Abstract
Background: In various connective tissue disorders, collagen fibrils and elastic fibers may exhibit some ultrastructural abnormalities.
Objective: This electron microscopy study focused on collagen fibril orientation and unusual shapes in the dermis of Ehlers-Danlos syndrome (EDS) and related entities, including spontaneous cervical artery dissection syndrome and recurrent preterm premature rupture of fetal membranes syndrome.
Results: In addition to some abnormal fibril shapes typically found in these syndromes, other conformations (hook shaped, S shaped, ring shaped) that have not been illustrated previously in the literature were observed.
Conclusion: The abnormal collagen fibril conformations observed in EDS and other related conditions characterized by tissue fragility likely affect both the internal cohesiveness of the bundles and the mechanobiologic properties of the tissue.
Similar content being viewed by others
References
Vogel A, Holbrook KA, Steinmann B, et al. Abnormal collagen fibril structure in the gravis form (type I) of the Ehlers-Danlos syndrome. Lab Invest. 1979; 40: 201–6
Holbrook KA, Byers PH. Structural abnormalities in the dermal collagen and elastic matrix from the skin of patients with inherited connective disorders. J Invest Dermatol. 1982; 79 Suppl. 1: 7S–11S
Piérard GE, Piérard-Franchimont C, Lapière CM. Histopathology aid at the diagnosis of the Ehlers-Danlos syndrome gravis and mitis types. Int J Dermatol. 1983; 22: 300–4
Piérard GE, Lê T, Piérard-Franchimont C, et al. Morphometric study of cauliflower collagen fibrils in Ehlers-Danlos syndrome type I. Coll Rel Res. 1988; 8: 453–7
Nusgens BV, Verellen-Dumoulin C, Hermanns-Lê T, et al. Evidence for a relationship between Ehlers-Danlos type VIIC in human and bovine dermatosparaxis. Nat Genet. 1992; 1: 214–7
Watson RB, Wallis GA, Holmes DF, et al. Ehlers-Danlos syndrome type II B: incomplete cleavage of the patient’s abnormal type I collagen by N-proteinase results in the formation of rough-bordered collagen fibrils characteristic of the disorder. J Biol Chem. 1992; 267: 25529–34
Piérard GE, Hermanns-Lê T, Arrese-Estrada J, et al. Structure of the dermis in type VIIC Ehlers-Danlos syndrome. Am J Dermatopathol. 1993; 15: 127–32
Hausser I, Anton-Lamprecht I. Differential ultrastructural aberration of collagen fibrils in Ehlers-Danlos syndrome type I-IV as a mean of diagnostics and classification. Hum Genet. 1994; 3: 394–407
Smith TL, Schwarze U, Goldstein J, et al. Mutations in the COL3A1 gene result in the Ehlers-Danlos syndrome type IV and alterations in the size and distribution of the major collagen fibrils of the dermis. J Invest Dermatol. 1997; 108: 241–7
Hermanns-Lê T. How I explore... some cutaneous disorders by the ultrastructural examination of the skin. Rev Med Liege. 2000; 55: 954–6
Flagothier C, Goffin V, Hermanns-Lê T, et al. A 4-generation Ehlers-Danlos syndrome with vascular dissections: skin ultrastructure and biomechanical properties. J Med Eng Technol. Epub 2006 Mar 29
Brandt T, Hausser I, Orbek E, et al. Ultrastructural connective tissue abnormalities in patients with spontaneous cervicocerebral artery dissections. Ann Neurol. 1988; 44: 281–5
Brandt T, Orbek E, Weber R, et al. Pathogenesis of cervical artery dissections: association with connective tissue abnormalities. Neurology. 2001; 57: 24–30
Hermanns-Lê T. How I explore... some vascular disorders using ultrastructural assessment of the skin. Rev Med Liege. 2004; 59: 598–600
Ulbricht D, Diederich NJ, Hermanns-Lê T, et al. Cervical artery dissection: the single clinical sign of a connective tissue disorder?. Neurology. 2004; 63: 1708–10
Hermanns-Lê T, Piérard GE, Quatresooz P. Ehlers-Danlos-like dermal abnormalities in women with recurrent preterm premature rupture of the fetal membranes. Am J Dermatopathol. 2005; 27: 407–10
Piérard GE, Lê T, Hermanns JF, et al. Morphometric study of cauliflower collagen fibrils in dermatosparaxis of the calves. Coll Rel Res. 1986; 6: 481–92
Kobayasi T, Ullman S. Twisted collagen fibrils: significance for diagnosis of Ehlers-Danlos syndrome [abstract]. J Invest Dermatol. 1996; 107: 266
Kobayasi T, Ullman S. Acrocyanosis and Ehlers-Danlos syndrome. Eur J Dermatol. 1995; 5: 167–8
Kobayasi T, Ullman S. Twisted collagen fibrils in acrocyanosis. Eur J Dermatol. 1999; 9: 285–8
De Moraes AM, Cintra ML, de Almeida Prado Sampaio S, et al. The ultrastructural and histophotometric study of elastic and collagen fibers in type II Ehlers-Danlos syndrome and subclinical forms. Ultrastruct Pathol. 2000; 24: 129–34
Oxlung H. Relationships between the biomechanical properties, composition and molecular structure of connective tissues. Connect Tissue Res. 1986; 15: 65–72
Piérard GE, the EEMCO group. EEMCO guidance to the in vivo assessment of tensile functional properties of the skin: part 1. Relevance to the structures and ageing of the skin and subcutaneous tissues. Skin Pharmacol Appl Skin Physiol. 1999; 12: 352–62
Zweers MC, van Vlijmen-Willems IM, van Kuppevelt TH, et al. Deficiency of tenascin-X causes abnormalities in dermal elastic fiber morphology. J Invest Dermatol. 2004; 122: 885–91
Hermanns-Lê T, Piérard GE. Ultrastructural modifications of elastic fibers in the skin of Ehlers-Danlos syndrome hypermobile type. Am J Dermatopathol. In press.
Graham R, Beighton P. Physical properties of the skin in the Ehlers-Danlos syndrome. Ann Rheum Dis. 1969; 28: 246–51
Piérard GE, Lapiére ChM. Microanatomy of the dermis in relation to relaxed skin tension line and Langer’s lines. Am J Dermatopathol. 1987; 9: 219–24
Acknowledgments
This work was supported by a grant from the Fonds d’Investissement de la Recherche Scientifique of the University Hospital of Liege. No other sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of the study.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hermanns-Lê, T., Piérard, G.E. Collagen Fibril Arabesques in Connective Tissue Disorders. Am J Clin Dermatol 7, 323–326 (2006). https://doi.org/10.2165/00128071-200607050-00006
Published:
Issue Date:
DOI: https://doi.org/10.2165/00128071-200607050-00006