Expression of Matrix Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinase-1 in Endometriosis Menstrual Blood.

Tita Husnitawati Madjid,Wiryawan Permadi,Dennis Fachmi Ardiansyah,Bethy Hernowo

doi:10.3390/diagnostics10060364

Tita Husnitawati Madjid, Wiryawan Permadi + Show 2 more

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https://doi.org/10.3390/diagnostics10060364

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Abstract

Endometriosis is a gynecological disease characterized by the presence of endometrial-like tissue outside the uterine cavity. Remodeling of the extracellular matrix (ECM) is a prerequisite for tissue implantation. The presence of matrix metalloproteinase (MMP) and its inhibitor, tissue inhibitor of metalloproteinase-1 (TIMP-1), in shed endometrium cells has a significant role in ECM degradation. A case–control study was performed to find other diagnostic markers using menstrual blood. We examined a sample of 68 women who visited the gynecology clinic in Dr Hasan Sadikin General Hospital, 40% of whom were confirmed to have endometriosis, and the rest tested negative by histopathological examination. All endometriotic cases presented MMP-9 and TIMP-1 expression with different cell distribution. MMP-9 expression in endometriosis patients was increased compared to the controls (p = 0.002). Expression of MMP-9 in >80% of endometrial cells was associated with a higher risk for endometriosis (OR 4.44 95% CI 1.31 to 15.56) compared to MMP-9 expression in 50%–80% of cells. TIMP-1 cell expression in women with endometriosis was lower than in the control group (p = 0.030). Subjects with TIMP-1 expression in 20%–50% of endometrial cells had a higher risk for endometriosis (OR 4.5, 95%CI 1.21–17.42) compared those with TIMP-1 expression in 50%–80% of cells. These expressions levels can be useful to predict endometriosis.

Highlights

Endometriosis is a common but poorly understood gynecological disorder that affects 2%–10% of reproductive-age women [1]
In 1927, Sampson proposed that the regurgitation of menstrual blood from the uterine cavity through the fallopian tube is responsible for its implantation outside the uterine cavity [3]
matrix metalloproteinase (MMP) are regulated by tissue inhibitor of metalloproteinase-1 (TIMP-1)–4, with each substrate possessing its own activity against specific

Summary

Introduction

Endometriosis is a common but poorly understood gynecological disorder that affects 2%–10% of reproductive-age women [1]. Endometriosis features the implantation of endometrial tissue outside the uterine cavity and is associated with chronic pelvic pain and infertility [1,2]. Million women are predicted to suffer from endometriosis [2]. In 1927, Sampson proposed that the regurgitation of menstrual blood from the uterine cavity through the fallopian tube is responsible for its implantation outside the uterine cavity [3]. Menstrual regurgitation is estimated to occur in 76% to 90% of women, a percentage much higher than the expected rate of endometriosis. This indicates the possible involvement of other factors that promote endometrial cell implantation

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