Department of Surgery K, Bispebjerg Hospital, Copenhagen, Denmark.
Wound Repair Regen. 2013 Sep-Oct;21(5):661-6. doi: 10.1111/wrr.12071. Epub 2013 Aug 8.
Incisional hernia formation is a common complication to laparotomy and possibly associated with alterations in connective tissue metabolism. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) are closely involved in the metabolism of the extracellular matrix. Our aim was to study serum levels of multiple MMPs and TIMPs in patients with and without incisional hernia. Out of 305 patients who underwent laparotomy, 79 (25.9%) developed incisional hernia over a median follow-up period of 3.7 years. Pooled sera from a subset (n = 72) of these patients were screened for MMP-1, MMP-2, MMP-3, MMP-7, MMP-8, MMP-9, MMP-10, MMP-12, MMP-13, TIMP-1, TIMP-2, and TIMP-4 using a multiplex sandwich fluorescent immunoassay supplemented with gelatin zymography. The screening indicated differences in serum MMP-9 and TIMP-1 levels. Consequently, MMP-9 and TIMP-1 levels were measured in serum in the whole patient cohort with enzyme-linked immunosorbent assay. There were no significant differences in either MMP-9 (p = 0.411) or TIMP-1 (p = 0.679) levels between hernia and hernia-free patients. MMP-9 was significantly increased in smokers compared with nonsmokers (p = 0.016). In conclusion, a possible involvement of MMPs and TIMPs in the pathogenesis of incisional hernia formation was not reflected systemically.
切口疝的形成是剖腹手术的常见并发症，可能与结缔组织代谢改变有关。基质金属蛋白酶（MMPs）和金属蛋白酶组织抑制剂（TIMPs）密切参与细胞外基质的代谢。我们的目的是研究有和无切口疝的患者血清中多种 MMP 和 TIMP 的水平。在 305 例行剖腹手术的患者中，79 例（25.9%）在中位随访 3.7 年后发生切口疝。从这些患者的亚组（n = 72）的混合血清中筛选出 MMP-1、MMP-2、MMP-3、MMP-7、MMP-8、MMP-9、MMP-10、MMP-12、MMP-13、TIMP-1、TIMP-2 和 TIMP-4，使用补充明胶酶谱的多重夹心荧光免疫测定法。筛选表明血清 MMP-9 和 TIMP-1 水平存在差异。因此，使用酶联免疫吸附测定法在整个患者队列中测量血清中 MMP-9 和 TIMP-1 的水平。在疝和无疝患者之间，MMP-9（p = 0.411）或 TIMP-1（p = 0.679）水平均无显著差异。与不吸烟者相比，吸烟者 MMP-9 明显升高（p = 0.016）。总之，MMP 和 TIMP 可能参与了切口疝形成的发病机制，但并未在系统中得到反映。
