Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 14;13(7):1123.
doi: 10.3390/biom13071123.

A Systematic Review on the Role of Matrix Metalloproteinases in the Pathogenesis of Inguinal Hernias

Umberto Bracale  1 , Roberto Peltrini  2 , Biancamaria Iacone  2 , Mirko Martirani  2 , Daniele Sannino  2 , Antonio Gargiulo  2 , Francesco Corcione  2 , Raffaele Serra  3 , Umberto Marcello Bracale  2
Affiliations

A Systematic Review on the Role of Matrix Metalloproteinases in the Pathogenesis of Inguinal Hernias

Umberto Bracale et al. Biomolecules. .

Abstract

The recurrence rate in patients who undergo surgery for abdominal wall hernias (AWHs) is high. AWHs have been hypothesized to be a disease of the extracellular matrix, which is supported by evidence showing a high incidence of AWHs in patients with connective tissue disorders. This study aimed to investigate the most recent literature studies describing the levels of several matrix metalloproteinases (MMPs) in the blood and fascia, with the objective of better clarifying the pathogenetic role of matrix metalloproteinases (MMPs) and their inhibitors in inguinal hernias (IHs). A systematic literature search was conducted using the PubMed, Scopus, and Web of Science electronic databases to identify eligible studies. The identified studies were included in the analysis, and a qualitative synthesis of the results is provided to describe the most recent findings. Seventeen studies were included. An association between MMP-2 and direct IHs has also been demonstrated. MMP-1, MMP-2, MMP-9, MMP-12, and MMP-13 levels were increased in both the serum and fascia of patients with IHs. The analysis of inhibitors showed an increase in tissue inhibitors of metalloproteinases (TIMPs), specifically TIMP-1 in IHs, particularly in direct hernias, and a reduction in TIMP-2 in the biopsy samples of the transversalis fascia. In contrast, a reduction in TIMP-1 and an increase in TIMP-2 levels have been reported only in the serum of patients with IHs. Metalloproteinases play a crucial role in the pathogenesis of IHs. The analysis of other molecules, such as TIMPs or their correlation with specific genes, is enhancing our understanding of the pathophysiology of IHs. However, more prospective studies, including comprehensive clinical and laboratory data collection, are required to confirm the relationship between the studied biomarkers and the risk of IHs.

Keywords: biomarkers; collagen; extracellular matrix; inguinal hernia; matrix metalloproteinases.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram for systematic review including databases search.
Figure 2
Figure 2
Crystal structure of the human MMP-2 catalytic domain in a complex with an inhibitor. From the RCSB Protein Data Bank (https://www.rcsb.org/, accessed on 22 June 2023).
Figure 3
Figure 3
proMMP-2/TIMP-2 complex. From the RCSB Protein Data Bank (https://www.rcsb.org/, accessed on 22 June 2023).
See this image and copyright information in PMC

References

    1. Stabilini C., Cavallaro G., Dolce P., Capoccia Giovannini S., Corcione F., Frascio M., Sodo M., Merola G., Bracale U. Pooled data analysis of primary ventral (PVH) and incisional hernia (IH) repair is no more acceptable: Results of a systematic review and metanalysis of current literature. Hernia. 2019;23:831–845. doi: 10.1007/s10029-019-02033-4. - DOI - PubMed
    1. Stabilini C., Cavallaro G., Bocchi P., Campanelli G., Carlucci M., Ceci F., Crovella F., Cuccurullo D., Fei L., Gianetta E., et al. Defining the characteristics of certified hernia centers in Italy: The Italian society of hernia and abdominal wall surgery workgroup consensus on systematic reviews of the best available evidences. Int. J. Surg. 2018;54:222–235. doi: 10.1016/j.ijsu.2018.04.052. - DOI - PubMed
    1. Flum D.R., Horvath K., Koepsell T. Have outcomes of incisional hernia repair improved with time? A population-based analysis. Ann. Surg. 2003;237:129–135. doi: 10.1097/00000658-200301000-00018. - DOI - PMC - PubMed
    1. Liem M.S., Vander Graaf Y., Beemer F.A., Van Vroonhoven T.J. Increased risk for inguinal hernia in patients with Ehlers-Danlos syndrome. Surgery. 1997;122:114–115. doi: 10.1016/S0039-6060(97)90273-7. - DOI - PubMed
    1. Lehnert B., Wadouh F. High coincidence of inguinal hernias and abdominal aortic aneurysms. Ann. Vasc. Surg. 1992;6:578–582. doi: 10.1007/BF02042733. - DOI - PubMed

Publication types

MeSH terms

Substances