title: Matrix metaloproteinase-2 and -9 serum levels as potential markers of intraperitoneal adhesions.
abstract: OBJECTIVE
  To assess the value of matrix metalloproteinases-2 (MMP-2) and -9 (MMP-9) as prognostic serum markers for intraperitoneal adhesions.
  
  
  BACKGROUND
  Postoperative adhesions are associated with serious complications responsible for increased patient's morbidity.
  
  
  METHODS
  Forty-eight rabbits were used and randomized into groups A, B, C, and D. Abdominal laparotomy and experimental adhesion formation model was carried out. In group A, 60 mL of N/S 0.9% were instilled intraperitoneally, in group B 60 mL of icodextrin 4% were instilled intraperitoneally, in group C 0.1 mL/kg of dimetindene maleate were administered intravenously, and in group D both agents were administered. Prior to euthanasia 0.5 mL of blood was obtained. The type, the surface area of adhesions, and serum concentration of MMPs were assessed.
  
  
  RESULTS
  The mean surface area and Zuhlke classification of adhesions of groups B, C, and D has been proved to be significantly lower compared to group A. Serum MMP-2 levels were significantly higher in groups B and D than in group A, while group D was higher when compared to group C. Serum MMP-9 levels were significantly higher in group D compared to groups A, B, and C. Serum MMP-9 was the most accurate test to differentiate between animals with and without adhesions with a sensitivity of 81.8% and a specificity of 100% at a cut-off point of 21.5 (AUC = 0.934).
  
  
  CONCLUSIONS
  The administration of icodextrin 4% and dimetindene maleate seems to prevent postoperative adhesion formation. Serum levels of MMP-2 and MMP-9 may serve as prognostic markers to identify postoperative adhesions.
authors.affiliation: General Surgery Department, University Hospital of Larissa, Larissa, Greece. gregsurg@yahoo.gr
authors.forename: Gregory
authors.initials: G
authors.lastname: Christodoulidis
authors.forename: Irene
authors.initials: I
authors.lastname: Tsilioni
authors.forename: Michail-Evangelos
authors.initials: ME
authors.lastname: Spyridakis
authors.forename: Theodoros
authors.initials: T
authors.lastname: Kiropoulos
authors.forename: Smaragda
authors.initials: S
authors.lastname: Oikonomidi
authors.forename: George
authors.initials: G
authors.lastname: Koukoulis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tepetes
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood*; D004115:Dimethindene / Q000627:therapeutic use*; D005260:Female; D005936:Glucans / Q000627:therapeutic use*; D005947:Glucose / Q000627:therapeutic use*; D000077607:Icodextrin; D020778:Matrix Metalloproteinase 2 / Q000097:blood*; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D010532:Peritoneal Diseases / Q000097:blood / Q000473:pathology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000175:diagnosis*; D011379:Prognosis; D011817:Rabbits; D000267:Tissue Adhesions / Q000097:blood / Q000473:pathology / Q000517:prevention & control
chemical_list: D015415:Biomarkers; D005936:Glucans; D000077607:Icodextrin; D004115:Dimethindene; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9; D005947:Glucose