Long-Term Follow-Up of Serum N-Terminal Propeptide of Collagen Type III Levels in Patients with Chronic Liver Disease†

Abstract

To evaluate the diagnostic and prognostic significance of the N-terminal propeptide of collagen Type III (Col 1-3) in chronic liver disease, the peptide level was measured in the serum of 4 patients with primary biliary cirrhosis, 5 with chronic persistent hepatitis, 12 with chronic active hepatitis, and 1 with autoimmune hepatitis, for a period of 2 to 10 years and compared with liver function and histology. In primary biliary cirrhosis, Col 1-3 peptide levels were always elevated, regardless of medical therapy; however, after liver transplantation in one patient, the Col 1-3 peptide level decreased. In chronic persistent hepatitis, the peptide level fluctuated around the upper limit of normal. Among patients with chronic active hepatitis, the Col 1-3 peptide level normalized in 2 patients during remission, but was elevated in 7 patients who developed cirrhosis. Only in a patient with autoimmune hepatitis was the Col 1-3 peptide level normal, although the patient developed cirrhosis during prednisone therapy. When prednisone was withdrawn, the Col 1-3 peptide level increased. The data suggest that the serum Col 1-3 peptide may estimate the course of liver fibrosis in chronic liver disease and has prognostic value, particularly in chronic active hepatitis. Persistent elevation suggests ongoing fibrosis and development of cirrhosis; normalization suggests remission.

Serum Markers as Tools to Monitor Liver Fibrosis

“…A long-term follow-up study showed that serum PIIINP levels changed to reflect the progression and regression of histological changes of the liver either in their natural course or in response to treatment [14]. Similar results were observed in patients with autoimmune hepatitis treated with immunosuppressive therapy and in patients with chronic hepatitis C treated with interferon-· [15].…”

RGTA OTR4120, a heparan sulfate mimetic, is a possible long‐term active agent to heal burned skin

“…17 Presence of a relative increase in collagen III is often associated with fibrosis and excessive scarring in many diseases. 12,[35][36][37] Antifibrotic effects of RGTA have been demonstrated in earlier studies. Thus, RGTA treatment decreased the production of collagen III in intestinal tissue specimens from patients with Crohn's disease.…”

Serum Hyaluronic Acid and Procollagen III Amino Terminal Propeptide in Chronic Renal Failure

“…Ele vated serum concentrations of HA have been found in various diseases such as rheumatoid arthritis [3], psoria sis [4], and liver diseases where it has been suggested to be a marker of hepatic fibrosis [5]. Recently, Hallgren et al [6] reported elevated serum concentrations of HA also in patients with renal failure which we have con firmed in a preliminary report [7], Procollagen III amino terminal propeptide (PIIINP), liberated during the conversion of procollagen into colla gen, is another potential marker of disturbed connectivetissue metabolism [8,9], High serum levels seem to reflect ongoing fibrosis in patients with chronic liver dis eases [10,11], Patients having acute renal failure [8] or various chronic renal disease [12] have also shown ele vated serum concentrations.…”