title: Recurrent inguinal hernia: disease of the collagen matrix?
abstract: The aim of this study was to investigate the collagen matrix in recurrent inguinal hernias. Total ribonucleic acid (RNA) was extracted from skin fibroblasts of three groups (control group I = healthy skin; control group II = plain skin scar; recurrent inguinal hernia group = skin of recurrent inguinal hernias; each n = 5). Reverse transcription-polymerase chain reaction (RT-PCR) and Northern blot analysis were used to investigate the expression of procollagen type I/- III, MMP-1, and MMP-13 mRNAs. Both ratios of procollagen types I to III mRNAs and collagen types I to III were apparently decreased in the recurrent hernia group compared to those of both control groups (p < 0.01). Significant differences were caused by the increase of both procollagen type III mRNA and collagen type III protein synthesis. A concomitant increase of MMP-1 and MMP-13 mRNAs and proteins was also observed in the recurrent hernia group and showed significant differences compared to those of both control groups I and II, respectively (p < 0.01). In conclusion, the decreased ratio of collagen types I to III seems not only to be the result of a relative increase in the levels of type III procollagen mRNA but also may be the result of an increase of MMP-1 and MMP-13. The data of the present study strongly suggest recurrent inguinal hernias to be a disease of the collagen matrix and result in a clearer understanding of the underlying pathophysiology and may support specific therapeutic strategies in hernia surgery (e.g., surgical meshes).
authors.affiliation: Department of Surgery, Technical University of Aachen, Pauwelstrasse 30, 52057 Aachen, Germany.
authors.forename: Hong
authors.initials: H
authors.lastname: Zheng
authors.forename: Zhongyi
authors.initials: Z
authors.lastname: Si
authors.forename: Reiner
authors.initials: R
authors.lastname: Kasperk
authors.forename: Rhanjit S
authors.initials: RS
authors.lastname: Bhardwaj
authors.forename: Volker
authors.initials: V
authors.lastname: Schumpelick
authors.forename: Uwe
authors.initials: U
authors.lastname: Klinge
authors.forename: Bernd
authors.initials: B
authors.lastname: Klosterhalfen
mesh_terms: D000368:Aged; D015152:Blotting, Northern; D002648:Child; D003094:Collagen / Q000378:metabolism*; D024042:Collagen Type I / Q000378:metabolism; D024061:Collagen Type III / Q000378:metabolism; D017364:Collagenases / Q000378:metabolism*; D015870:Gene Expression; D006552:Hernia, Inguinal / Q000503:physiopathology*; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D020781:Matrix Metalloproteinase 1 / Q000378:metabolism*; D053509:Matrix Metalloproteinase 13; D008875:Middle Aged; D011347:Procollagen / Q000378:metabolism; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D024042:Collagen Type I; D024061:Collagen Type III; D011347:Procollagen; D003094:Collagen; D017364:Collagenases; C507079:MMP13 protein, human; D053509:Matrix Metalloproteinase 13; D020781:Matrix Metalloproteinase 1