Department of General Surgery, Koc University School of Medicine, Istanbul, Turkey.
General Surgery Department, University of Health Sciences, Cam & Sakura City Hospital, Istanbul, Turkey.
Int Wound J. 2022 Oct;19(6):1502-1508. doi: 10.1111/iwj.13746. Epub 2022 Mar 11.
Inguinal and incisional hernias are the two most common types of hernias caused by abdominal wall weakness and defects in connective tissue. The structure of the extracellular matrix, mainly collagen and metalloproteinases (MMPs), and their regulators have been studied extensively and found to play a significant role in the pathophysiology of hernias. One of the regulators of MMPs, tissue inhibitor metalloproteinases (TIMPs), bind to MMPs and inhibit its activity significantly shifting the balance towards collagen synthesis rather than degradation. Due to their importance in collagen metabolism, their metabolism might be significant in the aetiology of hernias. Our study used immunohistochemical techniques to investigate the possible effects of TIMP 1 and 2 on the samples taken from the abdominal walls of patients with inguinal and incisional hernias, compared them with control patients, and reviewed the literature. In this study, samples of 90 patients (30 patients from control, inguinal hernia, and incisional hernia groups) were taken and analysed. These samples were stained with TIMP-1 Ab-2 and TIMP2 Ab-5 (Clone 3A4) antibodies and evaluated under ×100 magnification. The degree of staining was classified as (a): No staining (0), (b): Staining less than 10% (I), (c): Staining between 10% and 50% (II), (d): Staining more than 50% (III). Statistical analyses were done. No significant difference was found between groups in terms of patient demographics. Smoking and family history of hernia was not found to be associated with TIMP expression. TIMP1 expression was significantly higher in the incisional and inguinal hernia group than in the control group (P < .05), while the level of TIMP2 was higher in the control group. (P < .05). TIMP1 and TIMP2 levels did not significantly differ between incisional and inguinal hernia groups. We found significantly increased TIMP-1 levels in tissue samples from patients with hernia supporting its suggested role in hernia pathophysiology. Local alterations in MMP and TIMP levels might play a role in the pathogenesis of hernias. Thus detection of TIMP in tissues can be important for clinical use after further validation studies. In the era of molecular medicine, detecting TIMP levels in hernia patients can impact clinical practice.
腹股沟疝和切口疝是两种最常见的腹壁薄弱和结缔组织缺陷引起的疝。细胞外基质的结构，主要是胶原和基质金属蛋白酶（MMPs）及其调节剂，已经被广泛研究，并发现它们在疝的病理生理学中起着重要作用。MMPs 的一种调节剂，组织抑制剂金属蛋白酶（TIMPs），与 MMPs 结合并显著抑制其活性，从而使平衡向胶原合成而不是降解倾斜。由于它们在胶原代谢中的重要性，它们的代谢可能在疝的病因学中具有重要意义。我们的研究使用免疫组织化学技术，对腹股沟疝和切口疝患者腹壁组织样本中的 TIMP1 和 TIMP2 进行了研究，并与对照组患者进行了比较，同时回顾了文献。在这项研究中，对 90 名患者（30 名来自对照组、腹股沟疝和切口疝组）的样本进行了取样和分析。这些样本用 TIMP-1 Ab-2 和 TIMP2 Ab-5（克隆 3A4）抗体染色，并在 ×100 放大倍数下进行评估。染色程度分为（a）无染色（0）、（b）染色少于 10%（I）、（c）染色 10% 至 50%（II）、（d）染色超过 50%（III）。进行了统计学分析。在患者人口统计学方面，各组之间没有发现显著差异。吸烟和疝家族史与 TIMP 表达无关。与对照组相比，切口疝和腹股沟疝组的 TIMP1 表达明显升高（P<.05），而对照组的 TIMP2 水平较高（P<.05）。切口疝和腹股沟疝组之间的 TIMP1 和 TIMP2 水平没有显著差异。我们发现疝患者组织样本中 TIMP-1 水平显著升高，支持其在疝病理生理学中的作用。MMP 和 TIMP 水平的局部改变可能在疝的发病机制中起作用。因此，在进一步的验证研究后，组织中 TIMP 的检测对临床应用可能很重要。在分子医学时代，检测疝患者的 TIMP 水平可以影响临床实践。
