title: Effects of short-term dexamethasone treatment on collagen synthesis and degradation markers in preterm infants with developing lung disease.
abstract: OBJECTIVE
  To assess the effects of dexamethasone treatment on collagen turnover in preterm infants.
  
  
  METHODS
  The serum concentrations of the amino-terminal propeptide of type I and III procollagens (PINP and PIIINP), which reflect rates of type I and III collagen synthesis, respectively, and the carboxy-terminal telopeptide of type I procollagen (ICTP), which reflects the rate of type I collagen degradation, were monitored in 13 preterm infants receiving dexamethasone and 13 matched control infants without glucocorticoid treatment for a total period of 12 mo. Dexamethasone was started at a median age of 12 d and continued at tapering doses for a median total duration of 10 d. Blood samples were taken immediately after birth, at 7, 14 and 28 d of age and at 2, 3, 6, 9 and 12 mo. The same markers were also measured just before the initiation of dexamethasone and on days 1, 3, and 7 of treatment.
  
  
  RESULTS
  A striking decrease in all of the markers was already observed in every case on day 1 of dexamethasone, the suppression being greatest on day 3 and still considerable on day 7. The percentages from the pretreatment levels recorded on days 1, 3 and 7 were: for PINP 51, 26 and 45%; for PIIINP 63, 44% and 52%; and for ICTP 64, 41 and 51%. A rebound rise in PINP levels was seen in dexamethasone-treated infants, the levels exceeding those of the controls at 3 and 6 mo of age. A similar phenomenon was noted concerning PIIINP at 3 mo. The levels settled down at 9 and 12 mo.
  
  
  CONCLUSIONS
  Dexamethasone causes an immediate, inevitable, deep suppression of type I and III collagen synthesis and also type I collagen degradation. This should be taken into consideration, e.g. when assessing for the indications for steroid treatment in sick preterm infants and its dosing and duration.
authors.affiliation: Department of Paediatrics, University of Oulu, Oulu, Finland. timo.saarela@oulu.fi
authors.forename: T
authors.initials: T
authors.lastname: Saarela
authors.forename: J
authors.initials: J
authors.lastname: Risteli
authors.forename: M
authors.initials: M
authors.lastname: Koivisto
mesh_terms: D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D002657:Child Development / Q000187:drug effects*; D003094:Collagen / Q000096:biosynthesis* / Q000187:drug effects*; D003907:Dexamethasone / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000139:chemically induced*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008137:Longitudinal Studies; D008171:Lung Diseases / Q000151:congenital* / Q000188:drug therapy*; D008297:Male; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D003094:Collagen