Analysis of collagen-interacting proteins in patients with incisional hernias.

Abstract

BACKGROUND:

In recent years a disorder of the collagen metabolism has been suggested for the pathogenesis of abdominal wall hernias. Previous investigations of skin specimens revealed a reduction in the collagen I/III ratio and alterations in matrix metalloproteinases in patients with incisional hernias. We investigated known collagen-interacting proteins to further characterize connective tissue in these patients.

PATIENTS AND METHODS:

Skin scars from patients with either primary or recurrent incisional and recurrent inguinal hernias, as a subgroup of incisional hernias, were analyzed for overall collagen content and for the distribution of collagen types I and III by crosspolarization microscopy. The expression of collagen type V, collagen receptor discoidin domain receptor 2, matrix metalloproteinase 1, connective tissue-like growth factor, and tenascin was determined by immunohistochemistry. Mature abdominal skin scars from patients without evident hernia served as controls.

RESULTS:

Patients with recurrent incisional hernia showed lowest ratios of collagen types I to III. Contents of overall collagen and of collagen type V did not differ between the groups. In patients with either primary or recurrent incisional hernias the proportion of collagen receptor discoidin domain receptor 2 positive cells was increased. Matrix metalloproteinase 1 expression was more pronounced in patients with recurrent incisional or inguinal hernias than in controls. Connective tissue-like growth factor was significantly increased in recurrent inguinal hernia patients. The expression of tenascin was notably decreased in all hernia groups.

CONCLUSIONS:

The observed alterations in the expression of collagen-interacting proteins again indicate the possibility of a fundamental connective tissue disease as the causal factor in the pathogenesis of (recurrent) incisional hernias.

• Authors: R Rosch, K Junge, M Knops, P Lynen, U Klinge, V Schumpelick
• Journal: Langenbeck's archives of surgery (Langenbecks Arch Surg) Vol. 387 Issue 11-12 Pg. 427-32 (Feb 2003) ISSN: 1435-2443 [Print] Germany
• PMID: 12607124 (Publication Type: Journal Article)

Chemical References

• CCN2 protein, human
• Immediate-Early Proteins
• Intercellular Signaling Peptides and Proteins
• Receptors, Mitogen
• Tenascin
• Connective Tissue Growth Factor
• Collagen
• Discoidin Domain Receptors
• Receptor Protein-Tyrosine Kinases
• Matrix Metalloproteinase 1

Topics

• Aged
• Analysis of Variance
• Cicatrix (metabolism)
• Collagen (metabolism)
• Connective Tissue Growth Factor
• Discoidin Domain Receptors
• Female
• Hernia, Ventral (metabolism)
• Humans
• Immediate-Early Proteins (metabolism)
• Immunoenzyme Techniques
• Intercellular Signaling Peptides and Proteins (metabolism)
• Male
• Matrix Metalloproteinase 1 (metabolism)
• Middle Aged
• Receptor Protein-Tyrosine Kinases (metabolism)
• Receptors, Mitogen (metabolism)
• Recurrence
• Statistics, Nonparametric
• Tenascin (metabolism)