Collagen metabolism in the uterosacral ligaments and vaginal skin of women with uterine prolapse.
OBJECTIVE
To compare tissue markers of collagen metabolism in the uterosacral ligaments with those in vaginal tissue in women with uterine prolapse.


METHODS
Prospective observational experimental study.


METHODS
A tertiary urogynaecology unit.


METHODS
Women referred for hysterectomy for prolapse or benign gynaecological disease.


METHODS
Matrix metalloproteinase (MMP)-2 and -9 expression, tissue inhibitors of metalloproteinase (TIMP)-2 expression and hydroxyproline content were measured in the uterosacral ligaments and vaginal tissue from 14 women with prolapse compared with 14 controls.


METHODS
Levels of MMP, TIMP and hydroxyproline in the uterosacral ligaments and vaginal tissue of women with prolapse and controls.


RESULTS
Fourteen women with prolapse and 14 women without prolapse (controls) were included. A significant increase in pro MMP-2 expression was seen in vaginal tissue from women with prolapse (P < 0.05) but not activated MMP-2, MMP-9 and TIMP-2. For uterosacral ligaments, the differences were not statistically significant. No significant difference in hydroxyproline content was found between control and prolapse in either tissue. Significant correlations exist in expression of pro-MMP-2, activated MMP-2, MMP-9 and TIMP-2 in vaginal tissue with that in uterosacral ligaments.


CONCLUSIONS
Correlations existed between markers of collagen metabolism in the vaginal and uterosacral tissues. This suggests vaginal tissue reflects the endopelvic fascia. The changes which are more pronounced in vaginal tissue may be as a result of prolapse rather than cause.
Phillips
Christian H
CH
Faculty of Medicine Maternal, Fetal & Neonatal Physiology Group, Department of Gynecology, Princess Anne Hospital, Southampton, Hampshire, UK.
Anthony
Fred
F
Benyon
Chris
C
Monga
Ash K
AK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D003094:Collagen / Q000378:metabolism*; D005260:Female; D006801:Humans; D006909:Hydroxyproline / Q000378:metabolism; D008022:Ligaments / Q000378:metabolism; D020782:Matrix Metalloproteinases / Q000378:metabolism; D008875:Middle Aged; D011446:Prospective Studies; D012447:Sacrum / Q000378:metabolism; D012867:Skin / Q000378:metabolism*; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000378:metabolism; D014596:Uterine Prolapse / Q000378:metabolism*; D014599:Uterus / Q000378:metabolism; D014621:Vagina / Q000378:metabolism*
D015415:Biomarkers; D019716:Tissue Inhibitor of Metalloproteinase-2; D003094:Collagen; D020782:Matrix Metalloproteinases; D006909:Hydroxyproline