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Published in: Hernia 3/2008

01-06-2008 | Original Article

Analysis of c-myc, PAI-1 and uPAR in patients with incisional hernias

Authors: R. Rosch, M. Binnebösel, K. Junge, P. Lynen-Jansen, P. R. Mertens, U. Klinge, V. Schumpelick

Published in: Hernia | Issue 3/2008

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Abstract

Background

Disturbed wound healing leading to alterations in collagen composition has been thought to play a key role in the pathogenesis of incisional hernia formation. The aim of the present study was to further characterise the scarring process in such patients.

Methods

Mature skin scars from patients with either primary or recurrent incisional hernias were compared to mature abdominal skin scars from patients without hernias. The distribution of collagen types I and III was analysed using crosspolarisation microscopy. Expression of c-myc—a parameter for cell differentiation and proliferation—and of PAI-1 and uPAR—parameters of the proteolytic cascade in wound healing—were determined by immunohistochemistry.

Results

In agreement with previous studies, decreased collagen I/III ratios were found in patients with incisional hernias. In these patients, c-myc levels were significantly elevated whereas plasminogen activator inhibitor-1 (PAI-1) and urokinase-plasminogen activator receptor (uPAR) levels were only slightly increased. In contrast to controls, a significant correlation between c-myc, PAI-1 and uPAR expression and collagen I/III ratios was found in patients with incisional hernias.

Conclusion

The differential correlation of collagen types and expression of c-myc, PAI-1 and uPAR within the scar tissue might represent a causal factor in incisional hernia formation.
Literature
1.
go back to reference McEntyre RL, Raffensperger JG (1977) Surgical complications of Ehlers-Danlos syndrome in children. J Pediatr Surg 12:531–535PubMedCrossRef McEntyre RL, Raffensperger JG (1977) Surgical complications of Ehlers-Danlos syndrome in children. J Pediatr Surg 12:531–535PubMedCrossRef
2.
go back to reference Adye B, Luna G (1998) Incidence of abdominal wall hernia in aortic surgery. Am J Surg 175:400–402PubMed Adye B, Luna G (1998) Incidence of abdominal wall hernia in aortic surgery. Am J Surg 175:400–402PubMed
3.
go back to reference Girotto JA, Malaisrie SC, Bulkely G, Manson PN (2000) Recurrent ventral herniation in Ehlers-Danlos syndrome. Plast Reconstr Surg 106:1520–1526PubMedCrossRef Girotto JA, Malaisrie SC, Bulkely G, Manson PN (2000) Recurrent ventral herniation in Ehlers-Danlos syndrome. Plast Reconstr Surg 106:1520–1526PubMedCrossRef
4.
go back to reference Augestad KM, Wilsgaard T, Solberg S (2002) Incisional hernia after surgery for abdominal aortic aneurysm. Tidsskr Nor Laegeforen 122:22–24PubMed Augestad KM, Wilsgaard T, Solberg S (2002) Incisional hernia after surgery for abdominal aortic aneurysm. Tidsskr Nor Laegeforen 122:22–24PubMed
5.
go back to reference Papadimitriou D, Pitoulias G, Papaziogas B, Koutsias S, Vretzakis G, Argiriadou H, Papaziogas T (2002) Incidence of abdominal wall hernias in patients undergoing aortic surgery for aneurysm or occlusive disease. Vasa 31:111–114PubMedCrossRef Papadimitriou D, Pitoulias G, Papaziogas B, Koutsias S, Vretzakis G, Argiriadou H, Papaziogas T (2002) Incidence of abdominal wall hernias in patients undergoing aortic surgery for aneurysm or occlusive disease. Vasa 31:111–114PubMedCrossRef
6.
go back to reference Sorensen LT, Friis E, Jorgensen T, Vennits B, Andersen BR, Rasmussen GI, Kjaergaard J (2002) Smoking is a risk factor for recurrence of groin hernia. World J Surg 26:397–400PubMedCrossRef Sorensen LT, Friis E, Jorgensen T, Vennits B, Andersen BR, Rasmussen GI, Kjaergaard J (2002) Smoking is a risk factor for recurrence of groin hernia. World J Surg 26:397–400PubMedCrossRef
7.
go back to reference Sorensen LT, Hemmingsen UB, Kirkeby LT, Kallehave F, Jorgensen LN (2005) Smoking is a risk factor for incisional hernia. Arch Surg 140:119–123PubMedCrossRef Sorensen LT, Hemmingsen UB, Kirkeby LT, Kallehave F, Jorgensen LN (2005) Smoking is a risk factor for incisional hernia. Arch Surg 140:119–123PubMedCrossRef
8.
9.
go back to reference Bellon JM, Bujan J, Honduvilla NG, Jurado F, Gimeno MJ, Turnay J, Olmo N, Lizarbe MA (1997) Study of biochemical substrate and role of metalloproteinases in fascia transversalis from hernial processes. Eur J Clin Invest 27:510–516PubMedCrossRef Bellon JM, Bujan J, Honduvilla NG, Jurado F, Gimeno MJ, Turnay J, Olmo N, Lizarbe MA (1997) Study of biochemical substrate and role of metalloproteinases in fascia transversalis from hernial processes. Eur J Clin Invest 27:510–516PubMedCrossRef
10.
go back to reference Klinge U, Si ZY, Zheng H, Schumpelick V, Bhardwaj RS, Klosterhalfen B (2000) Abnormal collagen I to III distribution in the skin of patients with incisional hernia. Eur Surg Res 32:43–48PubMedCrossRef Klinge U, Si ZY, Zheng H, Schumpelick V, Bhardwaj RS, Klosterhalfen B (2000) Abnormal collagen I to III distribution in the skin of patients with incisional hernia. Eur Surg Res 32:43–48PubMedCrossRef
11.
go back to reference Bellon JM, Bajo A, Ga-Honduvilla N, Gimeno MJ, Pascual G, Guerrero A, Bujan J (2001) Fibroblasts from the transversalis fascia of young patients with direct inguinal hernias show constitutive MMP-2 overexpression. Ann Surg 233:287–291PubMedCrossRef Bellon JM, Bajo A, Ga-Honduvilla N, Gimeno MJ, Pascual G, Guerrero A, Bujan J (2001) Fibroblasts from the transversalis fascia of young patients with direct inguinal hernias show constitutive MMP-2 overexpression. Ann Surg 233:287–291PubMedCrossRef
12.
go back to reference Klinge U, Si ZY, Zheng H, Schumpelick V, Bhardwaj RS, Klosterhalfen B (2001) Collagen I/III and matrix metalloproteinases (MMP) 1 and 13 in the fascia of patients with incisional hernias. J Invest Surg 14:47–54PubMedCrossRef Klinge U, Si ZY, Zheng H, Schumpelick V, Bhardwaj RS, Klosterhalfen B (2001) Collagen I/III and matrix metalloproteinases (MMP) 1 and 13 in the fascia of patients with incisional hernias. J Invest Surg 14:47–54PubMedCrossRef
13.
go back to reference Si Z, Rhanjit B, Rosch R, Rene PM, Klosterhalfen B, Klinge U (2002) Impaired balance of type I and type III procollagen mRNA in cultured fibroblasts of patients with incisional hernia. Surgery 131:324–331PubMedCrossRef Si Z, Rhanjit B, Rosch R, Rene PM, Klosterhalfen B, Klinge U (2002) Impaired balance of type I and type III procollagen mRNA in cultured fibroblasts of patients with incisional hernia. Surgery 131:324–331PubMedCrossRef
14.
go back to reference Rosch R, Junge K, Knops M, Lynen P, Klinge U, Schumpelick V (2003) Analysis of collagen-interacting proteins in patients with incisional hernias. Langenbecks Arch Surg 387:427–432PubMed Rosch R, Junge K, Knops M, Lynen P, Klinge U, Schumpelick V (2003) Analysis of collagen-interacting proteins in patients with incisional hernias. Langenbecks Arch Surg 387:427–432PubMed
15.
go back to reference Salameh JR, Talbott LM, May W, Gosheh B, Vig PJ, McDaniel DO (2007) Role of biomarkers in incisional hernias. Am Surg 73:561–567PubMed Salameh JR, Talbott LM, May W, Gosheh B, Vig PJ, McDaniel DO (2007) Role of biomarkers in incisional hernias. Am Surg 73:561–567PubMed
16.
go back to reference Junge K, Klinge U, Rosch R, Mertens PR, Kirch J, Klosterhalfen B, Lynen P, Schumpelick V (2004) Decreased collagen type I/III ratio in patients with recurring hernia after implantation of alloplastic prostheses. Langenbecks Arch Surg 389:17–22PubMedCrossRef Junge K, Klinge U, Rosch R, Mertens PR, Kirch J, Klosterhalfen B, Lynen P, Schumpelick V (2004) Decreased collagen type I/III ratio in patients with recurring hernia after implantation of alloplastic prostheses. Langenbecks Arch Surg 389:17–22PubMedCrossRef
17.
go back to reference Remmele W SH (1987) Recommendation for uniform definition of an immunoreactive score (IRS) for immunohistochemical estrogen receptor detection (ER-ICA) in breast cancer tissue. Pathologe 8:138–140PubMed Remmele W SH (1987) Recommendation for uniform definition of an immunoreactive score (IRS) for immunohistochemical estrogen receptor detection (ER-ICA) in breast cancer tissue. Pathologe 8:138–140PubMed
18.
go back to reference Arumugam S, Jang YC, Chen-Jensen C, Gibran NS, Isik FF (1999) Temporal activity of plasminogen activators and matrix metalloproteinases during cutaneous wound repair. Surgery 125:587–593PubMed Arumugam S, Jang YC, Chen-Jensen C, Gibran NS, Isik FF (1999) Temporal activity of plasminogen activators and matrix metalloproteinases during cutaneous wound repair. Surgery 125:587–593PubMed
19.
go back to reference Mignatti P, Rifkin DB (1996) Plasminogen activators and matrix metalloproteinases in angiogenesis. Enzyme Protein 49:117–137PubMed Mignatti P, Rifkin DB (1996) Plasminogen activators and matrix metalloproteinases in angiogenesis. Enzyme Protein 49:117–137PubMed
20.
go back to reference Nicholl SM, Roztocil E, Davies MG (2006) Plasminogen activator system and vascular disease. Curr Vasc Pharmacol 4:101–116PubMedCrossRef Nicholl SM, Roztocil E, Davies MG (2006) Plasminogen activator system and vascular disease. Curr Vasc Pharmacol 4:101–116PubMedCrossRef
21.
22.
go back to reference Hu Z, Lou L, Luo S (2002) Experimental study of the expression of c-myc, c-fos and proto-oncogenes on hypertrophic and scars. Zhonghua Zheng Xing Wai Ke Za Zhi 18:165–167PubMed Hu Z, Lou L, Luo S (2002) Experimental study of the expression of c-myc, c-fos and proto-oncogenes on hypertrophic and scars. Zhonghua Zheng Xing Wai Ke Za Zhi 18:165–167PubMed
23.
go back to reference Prendergast GC, Diamond LE, Dahl D, Cole MD (1990) The c-myc-regulated gene mrl encodes plasminogen activator inhibitor 1. Mol Cell Biol 10:1265–1269PubMed Prendergast GC, Diamond LE, Dahl D, Cole MD (1990) The c-myc-regulated gene mrl encodes plasminogen activator inhibitor 1. Mol Cell Biol 10:1265–1269PubMed
24.
go back to reference Stojadinovic O, Brem H, Vouthounis C, Lee B, Fallon J, Stallcup M, Merchant A, Galiano RD, Tomic-Canic M (2005) Molecular pathogenesis of chronic wounds: the role of beta-catenin and c-myc in the inhibition of epithelialization and wound healing. Am J Pathol 167:59–69PubMed Stojadinovic O, Brem H, Vouthounis C, Lee B, Fallon J, Stallcup M, Merchant A, Galiano RD, Tomic-Canic M (2005) Molecular pathogenesis of chronic wounds: the role of beta-catenin and c-myc in the inhibition of epithelialization and wound healing. Am J Pathol 167:59–69PubMed
Metadata
Title
Analysis of c-myc, PAI-1 and uPAR in patients with incisional hernias
Authors
R. Rosch
M. Binnebösel
K. Junge
P. Lynen-Jansen
P. R. Mertens
U. Klinge
V. Schumpelick
Publication date
01-06-2008
Publisher
Springer-Verlag
Published in
Hernia / Issue 3/2008
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-007-0311-7

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