Local and Systemic Expressions of MMP-9, TIMP-1 and PAI-1 in Patients Undergoing Surgery for Clinically Suspected Appendicitis

Abstract

Background/Aims: To examine, compare and correlate the expressions of matrix metalloproteinase 9 (MMP-9), tissue inhibitor of metalloproteinase 1 (TIMP-1) and plasminogen activator inhibitor type 1 (PAI-1) in appendiceal tissue and pre- and postoperative blood samples in patients undergoing surgery for clinically suspected appendicitis. Methods: Fifty-seven patients with complete tissue and blood samples were included and divided into groups of noninflamed appendix/lymphadenitis (n = 7), phlegmonous appendicitis (n = 30), gangrenous appendicitis (n = 11) and perforated appendicitis (n = 9). The protein expressions were assessed with ELISAs. The local expressions of MMP-9, TIMP-1 and PAI-1 were correlated with the systemic expressions at the time of surgery while the systemic individual differences between surgery and recovery were compared. Results: There was a positive correlation between tissue and plasma PAI-1 (p < 0.05). The individual differences for plasma MMP-9 and PAI-1 were statistically nonsignificant, while they were higher for TIMP-1 in patients with perforated appendicitis compared with phlegmonous (p < 0.0001) and gangrenous appendicitis (p < 0.01). Conclusions: Plasma PAI-1 reflected the levels in appendiceal tissue at the time of surgery. Systemic TIMP-1 could have the potential of distinguishing perforated from nonperforated appendicitis.

Roles of TGF-β/Smad signaling pathway in pathogenesis and development of gluteal muscle contracture

“…It is the primary physiological inhibitor of the urokinase-plasminogen activator (uPA) and tissue-plasminogen activator (tPA) systems ( 43 ). The fibrinolytic system, which includes uPA and tPA systems, is the key to regulating the activity of matrix metalloproteinases (MMPs) and ECM degradation factors ( 42 , 44 ). Previous studies have demonstrated that overexpression of PAI-1 can induce fibrosis in many organs, especially in liver, where it can lead to hepatocellular carcinoma ( 45 ).…”

Matriks Metalloproteinase (MMP) sebagai Biomarker Terjadinya Perforasi pada Apendisitis Akut

“…MMP-9 memiliki peningkatan paling signifikan dan paling tinggi pada gangrenous appendicitis dan perforated appendicitis. [14] Gambar 4. Ekspresi MMP-9 pada Berbagai Komplikasi Apendisitis [14] Masing-masing komplikasi apendisitis memiliki peningkatan sangat signfikan pada ekspresi MMP-9.…”

“…[14] Gambar 4. Ekspresi MMP-9 pada Berbagai Komplikasi Apendisitis [14] Masing-masing komplikasi apendisitis memiliki peningkatan sangat signfikan pada ekspresi MMP-9. Gangrenous appendicitis memiliki nilai MMP tertinggi.…”

“…MMP-9 meningkat pada seluruh keadaan komplikasi apendisitis akut. [14] MMP-9 memiliki signifikansi untuk menentukan apendisitis terkomplikasi atau tidak, namun bukan merupakan pemeriksaan utama yang dapat dilihat untuk menentukan jenis komplikasi pada apendisitis. Di lain sisi, TIMP tidak dapat digunakan untuk memeriksa komplikasi pada apendisitis, namun nilai yang berbeda dapat digunakan untuk melihat jenis komplikasi yang terjadi pada suatu apendisitis.…”

“…Di lain sisi, TIMP tidak dapat digunakan untuk memeriksa komplikasi pada apendisitis, namun nilai yang berbeda dapat digunakan untuk melihat jenis komplikasi yang terjadi pada suatu apendisitis. [14]…”