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A local imbalance between MMP and TIMP may have an implication on the severity and course of appendicitis

Anna Solberg1, Lena Holmdahl, Peter Falk

  • 1Department of Surgery, Colorectal Unit, Sahlgrenska University Hospital/Ostra, Gothenburg University, Gothenburg, Sweden. anna.solberg@surgery.gu.se

International Journal of Colorectal Disease
|March 19, 2008
PubMed
Abstract

Insights

Matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs) show altered levels in appendicitis. Elevated MMP-9 in inflamed appendices suggests it may be a biomarker for perforation risk.

Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Biochemistry

Background:

  • Matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs) are implicated in intestinal inflammation.
  • Their role in acute appendicitis and varying clinical presentations requires further investigation.

Purpose of the Study:

  • To investigate MMP/TIMP balance alterations in acute appendicitis.
  • To determine if MMP and TIMP expression and localization vary with appendicitis severity.

Main Methods:

  • Tissue specimens from 40 appendectomy patients (phlegmonous, gangrenous, perforated) and 10 controls were analyzed.
  • Enzyme-linked immunosorbent assay (ELISA) assessed MMP and TIMP expression.
  • Immunohistochemistry localized enzyme expression.

Main Results:

  • MMP-1 was elevated in gangrenous and perforated appendicitis versus controls.
  • MMP-2 was lower in gangrenous and perforated appendicitis compared to controls.
  • MMP-9 showed significantly elevated expression in all appendicitis groups versus controls.

Conclusions:

  • MMP-9 is highly expressed in inflamed appendices.
  • An imbalance between MMP-9 and TIMP-1 may contribute to perforation.
  • MMPs show potential as biomarkers for predicting appendiceal perforation.

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