Effects of short-term dexamethasone treatment on collagen synthesis and degradation markers in preterm infants with developing lung disease

Acta Paediatr. 2003 May;92(5):588-94. doi: 10.1080/08035320310002687.


Aim: 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.

Conclusion: 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.

Publication types

  • Clinical Trial

MeSH terms

  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / pharmacology*
  • Anti-Inflammatory Agents / therapeutic use*
  • Child Development / drug effects*
  • Collagen / biosynthesis*
  • Collagen / drug effects*
  • Dexamethasone / adverse effects
  • Dexamethasone / pharmacology*
  • Dexamethasone / therapeutic use*
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Growth Disorders / chemically induced*
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Longitudinal Studies
  • Lung Diseases / congenital*
  • Lung Diseases / drug therapy*
  • Male
  • Prospective Studies
  • Time Factors


  • Anti-Inflammatory Agents
  • Dexamethasone
  • Collagen