Extracellular matrix remodeling derangement in ex-obese patients.
A known consequence of the large weight loss after bariatric surgery is the appearance of large skinfolds, particularly in the abdomen region of the patients. The balance between the synthesis of extracellular matrix (ECM) components and their proteolysis, mainly by fibrinolytic systems and matrix metalloproteases (MMPs), may be disturbed in these patients. The causes underlying the deregulation of ECM remodeling that occurs in these patients are not, however, clear. We investigated molecular mechanisms responsible for this dysfunction of ECM remodeling process, comparing it to normal skin. Collagen types, MMP2 and MMP9 expression and activity, interleukins 1β (IL1β) and 6 (IL6), and transcription coactivator PGC-1β expression were analyzed in 16 patients. Ex-obese patients presented increased expression of collagen types III and IV mRNA, increased expression of MMP2, decreased expression and activity of MMP9, and increased expression of PGC-1β in the skin. Inflammation markers IL1β and IL6 mRNA were not different. We have demonstrated that obese patients with extensive weight loss after bariatric surgery have increased expression of PGC-1β in the skin, which can result in a decreased expression and activity of MMP9 and increased collagen types III and IV deposition. These molecular changes may contribute for the formation of saggy skinfolds observed in these patients and impair wound healing.
Emergency Medicine Department, Faculdade de Medicina da Universidade de São Paulo, LIM-51, Av. Dr. Arnaldo, 455, 3 andar, sala 3189, Cerqueira César, São Paulo, SP, 01246-903, Brazil.
Iryna Hirata
IH
Prist
Plastic Surgery Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Alessandra Grassi
AG
Salles
Emergency Medicine Department, Faculdade de Medicina da Universidade de São Paulo, LIM-51, Av. Dr. Arnaldo, 455, 3 andar, sala 3189, Cerqueira César, São Paulo, SP, 01246-903, Brazil. thais@emercli.fm.usp.br.
Thais Martins
TM
de Lima
Plastic Surgery Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Miguel Luiz Antônio
ML
Modolin
Plastic Surgery Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Rolf
R
Gemperli
Emergency Medicine Department, Faculdade de Medicina da Universidade de São Paulo, LIM-51, Av. Dr. Arnaldo, 455, 3 andar, sala 3189, Cerqueira César, São Paulo, SP, 01246-903, Brazil.
Heraldo Possolo
HP
Souza
D050110:Bariatric Surgery; D024061:Collagen Type III / Q000096:biosynthesis; D024141:Collagen Type IV / Q000096:biosynthesis; D005109:Extracellular Matrix / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D053583:Interleukin-1beta / Q000096:biosynthesis; D015850:Interleukin-6 / Q000096:biosynthesis; D020778:Matrix Metalloproteinase 2 / Q000096:biosynthesis; D020780:Matrix Metalloproteinase 9 / Q000096:biosynthesis; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D012867:Skin / Q000378:metabolism* / Q000473:pathology; D015431:Weight Loss
D024061:Collagen Type III; D024141:Collagen Type IV; C508585:IL1B protein, human; C508600:IL6 protein, human; D053583:Interleukin-1beta; D015850:Interleukin-6; C522361:MMP2 protein, human; D020778:Matrix Metalloproteinase 2; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9
Bariatric surgery; Extracellular matrix; Inflammation; Metalloproteases; Obesity; Skinfolds