Peritoneal fluid concentrations of matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, and transforming growth factor-beta in women with pelvic adhesions.
OBJECTIVE
To establish whether the concentration of matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), and transforming growth factor-beta (TGF-beta) is influenced by the presence or absence of adhesions, and whether the concentration of these mediators vary throughout the menstrual cycle.


METHODS
Prospective case-control study.


METHODS
Women undergoing laparoscopy in a university hospital in the United Kingdom.


METHODS
Women undergoing laparoscopy for benign gynecological conditions.


METHODS
Samples of peritoneal fluid were collected at diagnostic laparoscopy in one group, and at laparoscopy and serially during the first 48 hours after laparoscopic adhesiolysis in a second group. We correlated the concentrations of mediators in serially sampled peritoneal fluid during the 48 hours following laparoscopic adhesiolysis to the adhesion formation and reformation found during second-look laparoscopy.


METHODS
The concentrations of MMP-9, TIMP-1, and TGF-beta in peritoneal fluid.


RESULTS
MMP-9 concentration was lower in the follicular phase than the luteal phase of the menstrual cycle. MMP-9 concentration was significantly lower in women with pelvic adhesions than in women with a normal pelvis. The MMP-9/TIMP-1 ratio is significantly higher in women with significant adhesions at second-look laparoscopy compared to women with minimal or no adhesions.


CONCLUSIONS
The components of extracellular matrix remodeling may play an important part in the adhesion formation/reformation process.
Department of Obstetrics and Gynaecology, St. Mary's Hospital, Milton Road, Portsmouth, Hampshire, United Kingdom. yingcheong@hotmail.com
Ying C
YC
Cheong
Jenny B
JB
Shelton
Susan M
SM
Laird
Tin Chiu
TC
Li
William L
WL
Ledger
Ian D
ID
Cooke
D000293:Adolescent; D000328:Adult; D001202:Ascitic Fluid / Q000737:chemistry*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D020780:Matrix Metalloproteinase 9 / Q000032:analysis*; D008875:Middle Aged; D011446:Prospective Studies; D024162:Second-Look Surgery; D000267:Tissue Adhesions / Q000378:metabolism*; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000032:analysis*; D016212:Transforming Growth Factor beta / Q000032:analysis*
D019715:Tissue Inhibitor of Metalloproteinase-1; D016212:Transforming Growth Factor beta; D020780:Matrix Metalloproteinase 9