The content and ratio of type I and III collagen in skin differ with age and injury
The aim of this study is to examine type I and III collagen content and distribution in skin within the contexts of patient age and injury, as well as to elucidate possible mechanisms of hypertrophic scar formation. Normal human skin and hypertrophic scar specimens were obtained from spontaneously aborted fetuses and burn patients of different ages (adolescent group, ≤18 years; adult group, >19 and ≤50 years; elderly group, >50 years). Total collagen content was indirectly determined by quantification of hydroxyproline. Levels of type I and III collagen as well as the ratio of type I/III were determined by immunohistochemistry and image analysis. Results obtained showed that the mean content of type I and III and type I/III ratio in normal skin differed significantly among age groups (P0.05), with the lowest levels of type I, III, and the highest ratio of type I/III observed in the elderly age group. Differences between normal uninjured skin and hypertrophic scar tissue were significant for all investigated parameters within any of the three age groups examined (adolescent, adult, elderly; P<0.05). Content of type I, III collagen and type I/III ratio also exhibited age-dependent differences during recovery in hypertrophic scar specimens. Thus, type III collagen synthesis decreases with age resulting in a skewed type I/III ratio and changes in skin tension, elasticity, and healing. Also, the content of type I, III collagen and type I/III ratio are significantly altered in hypertrophic scar tissue compared to uninjured age-matched controls, resulting in a different structural organization that is also influenced by patient age.
Key words: Age group, hypertrophic scar, collagen type I, collagen type III, immunohistochemistry, hydroxyproline.