day 14. Collagen I and III were chosen as the most appropriate markers as both of these types of collagens are formed in large quantities in granulation tissue in the healing wound . Previous studies had reported rapid collagen accumulation during the first 3 weeks of healing .…”