Investigations on collagen metabolism in patients with induratio penis plastica

The exact pathogenesis of Peyronie's Disease (PD) is still unknown. Penile traumas, inflammatory diseases and hormonal disorders are discussed as pote ntial reasons for the calcification of the dorsum penis. It is not clear, i f there's first a vasculitis and during the ongoing disease a fibrosis with a secondary calcification. Histopathological investigations suggest, that the metabolism of the collageneous tissue plays an important role. Another disease with simular alterations of the collagen tissue is the Dupuytren's Disease (DID). A Change in collagen type has been shown for these patients. As there is a high coincidence of PD and DD, a common reason in collagen m etabolism is possible. Therefore we started an evaluation of parameters of the collagen metabolism in patients with Peyronie's Disease. A prospective study with 22 participants was performed. The patient population consisted of 11 patients with PD and 11 healthy controls. We mesured the following bi ochemical parameters, which correspond to the collagen metabolism (procolla gen III [PIIIP], PMN-elastase [PMN-E], fibronectin [FN], fibronectinrecepto r [FN-R] and alpha (1)-proteinase-inhibitor [alpha (1)-PI]). Blood samples from the penis (corpus cavernosum) and from a peripheral vein were taken fr om each patient. There was no difference in PMN-E, PIIIP and FN-R in all sa mples. There was no difference in penile and venous blood as well. But we f ound a highly significant lower concentration of alpha (1)-PI in patients w ith PD (158,55 mg/dl) than in controls (214,82 mg/dl). A deficiency of alph a (1)-PI can lead to a higher activity of serum proteases, such as PMN-E. T his can result in a change of the collagen metabolism by an increased synth esis of collagen type III, that is found in PD. This general pathophysiolog ic factor may be completed by an additional local alteration of the tissue.