Serum procollagen‐III‐peptide: Failure to reflect the extent of hepatic fibrosis

Abstract

In order to test the hypothesis that serum levels of the amino terminal propeptide of type III procollagen (PPCP III) reflect hepatic fibrosis, we have studied PPCP III levels in 30 patients with genetic haemochromatosis (GH), a disease which is characterized by progressive fibrosis without significant inflammation or necrosis. Patients with alcoholic liver disease and chronic hepatitis were included as comparative diseases in which fibrosis occurs concurrently with inflammation and necrosis. Of 13 GH cases with cirrhosis, four (30%) had normal serum PPCP III levels, while of 17 GH cases without cirrhosis, two (12%) had elevated levels. The mean serum concentrations of the cirrhotic and non‐cirrhotic GH groups were not significantly different when patients with excessive alcohol consumption (> 80 g/day) were excluded from the GH groups. In 29 subjects with alcoholic liver disease, serum PPCP III correlated significantly with both fibrosis (P < 0.01) and necrosis (P < 0.02) but not with inflammation. In 23 subjects with chronic hepatitis, PPCP III levels correlated significantly with inflammation when assessed histologically (P < 0.01) or as reflected by serum AST (P < 0.01), but not with fibrosis or necrosis. Furthermore, the correlation between PPCP III and inflammation was not strengthened when the three features (inflammation, necrosis and fibrosis) were combined into a single variable. We conclude that elevated PPCP III levels in chronic liver disease do not reflect solely the extent of fibrosis but are also influenced by inflammation and necrosis and are thus of limited clinical value in predicting hepatic histopathology.

Hepatotoxicity of Iron Overload: Mechanisms of Iron-Induced Hepatic Fibrogenesis

“…133 Several studies have investigated alterations in MMPs and TIMPs and the products of extracellular matrix remodeling in patients with hemochromatosis. [134][135][136][137] Serum PIIIP has proven to be of little diagnostic value as a marker of fibrosis staging in hemochromatosis patients. 134,135 Serum laminin levels are unchanged when compared with age-and sexmatched controls.…”

“…[134][135][136][137] Serum PIIIP has proven to be of little diagnostic value as a marker of fibrosis staging in hemochromatosis patients. 134,135 Serum laminin levels are unchanged when compared with age-and sexmatched controls. 136 However, serum TIMP-1, MMP-2, and CL-IV are all elevated in hemochromatosis and both MMP-2 and CL-IV have been shown to correlate with the severity of hepatic fibrosis.…”