Active matrix metalloproteinase-2 upregulation in the abdominal skin of patients with direct inguinal hernia.
BACKGROUND
Prior studies suggest impaired collagen metabolism involving the whole abdominal wall including the skin in patients with abdominal hernia. We compared expression patterns of matrix metalloproteinase-2 (MMP-2) and its modulators membrane type-1-matrix metalloproteinase (MT-1 MMP) and tissue inhibitor of metalloproteinase-2 (TIMP-2) in the skin of patients with and without primary inguinal hernia.


METHODS
Skin biopsy specimens from abdominal wall incisions were obtained during surgery from patients with direct inguinal hernia, indirect inguinal hernia or without hernia (controls). MMP-2, MT-1 MMP and TIMP-2 expression were determined using immunocytochemistry and immunoblotting in intact tissue and in cultured fibroblasts isolated from the biopsies. The degradation activity of MMP-2 was semiquantitatively determined using zymography.


RESULTS
Significantly greater active MMP-2 expression was observed in skin fibroblasts obtained from patients with direct hernia compared with controls. MT1-MMP expression was directly correlated with MMP-2 expression with most intense staining produced in patients with direct or indirect inguinal hernia. TIMP-2, was maximally expressed in the control group, with significantly diminished expression levels recorded in the hernia groups.


CONCLUSIONS
Our findings indicate active MMP-2 upregulation in the abdominal skin of patients with direct inguinal hernia. This metalloproteinase plays a role in matrix degradation, weakening the abdominal wall. Skin disorders and previously described transversalis fascia defects in these patients could point to a systemic collagen metabolism abnormality as a risk factor for direct hernia.
Pascual
Gemma
G
Department of Medical Specialities, Faculty of Medicine, University of Alcala, Alcalá de Henares Networking Research Centre on Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
Rodríguez
Marta
M
Gómez-Gil
Verónica
V
Trejo
Cynthia
C
Buján
Julia
J
Bellón
Juan Manvel
JM
D000005:Abdomen; D000328:Adult; D001706:Biopsy; D002478:Cells, Cultured / Q000378:metabolism; D005260:Female; D005347:Fibroblasts / Q000378:metabolism; D006552:Hernia, Inguinal / Q000378:metabolism*; D006801:Humans; D015151:Immunoblotting; D007150:Immunohistochemistry; D008297:Male; D053511:Matrix Metalloproteinase 14 / Q000378:metabolism; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism*; D008875:Middle Aged; D012867:Skin / Q000378:metabolism* / Q000473:pathology; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000378:metabolism; D055815:Young Adult
D019716:Tissue Inhibitor of Metalloproteinase-2; D020778:Matrix Metalloproteinase 2; D053511:Matrix Metalloproteinase 14