Collagen metabolism in vaginal uterosacral tissue of women with pelvic organ prolapse

Abstract

Matrix metalloproteinases (MMP-2 & 9) content, concentrations of the inhibitor of MMP-2 (TIMP-2) and hydroxyproline were measured in biopsies of vaginal skin and uterosacral ligaments from women with prolapse (n=13) and matched controls (n=13).

There was a significant increase in pro MMP-2 expression in the vaginal skin of women with prolapse compared with controls (p<0.05).  There were small but not significant increases in the expression of active MMP-2, pro-MMP-9 and TIMP-2 in vaginal skin from women with prolapse.  For uterosacral ligaments, both pro-MMP-2 and active MMP-2 expression were increased in samples from the women with prolapse.  However, in contrast to samples of vaginal skin taken from the same women, this did not reach statistical significance.  No significant difference in hydroxyproline content was found between control and prolapse.  Interestingly, there were significant correlations between pro-MMP-2, active MMP-2, MMP-9 and TIMP-2 expression in vaginal skin with their expression in uterosacral ligaments (p<0.001, p<0.001, p<0.01 and p<0.01 respectively).  Oestrogen receptors (alpha) were present within the nuclei of smooth muscle bundles in the uterosacral ligaments, but not detected in smooth muscle of blood vessels.  There was no difference in oestrogen receptor expression in the uterosacral ligaments of women with prolapse compared with age matched controls.

In conclusion, evidence was shown for elevated matrix metalloproteinase in the vaginal skin of women with prolapse.  Although similar trends occurred in uterosacral ligaments this did not reach statistical significance.  Nevertheless, the fact that strong correlations existed between vaginal skin and uterosacral ligaments for markers of collagen metabolism suggested that changes occurring during the prolapse in uterosacral ligaments were reflected in vaginal skin.  Alterations in collagen turnover are likely to be exaggerated in the vaginal tissue as it is less resistant to stretching.  The expression of oestrogen receptor alpha did not appear the change in prolapse tissue but their presence in uterosacral ligaments suggest they may be a target for oestrogen.

More information

Identifiers

Catalogue record

Export record

ASCII CitationAtomBibTeXData Cite XMLDublin CoreDublin CoreEP3 XMLEndNoteHTML CitationHTML CitationHTML ListJSONMETSMODSMPEG-21 DIDLOpenURL ContextObjectOpenURL ContextObject in SpanRDF+N-TriplesRDF+N3RDF+XMLRIOXX2 XMLReferReference ManagerSimple Metadata