Top

Hernia

Published in:

01-12-2011 | Original Article

Roles of matrix metalloproteinases in the etiology of inguinal hernia

Authors: A. Aren, A. H. Gökçe, F. S. Gökçe, N. Dursun

Published in: Hernia | Issue 6/2011

Abstract

Introduction

The fascia transversalis is accepted as one of the anatomical structures that can prevent hernia formation. Degradation of collagen within the fascia transversalis is one of the known reasons for the development of inguinal hernia. In the present study, we investigated the roles of matrix metalloproteinases (MMPs), specifically MMP-1, MMP-2, and MMP-9 in the etiology of inguinal hernia.

Materials and methods

This prospective study included 60 inguinal hernia patients: 30 patients had indirect inguinal hernia and 30 patients had direct inguinal hernia. An additional 30 patients operated for reasons other than hernia in the inguinal canal were included as a control group. All patients underwent operations at Istanbul Training and Research Hospital between 1 June 2009 and 1 December 2009. Tissue specimens were taken from the fascia transversalis from patient and control groups during the operation, and MMP-1, MMP-2, MMP-9 values were investigated using immunohistochemical methods.

Results

Significantly higher values of MMP-1, MMP-2, MMP-9, were found in inguinal hernia cases than in the control group (P = 0.0001, P = 0.007, P = 0.021, respectively).

Conclusion

Increased MMP-1, MMP-2, MMP-9 values play a role in the etiology of inguinal hernia. Since weakening may also occur in other tissues in addition to the floor of inguinal canal in inguinal hernia patients, the association of arterial aneurisms and connective tissue diseases should also be investigated in these patients.

Lichtenstein IL, Shulman AG, Amid PK (1993) The cause, prevention and treatment of recurrent groin hernia. Surg Clin North Am 73:529–543PubMed

Akin ML, Karakaya M, Batkin A, Nogay A (1997) Prevalence of inguinal hernia in otherwise healthy males of 20 to 22 years of age. J R Army Med Corps 143:101–102PubMed

Bellon JM, Bajo A, Ga-Honduvilla N, Gimeno MJ et al (2001) Fibroblasts from the transversalis fascia of young patients with direct inguinal hernias show constitutive MMP-2 overexpression. Ann Surg 233(2):287–291PubMedCrossRef

Elkington PT, Green JA, Friedland JS (2009) Analysis of matrix metalloproteinase secretion by macrophages. Methods Mol Biol 531:253–265PubMedCrossRef

Rosai J (1996) Special techniques in surgical pathology. In: Rosai J (ed) Ackerman’s surgical pathology, vol 1, 8th edn. Mosby-Year Book, St Louis, pp 34–35

Kleiner DE, Stetler-Stevenson WG (1999) Matrix metalloproteinases and metastasis. Cancer Chemother Pharmacol 1:42–51CrossRef

Nagase H, Visse R, Murphy G (2006) Structure and function of matrix metalloproteinases and TIMPs. Cardiovasc Res 69:562–573PubMedCrossRef

Nagase H, Ogata Y, Suzuki K, Enghild JJ, Salvesen G (1991) Substrate specificities and activation mechanisms of matrix metalloproteinases. Biochem Soc Trans 12:715–718

Read RC (1992) Cooper’s posterior lamina of transversalis fascia. Surg Gynecol Obstet 174:426–434PubMed

10.

Read RC (1995) Blood Protease/antiprotease imbalance in patients with acquired herniation. Prob Gen Surg 12:41–46

11.

Casanova AB, Trindade EN, Trindade MR (2009) Collagen in the transversalis fascia of patients with indirect inguinal hernia: a case-control study. Am J Surg 198:1–5PubMedCrossRef

12.

Salameh JR, Talbott LM, May W et al (2007) Role of biomarkers in incisional hernias. Am Surg 73:561–568PubMed

13.

Zheng H, Si Z, Kasperk R, Bhardwaj RS et al (2002) Recurrent inguinal hernia: disease of the collagen matrix? World J Surg 26:401–408PubMedCrossRef

14.

Rosch R, Junge K, Knops M, Lynen P et al (2003) Analysis of collagen-interacting proteins in patients with incisional hernias. Langenbecks Arch Surg 387:427–432PubMed

15.

Amid PK, Friss E, Horeyseck G, Kux M (1999) Tension-free onlay mesh hernioplasty. Op Tech Gen Surg 1:156–168CrossRef

16.

Onoda T, Ono T, Dhar DK et al (2006) Tetracycline analogues (doxycycline and COL-3) induce caspase-dependent and -independent apoptosis in human colon cancer cells. Int J Cancer 118:1309–1315PubMedCrossRef

17.

Aziz F, Kuivaniemi H (2007) Role of matrix metalloproteinase inhibitors in preventing abdominal aortic aneurysm. Ann Vasc Surg 21:392–401PubMedCrossRef

18.

Smigielski J, Kolomecki K, Ziemniak P et al (2009) Degradation of collagen by metalloproteinase 2 in patients with abdominal hernias. Eur Surg Res 42:118–121PubMedCrossRef

19.

Rosch R, Lynen-Jansen P, Junge K et al (2006) Biomaterial-dependent MMP-2 expression in fibroblasts from patients with recurrent incisional hernias. Hernia 10:125–130PubMedCrossRef

20.

Manuel JA, Gawronska-Kozak B (2006) Matrix metalloproteinase 9 (MMP-9) is upregulated during scarless wound healing in athymic nude mice. Matrix Biol 25:505–514PubMedCrossRef

21.

Ardi VC, Kupriyanova TA, Deryugina EI, Quigley JP (2007) Human neutrophils uniquely release TIMP-free MMP-9 to provide a potent catalytic stimulator of angiogenesis. Proc Natl Acad Sci USA 104:20262–20267PubMedCrossRef

22.

Perez-Ilzarbe M, Agbulut O, Pelacho B et al (2008) Characterization of the paracrine effects of human skeletal myoblasts transplanted in infarcted myocardium. Eur J Heart Fail 10:165–172CrossRef

23.

Barbour JR, Spinale FG, Ikonomidis JS (2007) Proteinase systems and thoracic aortic aneurysm progression. J Surg Res 139:292–307PubMedCrossRef

24.

Keeling WB, Armstrong PA, Stone PA et al (2005) An overview of matrix metalloproteinases in the pathogenesis and treatment of abdominal aortic aneurysms. Vasc Endovascular Surg 39:457–464PubMedCrossRef

25.

Antoniou SA, Antoniou GA, Granderath FA, Simopoulos C (2009) The role of matrix metalloproteinases in the pathogenesis of abdominal wall hernias. Eur J Clin Invest 11:953–959CrossRef

26.

Fiotti N, Altamura N, Moretti M et al (2009) Short term effects of doxycycline on matrix metalloproteinases 2 and 9. Cardiovasc Drugs Ther 23:153–159PubMedCrossRef

27.

Xiong W, Knispel RA, Dietz HC et al (2008) Doxycycline delays aneurysm rupture in a mouse model of Marfan syndrome. J Vasc Surg 47:166–172PubMedCrossRef

Title: Roles of matrix metalloproteinases in the etiology of inguinal hernia
Authors: A. Aren
A. H. Gökçe
F. S. Gökçe
N. Dursun
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: Hernia / Issue 6/2011
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-011-0846-5

At a glance: The STEP trials

Springer Medicine

Roles of matrix metalloproteinases in the etiology of inguinal hernia

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2011

Regulatory issues in the United States pertinent to abdominal wall reconstruction

Mechanical properties and tissue reinforcement of polypropylene grafts used for pelvic floor repair—an experimental study

An unusual case of inguinal hernia with spontaneous evisceration

Internal herniation of the anterior gastric wall through an attenuated Nissen Fundoplication wrap: an unusual complication and its laparoscopic management

Growth and trends in publications about abdominal wall hernias and the impact of a specific journal on herniology: a bibliometric analysis

Femoral hernia containing incarcerated fallopian tube