Connective tissue and aging
Authors: Oikarinen A. 
Published: March 2004

Human skin is composed of epidermal and dermal layers, each of which has its own functional importance. Dermis consist of a fine network of collagen fibers, elastic fibers, and other components of the extracellular matrix (ECM). ECM consist primarily of proteins and complex sugars, which form fibrillar networks and a ground substance. Collagen is an important structural component of skin connective tissue and provides the tensile strength of skin.

Approximately 70–80% of the dry weight of skin consists of collagen. The most abundant collagen types in skin are types I and III; the former accounts for 80% of the total collagen content of skin and the latter for approximately 15%. The other collagen types present in skin include type IV collagen, which is abundant in the basement membrane (BM); type V collagen, which is located pericellularly; type VI collagen, which plays a role in matrix assembly and is present as microfibrils between collagen fibers; and type VII collagen, which is a structural component of anchoring fibrils. Elastin accounts for only about 1–2% of the dry weight of skin but is important for the maintenance of skin elasticity and resilience. Glycosaminoglycans are of central importance for the maintenance of a water balance in skin, even though the quantities in ECM are small (0.1–0.3% of the dry weight of skin).

In the dermis fibroblasts are responsible for the synthesis of ECM proteins. The fibroblasts in the dermis spend majority of time in quiescent state. However in response to activation, the fibroblasts can be reactivated, and certain pool of cell is able to differentiate into myofibroblasts which have important role in repairing skin defects such as during wound healing. During aging the number of fibroblasts is markedly reduced.

Also the response of fibroblasts to various growth factors and mechanical or pathological stimulates (wound healing) is diminished.

Skin collagen synthesis declines with aging and as the result of such external factors as long‐term sun exposure and medications, for example, topical corticosteroids. In aging skin, collagen fibers become thicker and less soluble and the synthesis of collagen declines. Skin thickness remains quite constant between 20 and 70 years of age, after which a marked decrease in skin thickness occurs. During aging the expression of collagenases are increased and inhibitors of collagenases are reduced leading to increased proteolysis of connective tissue. Recent studies have shown that collagen synthesis is declined in the skin of heavy smokers, while collagenases are increased inducing premature skin aging.

The elastic properties of skin are also affected by aging. Along with increasing age, dermal elastic fibers become thicker and fragmented and oxytalan fibers appear fragmented and shortened. Disintegration of elastic fibers is already seen in a minority of fibers between ages 30 and 70, but the changes become more profound after the age of 70 years, affecting a majority of the fibers. As a result of the decreased number of elastic fibers in aged skin, the elastic recovery of skin decreases in elderly people. Even though the content of GAGs and proteoglycans is relatively small, they have significant role in collagen fibril formation, water content of dermis and in mechanical properties. During aging there are marked alterations in different proteoglycans. The amount and synthesis of versican (high molecular size) is decreased and small molecular size decorin is increased. In photoaged skin versican is increased and is closely associated to elastin while decorin is decreased.