Expression of matrix metalloproteinase-2 and tissue inhibitors of metalloproteinase-1 (TIMP-1, TIMP-2 and TIMP-3) in women with uterine prolapse but without urinary incontinence

Abstract

Objective To investigate the activities of matrix metalloproteinase-2 (MMP-2) and its inhibitors, tissue inhibitor of metalloproteinase-1, -2 and -3 (TIMP-1, TIMP-2 and TIMP-3), in the pelvic support and nonsupport tissue of women with uterine prolapse but without urinary incontinence. Study design Paired samples of uterosacral ligament and cervical tissue were obtained from 11 postmenopausal and 8 premenopausal women with severe uterine prolapse. Nine premenopausal women without prolapse were selected as normal controls. Immunoreactivity of MMP-2 and TIMPs was demonstrated by immunohistochemistry. Steady state of MMP-2 as well as TIMPs messenger RNA (mRNA) expression was analyzed by polymerase chain reaction (PCR) with quantitative expression determined by multiplex PCR. Results A significantly higher expression of MMP-2 mRNA and lower expression of TIMP-2 mRNA were found in uterosacral ligament in uterine prolapse women compared to controls. In the cervical tissue, however, the MMP-2 and TIMPs mRNA expression was comparable between prolapse and control groups. With regard to menopausal status, there was no significant difference in MMP-2 and TIMPs mRNA expression between premenopausal and postmenopausal women with uterine prolapse. Conclusions An increase in MMP-2 mRNA and a decrease in TIMP-2 mRNA expression in uterosacral ligament are related to uterine prolapse in women without urinary incontinence.