To analyze the correlations between the presence of
cirrhosis and hepatocellular
inflammation and the serum concentrations of the amino-terminal
peptide of
procollagen type III in chronic
liver disease, we measured
procollagen type III concentrations in paired serum samples from 46 patients (17 had
cirrhosis) with severe
chronic active hepatitis during a therapeutic treatment trial. Coded sera were analyzed for
procollagen type III concentrations using both a standard and a recently described Fab radioimmunoassay to compare their relative diagnostic accuracy. Mean
procollagen type III levels were elevated to the same extent in the cirrhotic and noncirrhotic groups at entry into the study. In response to immunosuppressive therapy, the initially elevated
procollagen type III levels improved to normal values at remission in both groups. Qualitatively, the results were similar using either assay, but the standard assay was more sensitive for identifying the clinical stage of disease (i.e., active disease vs. disease in remission) than the Fab assay. Since both
procollagen type III levels and standard liver function tests correlated well individually with the presence or absence of active disease, they also correlated with each other when both entry and remission values were considered. However,
procollagen type III levels correlated poorly with indicators of
inflammation (histologic grade and serum
transaminase levels) during active disease. It is concluded that
procollagen type III levels change in concert with standard liver function tests but do not quantitatively reflect
inflammation or static measurements of hepatic
fibrosis in severe
chronic active hepatitis. However, these preliminary results suggest that
procollagen type III can distinguish active disease from
chronic active hepatitis in remission.(ABSTRACT TRUNCATED AT 250 WORDS)