SERUM MARKERS OF COLLAGEN-SYNTHESIS AND DEGRADATION IN SKIN DISEASES - ALTERED LEVELS IN DISEASES WITH SYSTEMIC MANIFESTATION AND DURING SYSTEMIC GLUCOCORTICOID TREATMENT

Serum concentrations of the markers of collagen synthesis and degradat ion, collagen I propeptide (PICP), collagen III propeptide (PIIINP) an d the cross-linked telopeptide of type I collagen (ICTP) were measured in young male dermatological patients and in control subjects. No sig nificant differences were noted between patients suffering from atopic eczema (n = 24), other eczemas (n = 11), acne (n = 8), psoriasis (n = 7) or tinea (n = 9) and the control subjects (n = 24). In the total s tudy population representing patients with common skin diseases and co ntrol subjects there was a significant correlation between the serum c oncentrations of PICP and PIIINP and between the concentrations of PIC P and ICTP. This suggests that synthesis of type I and III collagens i n vivo is coordinated and that the degradation and synthesis of type I collagen is balanced. These markers were also measured in older patie nts suffering from psoriasis, eczema and various connective tissue dis eases. It was noted that the degree of skin involvement in these disea ses was not related to the serum concentrations of the markers of coll agen metabolism. The highest levels of PICP and PIIINP were observed i n a patient with systemic mastocytosis (PICP 309 mug/l and PIIINP 8.0 mug/l). Increased levels of PIIINP were also found in patients with a high alcohol consumption. We have previously demonstrated that systemi c glucocorticoids reduce collagen propeptide levels in serum. In the p resent study we also proved that systemic gluocorticoids have no effec t on collagen degradation. Thus the side effects of glucocorticoids, s uch as growth inhibition, skin atrophy and decrease in bone mass, are a result of inhibition of the synthesis of collagen and other macromol ecules. The results indicate that local or generalized skin diseases d o not markedly alter serum markers of collagen synthesis or degradatio n. The alterations in collagen metabolism determined by measurements i n serum are thus mostly related to systemic involvement and medication (especially glucocorticoids).