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Monitoring of extracellular matrix metabolism and cross‐linking in tissue, serum and urine of patients with chromoblastomycosis, a chronic skin fibrosis
Author(s) -
Sylvie RicardBlum,
M.D. Hartmann,
Esterre
Publication year - 1998
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.1998.00335.x
Subject(s) - pyridinoline , chromoblastomycosis , lesion , medicine , fibrosis , pathology , terbinafine , extracellular matrix , urinary system , urine , gastroenterology , dermatology , chemistry , antifungal , enzyme , itraconazole , biochemistry , alkaline phosphatase , osteocalcin
Background Chromoblastomycosis is a fungal disease leading to a granulomatous reaction associated with dermal fibrosis. Methods In an attempt to elucidate the mechanisms leading to improvement in the cutaneous lesions after treatment with terbinafine, a new antifungal drug, we analysed collagen content and cross‐linking before and at the end of the treatment. The turnover of extracellular matrix was monitored for 1 year by following up serum and urinary metabolites. Results The serum levels of type III collagen and its N‐terminal propeptide were correlated with the lesion size ( P < 0.035) after 4 and 12 months of treatment respectively. After 4 months of treatment, urinary pyridinoline was higher ( P = 0.04) in patients whose lesion size was reduced by more than 50% and serum hyaluronan was lower in patients who had lesions active for less than 5 years ( P < 0.05). The treatment increased pyridinoline and pentosidine cross‐links in the lesions but significantly reduced the collagen content ( P = 0.05). Conclusion This is the first demonstration that, in addition to its fungicidal activity, terbinafine acts in vivo as an antifibrotic drug.