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FRI0201 Circulating procollagen iii aminopropeptide in systemic sclerosis: relationship to a recently validated disease activity index
  1. S D’Angelo1,
  2. A Della Rossa2,
  3. M Caronni3,
  4. R Scorza3,
  5. S Bombardieri2,
  6. G Valentini1
  1. 1Rheumatology Unit, Second University of Naples, Naples
  2. 2Clinical Immunology Unit, University of Pisa, Pisa
  3. 3Clinical Immunology Unit, University of Milan, Milan, Italy


Background Systemic sclerosis (SSc) is characterised by excessive deposition of extracellular matrix components in the skin and in involved internal organs. Serum levels of procollagen III aminopropeptide (PIIINP), an index of collagen synthesis, have been reported as a possible marker of disease activity in SSc.1

Objectives To study the relationship between a recently developed index of disease activity (2, 3) and serum concentrations of PIIINP.

Methods Nineteen SSc patients (17 F, 2 M; age ranging from 24 to 76, median 55.5 years; 13 lcSSc, 6 dcSSc; disease duration ranging from 2 to 34, median 12 years) consecutively admitted to 3 Italian tertiary centres and 19 sex and age-matched healthy controls were investigated, for serum levels of PIIINP, by radioimmunoassay.

For each SSc patient a recently validated activity index2,3 was calculated.

Results Increased serum concentrations of PIIINP were found in SSc compared with controls (4.59 ± 1.84 vs. 3.05 ± 0.85 micrograms/L; p = 0.002). Age, sex, subset and disease duration did not influence PIIINP serum levels.

The activity scores calculated in SSc patients ranged from 0.0 to 7.0, median 2.0. No significant correlations were registered between the PIIINP levels and the calculated activity index (rho = 0.04; p > 0.05).

Conclusion This study demonstrates that elevated PIIINP serum levels found in SSc, even reflecting fibroblast activation, cannot be used as a surrogate for the measurement of disease activity as evaluated by a recently proposed index.


  1. Stevens, et al. Br J Rheumatol. 1992;31:683–89

  2. Valentini, et al. Arthritis Rheum. 2000;43:S9-S392

  3. Valentini, et al. Ann Rheum Dis. 2001, in press

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