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Biochemistry


Full details for "Pro-collagen 3 amino-terminal peptide".  

Name

 Pro-collagen 3 amino-terminal peptide

Alternative name/Profile

 PIIINP

Department

 Biochemistry

Investigation

 PIIINP may be increased in patients with liver fibrosis and cirrhosis. It is used in St James's Hospital to assess hepatic fibrosis in patients on long-term Methotrexate treatment.

Specimen type

 Serum

Sample type

 Sample should be separated within one hour and serum frozen. Lithium Heparin plasma is not a suitable sample type for this assay. Highly lipemic and haemolysed samples will not be processed

Sample container & volume

 1 X 5 mL Red tube

Frequency of analysis

Turnaround time

 28 days

Availability

Notes

Serum Pro-collagen 3 N-Terminal Peptide

P3NP is the amino terminal peptide of type 3 procollagen, released from the precursor peptide during the synthesis and deposition of type 3 collagen. P3NP in the serum can be derived from the synthesis of new type 3 collagen or from the degradation of existing type III collagen fibrils.

Clinical utility of serum P3NP analysis

  • There is evidence that serum PIIINP measurement is an effective non-invasive test for the detection and monitoring of Methotrexate-induced liver fibrosis and cirrhosis, and serial measurements may reduce the need for liver biopsy.
  • However, P3NP can be raised following bone fracture and also in rheumatology patients as it can be falsely elevated in inflammatory arthritis.

Helpful links

https://www.southtees.nhs.uk/services/pathology/tests/type-iii-procollagen-peptide-piiinp/

Related links

Reference range

Reference Range = 1.7 - 4.2 µg/L

Consider liver biopsy in adult patients treated with Methotrexate for psoriasis if:
Pre-treatment PIIINP > 8.0 µg/L
PIIINP >4.2 µg/L in three consecutive samples over 12 month.
PIIINP > 8.0 µg/L in two consecutive samples.

Consider withdrawal of Methotrexate if:
PIIINP > 10 µg/L in three samples over 12 months.

Last updated

Fri, 14 Nov 2025 15:17:04 GMT


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