COMPARISON OF THE EFFECT OF HYDROCORTISONE, HYDROCORTISONE-17-BUTYRATE AND BETAMETHASONE ON COLLAGEN-SYNTHESIS IN HUMAN SKIN IN-VIVO

It has been shown previously that topical corticosteroid treatment dec reases collagen synthesis in human skin in vivo and that the adverse e ffects are due to reduced collagen synthesis, The aim of the present s tudy was to evaluate the effect of hydrocortisone, hydrocortisone-17-b utyrate and betamethasone on collagen synthesis in human skin in vivo. Fourteen healthy male volunteers applied hydrocortisone, hydrocortiso ne-17-butyrate, betamethasone and vehicle twice a day for one week to four separate areas marked on their abdominal skin. The collagen synth esis rate in the skin was measured by assaying collagen propeptides fr om the suction blisters induced on the treated areas. Aminoterminal pr opeptide of type I procollagen (PINP) and aminoterminal propeptide of type III procollagen (PIIINP) were measured from skin blister fluid us ing radioimmunoassays. Skin thickness was measured with ultrasound. Hy drocortisone decreased the two propeptides studied in the suction blis ter fluids less than did hydrocortisone-17-butyrate and betamethasone, but the interindividual variation was great, Hydrocortisone-17-butyra te and betamethasone had almost similar decreasing effects on the prop eptides in the suction blister fluid. Hydrocortisone decreased the con centrations of PINP and PIIINP by about 35%. In some subjects (4/14) t he decline of the collagen propeptide levels was over 50%. The decline in the concentration of PINP was 63% by hydrocortisone-17-butyrate an d 69% by betamethasone, while the decrease in PIIINP was 55% by hydroc ortisone-17-butyrate and 62% by betamethasone. None of the treatments had any effect on skin thickness within one week. In conclusion, it se ems that hydrocortisone is less atrophogenic than hydrocortisane-17-bu tyrate and betamethasone, as shown by radioimmunoassays for collagen p ropeptides. The order of inhibitory potency of the three glucocorticoi ds on collagen synthesis was hydrocortisone < hydrocortisone-17-butyra te < betamethasone. Thus, assay of collagen propeptides from suction b listers can be used to screen various steroids with respect to their a ction on collagen synthesis.