Lorentzen L, Henriksen N A, Juhl P, Mortensen J H, Ågren M S, Karsdal M A, Jorgensen L N
1 Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
2 Nordic Bioscience A/S, Herlev, Denmark.
Scand J Surg. 2018 Sep;107(3):212-217. doi: 10.1177/1457496918766694. Epub 2018 Apr 9.
Hernia formation is associated with alterations of collagen metabolism. Collagen synthesis and degradation cause a systemic release of products, which are measurable in serum. Recently, we reported changes in type V and IV collagen metabolisms in patients with inguinal and incisional hernia. The aim of this study was to determine if the altered collagen metabolism was persistent after hernia repair.
Patients who had undergone repairs for inguinal hernia (n = 11) or for incisional hernia (n = 17) were included in this study. Patients who had undergone elective cholecystectomy served as controls (n = 10). Whole venous blood was collected 35-55 months after operation. Biomarkers for type V collagen synthesis (Pro-C5) and degradation (C5M) and those for type IV collagen synthesis (P4NP) and degradation (C4M2) were measured by a solid-phase competitive assay.
The turnover of type V collagen (Pro-C5/C5M) was slightly higher postoperatively when compared to preoperatively in the inguinal hernia group (P = 0.034). In addition, the results revealed a postoperatively lower type V collagen turnover level in the inguinal hernia group compared to controls (P = 0.012). In the incisional hernia group, the type V collagen turnover was higher after hernia repair (P = 0.004) and the postoperative turnover level was not different from the control group (P = 0.973).
Patients with an inguinal hernia demonstrated a systemic and persistent type V collagen turnover alteration. This imbalance of the collagen metabolism may be involved in the development of inguinal hernias.
疝形成与胶原代谢改变有关。胶原合成与降解导致产物的全身释放，这些产物可在血清中检测到。最近，我们报道了腹股沟疝和切口疝患者V型和IV型胶原代谢的变化。本研究的目的是确定疝修补术后胶原代谢改变是否持续存在。
本研究纳入了接受腹股沟疝修补术（n = 11）或切口疝修补术（n = 17）的患者。接受择期胆囊切除术的患者作为对照组（n = 10）。术后35 - 55个月采集全静脉血。通过固相竞争法检测V型胶原合成（Pro - C5）和降解（C5M）以及IV型胶原合成（P4NP）和降解（C4M2）的生物标志物。
腹股沟疝组术后V型胶原周转率（Pro - C5/C5M）与术前相比略有升高（P = 0.034）。此外，结果显示腹股沟疝组术后V型胶原周转率低于对照组（P = 0.012）。在切口疝组，疝修补术后V型胶原周转率较高（P = 0.004），且术后周转率水平与对照组无差异（P = 0.973）。
腹股沟疝患者表现出全身性且持续的V型胶原周转率改变。这种胶原代谢失衡可能参与了腹股沟疝的发生发展。
