Dianchen Wang1, Yuqian Han2, Xiuli Xu3, Jianmin Chen4, Yake Chen4. 1. Department of Hernia and Abdominal Wall Surgery, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450052, Henan, China. wdc8681949@163.com. 2. Department of General Surgery, The First Affiliated Hospital of Henan University of CM, No. 19 Renmin Road, Zhengzhou, 450001, Henan, China. 3. Department of General Surgery, The Third Affiliated Hospital of Henan University of CM, No. 63 Dongming Road, Zhengzhou, 450001, Henan, China. 4. Department of Hernia and Abdominal Wall Surgery, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450052, Henan, China.
Abstract
BACKGROUND: The development of inguinal hernia might be related with collagen metabolism, which was regulated by matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). The aim of this study was to evaluate the mRNA and protein expression levels of MMP-2 and TIMP-2 in anterior rectus sheath fascia to investigate the function of them in inguinal hernia formation. METHODS: The study enrolled 48 primary inguinal hernia patients: 32 participants had indirect inguinal hernia and 16 patients suffered direct inguinal hernia. Specimens were taken from the anterior rectus sheath fascia. The amounts of MMP-2 mRNA and TIMP-2 mRNA were evaluated by real-time fluorescence quantitative polymerase chain reaction (RT-PCR), and immunohistochemistry was performed to assess the protein expression of them. RESULTS: The mRNA and protein expression levels of MMP-2 in direct group were significantly higher than those of control group (P < 0.05) and indirect group (P < 0.05), while the expression levels of TIMP-2 in direct group were significantly lower than those of control group (P < 0.05) and indirect group (P < 0.05). The ratio of MMP-2 mRNA/TIMP-2 mRNA in direct group was significantly higher than that of control group (P < 0.05) and indirect group (P < 0.05), and the ratio of indirect group was significantly higher than that of control group (P < 0.05). According to receiver operating characteristic (ROC) curve, MMP-2/TIMP-2 can diagnose direct hernia from controls with area under the curve (AUC) of 0.950 and indirect hernia with AUC of 0.730 effectively. CONCLUSIONS: Elevated level of MMP-2 and decreased level of TIMP-2 may play a role in direct inguinal hernia development. The ratio of MMP-2/TIMP-2 may be useful in identification of direct hernia.
BACKGROUND: The development of inguinal hernia might be related with collagen metabolism, which was regulated by matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). The aim of this study was to evaluate the mRNA and protein expression levels of MMP-2 and TIMP-2 in anterior rectus sheath fascia to investigate the function of them in inguinal hernia formation. METHODS: The study enrolled 48 primary inguinal herniapatients: 32 participants had indirect inguinal hernia and 16 patients suffered direct inguinal hernia. Specimens were taken from the anterior rectus sheath fascia. The amounts of MMP-2 mRNA and TIMP-2 mRNA were evaluated by real-time fluorescence quantitative polymerase chain reaction (RT-PCR), and immunohistochemistry was performed to assess the protein expression of them. RESULTS: The mRNA and protein expression levels of MMP-2 in direct group were significantly higher than those of control group (P < 0.05) and indirect group (P < 0.05), while the expression levels of TIMP-2 in direct group were significantly lower than those of control group (P < 0.05) and indirect group (P < 0.05). The ratio of MMP-2 mRNA/TIMP-2 mRNA in direct group was significantly higher than that of control group (P < 0.05) and indirect group (P < 0.05), and the ratio of indirect group was significantly higher than that of control group (P < 0.05). According to receiver operating characteristic (ROC) curve, MMP-2/TIMP-2 can diagnose direct hernia from controls with area under the curve (AUC) of 0.950 and indirect hernia with AUC of 0.730 effectively. CONCLUSIONS: Elevated level of MMP-2 and decreased level of TIMP-2 may play a role in direct inguinal hernia development. The ratio of MMP-2/TIMP-2 may be useful in identification of direct hernia.