Abstract
The objective of this study is to examine the level balance of serum and peritoneal fluid MMP-2 and TIMP-2 in patients with severe endometriosis. The method of this study was a cross sectional study with twenty patients were diagnosed as severe endometriosis based on laparoscopy and laparotomy with five controls. Serum samples were taken before surgery, peritoneal fluid samples were taken during surgery, and MMP-2 and TIMP-2 examination was conducted in the end of the study by using ELISA method. The mean level of serum, peritoneal fluid MMP-2 and TIMP-2 were compared by using unpaired t-test. Based on this study, we found that MMP-2 level of serum and peritoneal fluid was significantly different in the case compared to the control, 5.848±3.016 vs. 1.600±0.063 ng/mL and 1.977±1.883 vs. 0.573±0.084 ng/mL respectively. When TIMP-2 level of serum and peritoneal fluid compared to the control, the significant difference was only found in serum (p < 0.05), 0.853±0.343 vs. 0.637±0.116 ng/mL and 1.339±2.141 vs. 0.105±0.028 ng/mL respectively. This study showed that there was an increase of MMP-2 level of serum and peritoneal fluid and low level of serum and peritoneal TIMP-2 in severe endometriosis. Serum and peritoneal fluid MMP-2 as well as TIMP-2 in serum had a significant relationship with the incidence of severe endometriosis. Meanwhile, TIMP-2 in peritoneal fluid had no significant relationship with the incidence of severe endometriosis.
Highlights
Endometriosis is a disease characterized by the appearance of tissue resembling endometrium outside the uterine cavity that causes chronic inflammation in the surrounding tissue
Matrix metalloproteinase-2 (MMP-2) activity occurs in two steps; a precursor of latent MMP-2 is broken by Membrane Type-1 Matrix Metalloproteinase (MT1MMP) to produce an intermediate MMP-2, and through a catalytic process, it automatically changes MMP-2 into its active form
This study aimed to examine the balance of MMP-2 and tissue inhibitor of MMP (TIMP)-2 towards the incidence of severe endometriosis
Summary
Endometriosis is a disease characterized by the appearance of tissue resembling endometrium outside the uterine cavity that causes chronic inflammation in the surrounding tissue. Three tissue inhibitors of MMP (TIMP-1, TIMP-2, TIMP-3) regulate the protease activity. [5] TIMPs are specific endogenous enzymes involved in controlling the local activities of MMPs in tissue. Matrix metalloproteinase-2 (MMP-2) degrades type IV collagen and is presumed to play a role in the process of adhesion and invasion in endometriosis. MMP-2 activity occurs in two steps; a precursor of latent MMP-2 is broken by Membrane Type-1 Matrix Metalloproteinase (MT1MMP) to produce an intermediate MMP-2, and through a catalytic process, it automatically changes MMP-2 into its active form. Unlike Matrix Metalloproteinase (MMPs) that are soluble, MT1-MMP called Matrix Metalloproteinase-14 (MMP-14) is located on the cell surface and its increased expression activates cell surface MMP-2, a process that leads to cell invasion. Unlike Matrix Metalloproteinase (MMPs) that are soluble, MT1-MMP called Matrix Metalloproteinase-14 (MMP-14) is located on the cell surface and its increased expression activates cell surface MMP-2, a process that leads to cell invasion. [7]
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