hydroxylysine and Burns

Scarring is a well-known side effect to cutaneous laser treatment. Therefore we investigated if wounds and scarring could be decreased by pharmacological interference in the acute inflammatory reaction following laser therapy. A copper vapor laser operating at 578 nm was used at three different intensities and doses. The antiinflammatory drugs methylprednisolone (1 mg/kg/24 h) and indomethacin (2 mg/kg/24 h) were administered through the drinking water. The laser induced wounds were evaluated daily and histologic and biochemical analyses were used to estimate scarring. The administration of antiinflammatory drugs resulted at some laser intensities in increased scores of maximum wound area, healing time, cumulated wound area, fibrosis, hydroxyproline, and hydroxylysine, being mostly pronounced for indomethacin at 0.8 W/spot. The maximum wound area and the wound healing time could be used as a predictor of scarring. A dose response was shown between the laser intensities and the mentioned parameters. We recommend carefulness in the laser treatment of patients receiving indomethacin and disrecommend use of the drug in the prophylaxis against laser induced scarring.

Topics: Administration, Oral; Animals; Burns; Cicatrix; Dose-Response Relationship, Radiation; Female; Fibrosis; Hydroxylysine; Hydroxyproline; Indomethacin; Laser Therapy; Methylprednisolone; Mice; Mice, Inbred C3H; Mice, Nude; Proline; Skin; Wound Healing

Urimary excretion of hydroxyprolin (Hyp) is one index of total collagen degradation, from all sources. Since some of the Hyp released from collagen may be further metabolized before it is excreted, other markers are necessary to measure collagen breakdown. Excretion of the glycosides of hydroxylysine (Hyl), glucosyl galactosyl hydroxylysine (Hy1[Gl)cGa1]), and galactosyl hydroxylysine (Hyl[Ga)]), more accurately reflects collagen metabolism since these products occur in specificratios in different tissue collagens and are themselves metabolized only to a minor degree. The ratios of total Hy1/Hyp and Hyl(GlcGal)/Hyl(Ga1) were measured in the urine of norma. subjects and of patients with Paget's disease of bone, hyperphosphatasia, and extensive thermal burns. In patients with extensive thermal burns the pattern of urinary Hy1 and its glycosides was consistent with degradation of collagen in dermis and fascia. When bone collagen degradation was dominant, the pattern of urinary metabolites reflected that source. Pagetic bone collagen has an amino acid composition similar to normal bone and Hy1(G1cGa1/Hyl(G1) of 0.396-0.743,vs. normal of 0.474+/-0.088. In untreated patients with severe Paget's disease of bone or hyperphosphatasia (urinary Hyp greater than 2.0 micronmol/mg creatinine) urinary Hyl/Hyp averaged 0.052+/-0.042 (0.042+/-0.009 in normal bone) and Hy1(G1cGa1)/Hy1(Ga1) 0.601+/-0.017 (0.47+/-0.009 in normal bone). When bone resorption was decreased sufficiently with calcitonin or disodium etidronate in these patients, both the urinary ratios of Hy1/Hyp and Hy1(G1cGa1)/Hyl(Gal) rose. In normal subjects treated with calcitonin and excreting relatively little Hyp, the ratio of Hy1/H)P approached 0.7 and Hy1(G1ycGa1)/Hy1(Ga1) approached 3.5. There increased ratios reveal the existence of a source of collagen breakdown other than skin or bone. The first subcompoent of complement, Clq, which has collagen-like sequences, relatively high amounts of Hy1, and most of the glycosylated Hy1 as Hy1(G1cGa1), could be the source of these metabolites.

Topics: Adolescent; Adult; Amino Acids; Bone and Bones; Burns; Calcitonin; Child; Collagen; Etidronic Acid; Fascia; Female; Glycosides; Humans; Hydroxylysine; Hydroxyproline; Male; Middle Aged; Osteitis Deformans