title: Study of matrix metalloproteinase-2 in inguinal hernia.
abstract: BACKGROUND
  Abnormal collagen metabolism is thought to play an important role in the development of primary inguinal and ventral hernia. The detection of an impaired collagen balance both in the tissue as well as in cultured fibroblasts underlines the suspicion that the development of hernia is likely to be implemented primarily by a disturbance of the fibroblast function and their collagen genes. Based on these results we assume that the altered collagen synthesis in hernia patients can be regarded as a genetically linked deregulation serving as a basic initiating or promoting factor for the development of primary inguinal hernias. With the hypothesis that hernia is a local manifestation of a systemic disease manifested by increased expression of matrix metallo-proteinase-2 (MMP-2), a study was planned with following aims: 1) to establish a causal association between inguinal hernia and MMP-2; 2) to test the hypothesis that hernia is a local manifestation of a systemic disorder rather than a mere local mechanical defect.
  
  
  METHODS
  A case control study was conducted on 30 subjects of each direct and indirect inguinal hernia and 30 controls. DAC-ELISA test was used for analysis of serum (preoperative) and tissue samples (fascia transversalis) in patients as well as controls.
  
  
  RESULTS
  Statistically, serum levels of MMP-2 were significantly increased in all the hernia patients as compared to controls. This increment was maximum in patients of direct hernia. MMP-2 was not detectable in tissue samples.
  
  
  CONCLUSIONS
  Hernia is a local manifestation of a systemic disease rather than a mere local mechanical defect.
  
  
  BACKGROUND
  MMP-2; Matrix Metalloproteinase-2; Inguinal hernia; DAC-ELISA; Collagen metabolism; PBST-Phosphate Buffer Saline Tween-20.
authors.affiliation: Department of General Surgery, Chhatrapati Shahuji Maharaj Medical University, Lucknow, India.
authors.forename: Vinod
authors.initials: V
authors.lastname: Jain
authors.forename: Rohit
authors.initials: R
authors.lastname: Srivastava
authors.forename: Shweta
authors.initials: S
authors.lastname: Jha
authors.forename: Samir
authors.initials: S
authors.lastname: Misra
authors.forename: Nagendra Singh
authors.initials: NS
authors.lastname: Rawat
authors.forename: Devendra Vijai
authors.initials: DV
authors.lastname: Amla