Urogynaecology: Collagen metabolism in the uterosacral ligaments and vaginal skin of women with uterine prolapse

Phillips, Christian; Anthony, F.W.; Benyon, Chris; Monga, Ash

doi:10.1111/j.1471-0528.2005.00773.x

Cited by 110 publications

(84 citation statements)

References 24 publications

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“…Furthermore, an imbalance between MMPs and TIMPs in ECM has been reported to be closely associated with collagen metabolism (11). The expression and involvement of several MMPs and TIMPs in POP patients have been determined in several studies (12)(13)(14). However, the studies have produced conflicting results regarding the contribution of MMPs and TIMPs to the clinicopathological findings and prognosis of POP patients.…”

Section: Introductionmentioning

confidence: 90%

Differential expression profiling of matrix metalloproteinases and tissue inhibitors of metalloproteinases in females with or without pelvic organ prolapse

Wang

Chen

et al. 2014

Molecular Medicine Reports

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Abstract. Pelvic organ prolapse (POP) is a common disorder that can disturb the health and quality of life of females. However, the basic pathophysiology and underlying mechanism of POP are not fully understood. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) have been reported to be associated with the onset and development of POP. In the present study, to characterize the differential expression profile of MMPs and TIMPs in female patients with and without POP, a total of 72 POP patients were sampled as a patient group and 72 non-POP patients that underwent hysterectomy due to benign tumors were sampled as a control group. Immunohistochemistry and polymerase chain reaction analysis were used to detect the expression levels of MMP-1, -2, -3 and -9 as well as TIMP-1 protein and mRNA in the anterior vaginal wall tissues. The expression levels of MMP-1, -2, -3 and -9 in the patient group were found to be significantly higher than those in the control group. By contrast, TIMP-1 expression levels in the patient group were significantly lower than those in the control group. Correlational analysis revealed a significantly positive correlation among the expression levels of MMP-2, -3 and -9. TIMP-1 expression levels were significantly negatively correlated with the expression levels of MMP-3 and -9. In addition, the expression levels of MMP-1 exhibited a positive correlation with those of MMP-2, -3 and -9, but a negative correlation with those of TIMP-1. The results demonstrated that the increased expression levels of MMPs and the reduced expression levels of TIMPs were directly associated with the presence of uterine prolapse, indicating that the differential expression levels of MMPs and TIMPs were correlated with the occurrence and development of POP. This data may assist in elucidating the molecular mechanism of MMP and TIMP involvement in POP, and also provide an underlying theoretical basis for the prevention and treatment of POP. IntroductionPelvic organ prolapse (POP) is the displacement of pelvic organs caused by various types of damage to the pelvic floor fascia and ligaments, which have failed to fully recover, or by weakened supporting structures, due to hypotonia. The predominant clinical manifestations are anterior and/or posterior vaginal wall prolapse as well as uterine prolapse (1). POP, a pelvic floor dysfunction (PFD) disorder, is a global health problem that affects 50% of parous females. It contributes to reduced quality of life and is a major reason for gynecological surgery in aging females (2). The pelvic organs are supported by pelvic floor muscles, the bony pelvis, ligaments and fascial supports. Abnormalities in the connective tissues of the pelvic support system have been suggested to contribute to the genesis of POP (3,4). The exact pathophysiology and natural history of POP, however, are not fully understood.The fascia and ligaments in the bladder and urethra are mainly composed of connective tissue, and the main structural protein is type I collagen...

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Section: Introductionmentioning

confidence: 90%

Differential expression profiling of matrix metalloproteinases and tissue inhibitors of metalloproteinases in females with or without pelvic organ prolapse

Wang

Chen

et al. 2014

Molecular Medicine Reports

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“…[20][21][22] Several studies have compared the amount of total and individual subtypes of collagen in the supporting ligaments and vaginal tissue of women with POP to a control group (see Table 1). 19,[23][24][25][26][27][28][29][30][31][32][33][34][35][36] Figure 1 Current anatomical considerations for prolapse. Level 1: The upper 1/3 of the vagina is suspended to the pelvic wall by the uterosacral and cardinal ligaments, condensations of endopelvic fascia.…”

Section: Collagen Compositionmentioning

confidence: 99%

“…Two other studies found no difference in collagen content between women with prolapse and the control group. 24,25 These studies quantified collagen via hydroxyproline assay -hydroxyproline is a component of collagen and is thus an indirect measure of collagen levels. This assay is not collagen specific and is not entirely reliable in unpurified tissue samples, with results differing depending on assessment methods.…”

Section: Studies Of Collagen Composition In Uterosacral/ Cardinal Ligmentioning

confidence: 99%

Recent studies of genetic dysfunction in pelvic organ prolapse: The role of collagen defects

Lim

Khoo

Wong

et al. 2014

Aust NZ J Obst Gynaeco

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Gynaecologists are becoming increasingly aware that women with a family history of prolapse are at an increased risk of prolapse refractory to treatment. In the past five years, several genetic mutations have been shown to correlate with increased prolapse susceptibility. These mutations can result in disordered collagen metabolism, which weaken the fascial support of the pelvic organs. This review examines the contemporary evidence regarding the role of collagen in prolapse.

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“…Collagen turnover is decreased in ageing women without hormone therapy, and these changes may be of importance in vaginal prolapsed. [4][5][6] Dryness of the vagina occurs early in the postmenopausal period and is most apparent in sexually active women in whom it is associated with pain with intercourse or dyspareunia. 2,7 The majority of vaginal fluid in postmenopausal women appears to be secreted from the vaginal epithelium.…”

Section: Physiological Changes In Vagina Due To Estrogen Deficiencymentioning

confidence: 99%

Management of Postmenopausal Vaginal Atrophy: Review of Literature

Dayal¹,

Yadav²

2017

Journal of SAFOMS

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Aim: As there is dilemma for treatment of postmenopausal vaginal atrophy, effort has been made to review the literature for the same.Background: About half of all postmenopausal women will experience symptoms related to urogenital atrophy. Vaginal atrophy becomes clinically apparent 4 to 5 years after menopause, and subjective complaints as well as objective changes are present in 25 to 50% of all postmenopausal women.

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Urogynaecology: Collagen metabolism in the uterosacral ligaments and vaginal skin of women with uterine prolapse

Cited by 110 publications

References 24 publications

Differential expression profiling of matrix metalloproteinases and tissue inhibitors of metalloproteinases in females with or without pelvic organ prolapse

Differential expression profiling of matrix metalloproteinases and tissue inhibitors of metalloproteinases in females with or without pelvic organ prolapse

Recent studies of genetic dysfunction in pelvic organ prolapse: The role of collagen defects

Management of Postmenopausal Vaginal Atrophy: Review of Literature

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