The collagen turnover profile is altered in patients with inguinal and incisional hernia

TY - JOUR

T1 - The collagen turnover profile is altered in patients with inguinal and incisional hernia

AU - Henriksen, Nadia A

AU - Mortensen, Joachim H

AU - Sorensen, Lars T

AU - Bay-Jensen, Anne C

AU - Ågren, Magnus S

AU - Jorgensen, Lars N

AU - Karsdal, Morten A

N1 - Copyright © 2015 Elsevier Inc. All rights reserved.

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Background Disturbed metabolism in the extracellular matrix (ECM) contributes to formation of abdominal wall hernias. The aim of this study was to gain deeper insight into the ECM turnover in hernia patients by analyzing serum biomarkers specifically reflecting collagen synthesis and breakdown in the interstitial matrix (types I, III, and V collagens) and in the basement membrane (type IV collagen). Material and Methods Patients with 3 different types of hernias were included: Primary unilateral inguinal hernia (n = 17), multiple hernias defined as ≥3 hernias (n = 21), and incisional hernia (n = 25). Patients without hernias scheduled to undergo elective operation for gallstones (n = 18) served as controls. Whole venous blood was collected preoperatively. Biomarkers for synthesis of interstitial matrix (PINP, Pro-C3, P5CP) and basement membrane (P4NP) as well as corresponding degradation (C1M, C3M, C5M, and C4M) were measured in serum by validated, solid-phase competitive assays. Results In inguinal hernia patients, the turnover of the interstitial matrix collagens type III (P <.042) and V (P <.001) was decreased compared with controls, whereas the turnover of the basement membrane collagen type IV was increased (P <.001). In incisional hernia patients, the turnover of type V collagen was decreased (P =.048) and the turnover of type IV collagen was increased compared with the hernia-free controls (P <.001). Conclusion Hernia patients demonstrated systemically altered collagen metabolism. The serologic turnover profile of type IV collagens may predict the presence of inguinal and incisional hernia. Regulation of type IV collagen turnover may be crucial for hernia development.

AB - Background Disturbed metabolism in the extracellular matrix (ECM) contributes to formation of abdominal wall hernias. The aim of this study was to gain deeper insight into the ECM turnover in hernia patients by analyzing serum biomarkers specifically reflecting collagen synthesis and breakdown in the interstitial matrix (types I, III, and V collagens) and in the basement membrane (type IV collagen). Material and Methods Patients with 3 different types of hernias were included: Primary unilateral inguinal hernia (n = 17), multiple hernias defined as ≥3 hernias (n = 21), and incisional hernia (n = 25). Patients without hernias scheduled to undergo elective operation for gallstones (n = 18) served as controls. Whole venous blood was collected preoperatively. Biomarkers for synthesis of interstitial matrix (PINP, Pro-C3, P5CP) and basement membrane (P4NP) as well as corresponding degradation (C1M, C3M, C5M, and C4M) were measured in serum by validated, solid-phase competitive assays. Results In inguinal hernia patients, the turnover of the interstitial matrix collagens type III (P <.042) and V (P <.001) was decreased compared with controls, whereas the turnover of the basement membrane collagen type IV was increased (P <.001). In incisional hernia patients, the turnover of type V collagen was decreased (P =.048) and the turnover of type IV collagen was increased compared with the hernia-free controls (P <.001). Conclusion Hernia patients demonstrated systemically altered collagen metabolism. The serologic turnover profile of type IV collagens may predict the presence of inguinal and incisional hernia. Regulation of type IV collagen turnover may be crucial for hernia development.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Basement Membrane

KW - Biomarkers

KW - Case-Control Studies

KW - Collagen

KW - Collagen Type I

KW - Collagen Type III

KW - Collagen Type IV

KW - Collagen Type V

KW - Female

KW - Hernia

KW - Hernia, Inguinal

KW - Humans

KW - Male

KW - Middle Aged

KW - Peptide Fragments

KW - Postoperative Complications

KW - Proteolysis

U2 - 10.1016/j.surg.2014.09.006

DO - 10.1016/j.surg.2014.09.006

M3 - Journal article

C2 - 25616945

SN - 0039-6060

VL - 157

SP - 312

EP - 321

JO - Surgery (United States)

JF - Surgery (United States)

IS - 2

ER -