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Local and systemic expressions of MMP-9, TIMP-1 and PAI-1 in patients undergoing surgery for clinically suspected

A Solberg1, L Holmdahl, P Falk

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

European Surgical Research. Europaische Chirurgische Forschung. Recherches Chirurgicales Europeennes
|April 21, 2012
PubMed
Abstract

Insights

Plasma PAI-1 levels correlate with appendiceal tissue, aiding diagnosis. Elevated systemic TIMP-1 may help distinguish perforated appendicitis from other forms.

Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Biochemistry

Background:

  • Appendicitis diagnosis relies on clinical presentation and imaging, with biomarkers offering potential adjunctive value.
  • Matrix metalloproteinase 9 (MMP-9), tissue inhibitor of metalloproteinase 1 (TIMP-1), and plasminogen activator inhibitor type 1 (PAI-1) are implicated in inflammatory processes.

Purpose of the Study:

  • To investigate and correlate the expression of MMP-9, TIMP-1, and PAI-1 in appendiceal tissue and blood.
  • To compare local and systemic biomarker levels in appendicitis patients.
  • To assess the potential of these biomarkers in differentiating appendicitis severity.

Main Methods:

  • Fifty-seven patients with suspected appendicitis were categorized by appendix status: noninflamed, phlegmonous, gangrenous, and perforated.
  • Protein expressions of MMP-9, TIMP-1, and PAI-1 were quantified using ELISAs in tissue and blood samples.
  • Correlations between tissue and plasma levels were analyzed, and changes from pre- to post-surgery were examined.

Main Results:

  • A significant positive correlation was observed between tissue and plasma PAI-1 levels (p < 0.05).
  • Plasma MMP-9 and PAI-1 showed no significant individual differences between surgical and recovery phases.
  • Systemic TIMP-1 levels were significantly higher in perforated appendicitis cases compared to phlegmonous (p < 0.0001) and gangrenous (p < 0.01) appendicitis.

Conclusions:

  • Plasma PAI-1 serves as a reliable indicator of appendiceal tissue PAI-1 levels during surgery.
  • Systemic TIMP-1 demonstrates potential as a biomarker for distinguishing perforated appendicitis from nonperforated cases.

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