Introduction and Its Role in Collagen Synthesis

• PIIINP is a marker released during the synthesis of type III collagen.
• Involved in tissue repair and remodelling processes in skin, lungs, liver, and blood vessels.
• Maintains structural integrity and flexibility of tissues.
• Released into the bloodstream during collagen production, indicating collagen turnover.

Biomarker for Fibrosis and Disease Progression

• Indicates excessive tissue fibrosis in conditions like liver scarring and heart/lung function issues.
• Effective marker for fibrotic activity in liver conditions (e.g., NASH, hepatitis C).
• Helps track changes in fibrosis over time and guide treatment decisions.
• Increased serum PIIINP levels in heart failure indicate fibrosis affecting heart function.
• High PIIINP levels in IPF (lung disease) indicate lung tissue scarring and could signal disease progression.

The Mechanisms of Release in Tissue Remodelling

• Linked to type III collagen creation and placement, controlled by fibroblasts and other cell types.
• Tissue damage or inflammation activates fibroblasts to produce collagen.
• Procollagen is enzymatically broken down, releasing PIIINP into the bloodstream.
• Collagen synthesis and PIIINP release regulated by growth factors like TGF-β, a promoter of fibrosis.
• Continuous TGF-β signalling in liver cirrhosis or cardiac fibrosis increases blood levels of PIIINP.

Clinical Applications and Future Directions for Monitoring

• Measuring PIIINP levels helps diagnose and track fibrosis-related diseases without invasive procedures.
• In liver disease, serum PIIINP is a potential non-invasive substitute for liver biopsy.
• High PIIINP levels indicate liver fibrosis, providing a non-invasive option for evaluation and monitoring.
• Research explores PIIINP levels as predictors of outcomes in heart failure and related diseases.
• Monitoring PIIINP helps identify patients at risk, guiding treatment and closer observation.