Cheong, Ying C., Shelton, Jenny B., Laird, Susan M., Li, Tin-Chiu, Ledger, William L. and Cooke, Ian D.
Peritoneal fluid concentrations of matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, and transforming growth factor-beta in women with pelvic adhesions.
Fertility and Sterility, 79, (5), . (doi:10.1016/S0015-0282(03)00079-7).
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Objective: to establish whether the concentration of matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), and transforming growth factor-beta (TGF-beta) is influenced by the presence or absence of adhesions, and whether the concentration of these mediators vary throughout the menstrual cycle. Design: prospective case-control study. Setting: women undergoing laparoscopy in a university hospital in the United Kingdom. Patient(s): women undergoing laparoscopy for benign gynecological conditions. Intervention(s): samples of peritoneal fluid were collected at diagnostic laparoscopy in one group, and at laparoscopy and serially during the first 48 hours after laparoscopic adhesiolysis in a second group. We correlated the concentrations of mediators in serially sampled peritoneal fluid during the 48 hours following laparoscopic adhesiolysis to the adhesion formation and reformation found during second-look laparoscopy. Main outcome measures: the concentrations of MMP-9, TIMP-1, and TGF-beta in peritoneal fluid. Result(s): MMP-9 concentration was lower in the follicular phase than the luteal phase of the menstrual cycle. MMP-9 concentration was significantly lower in women with pelvic adhesions than in women with a normal pelvis. The MMP-9/TIMP-1 ratio is significantly higher in women with significant adhesions at second-look laparoscopy compared to women with minimal or no adhesions. Conclusion(s): the components of extracellular matrix remodeling may play an important part in the adhesion formation/reformation process.
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