Rosch R, Lynen-Jansen P, Junge K, Knops M, Klosterhalfen B, Klinge U, Mertens P R, Schumpelick V
Department of Surgery, University Hospital Aachen, Aachen, Germany.
Hernia. 2006 Apr;10(2):125-30. doi: 10.1007/s10029-005-0060-4. Epub 2006 Jan 11.
With regard to the pathogenesis of recurrent incisional hernia, an impaired connective tissue quality leading to an aberrant scarring process has been proposed. For the matrix metalloproteinase (MMP-2) a pathogenetic involvement in direct inguinal hernia development is reported. With mesh implantation as the gold standard treatment for incisional hernias, the aim of the present study was to investigate the MMP-2 expression in patients with recurrent incisional hernias with and without mesh-materials. In primary fibroblast cultures obtained from skin scars in patients with and without recurrent incisional hernias, MMP-2 synthesis and gene expression were investigated. Furthermore, MMP-2 synthesis and gene expression of fibroblasts were compared after incubation with two different mesh materials: polypropylene and absorbable polyglactin filaments. MMP-2 enzyme activity was determined by semiquantitative zymography and mRNA synthesis by quantitative RT-PCR. Both MMP-2 enzyme activity and mRNA expression were similar in hernia and control fibroblasts in vitro. In control fibroblasts mesh incubation did not significantly affect MMP-2 expression, whereas polypropylene mesh contact of fibroblasts from patients with recurrent incisional hernias led to a major decrease of MMP-2 activity and of mRNA expression. In the absence of biomaterials fibroblasts from recurrent incisional hernia, patients have no alterations of their MMP-2 synthesis compared to control fibroblasts, whereas a specific response was found after biomaterial contact hereby indicating differences in fibroblast phenotype.
关于复发性切口疝的发病机制，有人提出结缔组织质量受损会导致异常瘢痕形成过程。据报道，基质金属蛋白酶（MMP - 2）在腹股沟直疝的发生发展中具有致病作用。以网片植入作为切口疝的金标准治疗方法，本研究的目的是调查有或没有使用网片材料的复发性切口疝患者中MMP - 2的表达情况。在从有或没有复发性切口疝的患者皮肤瘢痕中获取的原代成纤维细胞培养物中，研究了MMP - 2的合成和基因表达。此外，将成纤维细胞与两种不同的网片材料（聚丙烯和可吸收聚乳酸细丝）孵育后，比较了它们的MMP - 2合成和基因表达。通过半定量酶谱法测定MMP - 2酶活性，通过定量逆转录聚合酶链反应测定mRNA合成。在体外，疝和成纤维细胞对照中的MMP - 2酶活性和mRNA表达均相似。在对照成纤维细胞中，网片孵育对MMP - 2表达没有显著影响，而复发性切口疝患者的成纤维细胞与聚丙烯网片接触导致MMP - 2活性和mRNA表达大幅下降。在没有生物材料的情况下，复发性切口疝患者的成纤维细胞与对照成纤维细胞相比，其MMP - 2合成没有改变，而在生物材料接触后发现了特异性反应，这表明成纤维细胞表型存在差异。
