Serum MMP 2 and TIMP 2 in patients with inguinal hernias

Abstract

Background: More than sixty thousand inguinal hernia operations are performed every year in Poland. Despite many years of related research, the exact pathologic mechanism of this condition is still not fully understood. Recent studies suggested a pronounced relationship between the molecular structure of collagen fibers and the activity of metalloproteinases, the enzymes taking part in the degradation of collagen, as well as their tissue inhibitors.

Materials and methods: A prospective study has been established to measure serum levels of the matrix metalloproteinase 2 (MMP-2) and Matrix metalloproteinase tissue inhibitor 2 (TIMP-2) in 150 males between the ages of 26 and 70. The control group (CG) consisted of thirty healthy male volunteers of a similar age distribution.

Results: Our results indicate that MMP-2 was highest in the direct hernia group, a statistically very significant elevation (P<0(.) 05) of 1562ng mL(-1) against the CG 684ng mL(-1) . The highest level of TIMP, 78ng mL(-1) , was found in the group with recurrent hernia, against 49(.) 5ng mL(-1) of the CG (statistical significance of P<0(.) 05).

Discussion: The MMP-2 and TIMP-2 levels were concurrently elevated only in the recurrent hernia group.

Conclusions: The patients with inguinal hernia have a statistically significant increase in serum levels of MMP-2. Our finding of the MMP-2 and TIMP-2 distinctly higher in the patients suffering from recurrence of direct inguinal hernia (reflecting a previous surgical failure) may suggest the theory that the extracellular matrix defect lies at the basis of this disorder.