Progress of tissue injury in appendicitis involves the serine proteases uPA and PAI-1

Abstract

The expression of uPA and especially the over-expression of PAI-1 seem to correlate to the progression of local inflammatory response in acute appendicitis.

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

“…The data shown in table 2 indicate that patients with perforated appendicitis had longer hospital stays, longer times from symptom onset until surgery and the prevalence for postoperative complications was higher in this group than in that with nonperforated appendicitis, hence confirming earlier observations [21,22,23,51]. Patients with gangrenous or recently perforated appendicitis may derive the most advantages from prompt surgery [2] while those with phlegmonous appendicitis could be considered for conservative treatment with antibiotics or continued active observation.…”

“…The tissue expressions of MMP-9, TIMP-1 and PAI-1 confirmed our earlier results indicating higher MMP-9, similar TIMP-1 and higher PAI-1 expressions in gangrenous and perforated appendicitis compared to phlegmonous appendicitis and noninflamed appendix [22,23]. Although the individual differences of plasma MMP-9 were unable to distinguish perforated from nonperforated appendicitis or appendicitis from lymphadenitis, other recent studies of systemic MMP-9 have demonstrated that it correlates with the severity of appendicitis [26] and predicts the grade of ulcerative colitis in children [27].…”

“…MMP-9, TIMP-1 and PAI-1 participate in the interaction of coagulation and inflammation involved in ECM degradation that leads to tissue injury in appendicitis [22,23,24,52]. The delay from symptom onset until surgery could affect the plasma MMP-9, TIMP-1 and PAI-1 levels.…”

“…It has recently been shown that extracellular matrix (ECM)-degrading matrix metalloproteinases (MMPs) act in close association with the plasminogen-plasmin system, contributing to tissue injury and to the perforation process in appendicitis [22,23,24]. Our hypothesis in this study was that the systemic expressions of metalloproteinase 9 (MMP-9), tissue inhibitor of metalloproteinase 1 (TIMP-1) and plasminogen activator inhibitor type 1 (PAI-1) correlate with the local expressions in appendiceal tissue.…”

Differential Prognostic Impact of uPA and PAI-1 in Colon and Rectal Cancer

“…Earlier studies indicate that MMP-9 and uPAR expression in tumour-associated lymphocytes, macrophages and neutrophils are inversely associated with invasion and metastasis [41] . It is also reported that inflammatory conditions in the colon is associated with an increased uPA expression [42,43] . These observations could also in part explain the findings in the present study, as tumourassociated lymphocytes are suspected to exert anticancer effects [44] .…”