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Long-Term Course of Circulating Elastin, Collagen Type I, and Collagen Type III in Patients with Spontaneous Cervical
Silke Zimmermann1, Markus Weißenfels2, Norma Krümmer3
1Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany.
Insights
Low elastin and collagen levels in spontaneous cervical artery dissection (sCAD) patients suggest extracellular matrix (ECM) affection. These markers are not suitable for acute sCAD diagnosis but indicate chronic ECM changes.
Area of Science:
- Vascular Biology
- Biochemistry
- Neurology
Background:
- Spontaneous cervical artery dissection (sCAD) involves vascular and extracellular matrix (ECM) integrity impairment.
- Understanding the temporal dynamics of ECM components in sCAD is crucial for pathophysiology insights.
Purpose of the Study:
- To investigate the time course of circulating elastin, collagen type I, and collagen type III in sCAD patients.
- To assess the diagnostic potential of these proteins as biomarkers for sCAD.
Main Methods:
- Prospective enrollment of sCAD patients across four German stroke centers.
- Serum sample collection at acute, subacute (10±3 days), and chronic (6±1 months) phases.
- ELISA quantification of elastin, collagen I, and collagen III, compared against control groups (ischemic stroke, healthy, carotid endarterectomy).
Main Results:
- sCAD patients exhibited significantly lower elastin and collagen type III levels at baseline and 6 months compared to all controls.
- Collagen type I levels were similar to healthy controls in acute/subacute phases but increased at 6 months.
- No acute phase elevation of elastin, collagen I, or collagen III suggests limited diagnostic utility in the acute setting.
Conclusions:
- Circulating elastin and collagen types I and III are not elevated in the acute phase of sCAD, limiting their use as acute diagnostic biomarkers.
- Persistently low serum elastin and collagen type III in chronic sCAD support a hypothesis of subtle, often subclinical, ECM affection.
- Further research may elucidate the role of these ECM components in the long-term pathophysiology of sCAD.
Abstract:
An impaired integrity of vascular elements and the extracellular matrix (ECM) has been discussed to play a critical role in the pathophysiology of spontaneous cervical artery dissection (sCAD). This study aimed to explore the temporal course of circulating elastin, collagen type I, and collagen type III in patients with sCAD and evaluated their eligibility as diagnostic biomarkers. Patients with sCAD were prospectively enrolled in four German stroke centers. Blood samples were collected at baseline (acute phase), at day 10 ± 3 (subacute phase), and after 6 ± 1 months (chronic phase). Patients with acute ischemic stroke not related to sCAD, healthy probands, and patients undergoing thromboendarterectomy of the carotid artery served as control groups. Serum levels of elastin and collagen types I and III were determined by ELISAs. Fifty-seven patients with sCAD were enrolled. Compared to all three control groups, patients with sCAD had significantly lower levels of elastin and collagen type III at baseline and after 6 months. Compared to healthy probands, patients with sCAD showed similar collagen type I levels at baseline and in the subacute phase, but significantly increased levels after 6 months. As serum levels of elastin, collagen types I and III were not elevated in the acute phase, they do not appear eligible as biomarkers for the diagnosis of sCAD. Persisting low serum levels of elastin and collagen type III towards the chronic phase of sCAD strengthens the hypothesis of a subtle, in most cases clinically inapparent affection of the ECM in patients with sCAD.
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