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Alteration of elastin metabolism in women with pelvic organ prolapse

Authors
 Yeo Jung Moon ; Jong Rak Choi ; Sang Wook Bai ; Sei Kwang Kim ; Myung Jae Jeon 
Citation
 Journal of Urology, Vol.185(5) : 1786~1792, 2011 
Journal Title
 Journal of Urology 
ISSN
 0022-5347 
Issue Date
2011
Abstract
PURPOSE: Although there are many studies about the effects of vaginal birth, the effects of menopause on pelvic floor support have not been identified. We compared elastin metabolism in the uterosacral ligament of women with and without pelvic organ prolapse, and defined the menopausal regulation of this process. MATERIALS AND METHODS: The study group consisted of 35 women who underwent hysterectomy for pelvic organ prolapse. The control group consisted of 39 women without pelvic organ prolapse. A questionnaire was administered to assess age, parity, body mass index, and menopausal status. Expression levels of mRNA, and protein for neutrophil elastase, matrix metalloproteinase-2, and matrix metalloproteinase-9 were determined by real-time quantitative polymerase chain reaction and ELISA, respectively, using uterosacral ligament samples from each patient. Expression of alpha-1-antitrypsin, an inhibitor of neutrophil elastase, was also determined. ANOVA, the Kruskal-Wallis test and multivariate linear regression were used for statistical analysis. RESULTS: Expression of neutrophil elastase and matrix metalloproteinase-2 mRNA was higher in women with pelvic organ prolapse than in those without pelvic organ prolapse. Compared to before menopause, neutrophil elastase and matrix metalloproteinase-2 showed a significant decrease in postmenopausal women without pelvic organ prolapse, although these remained increased in postmenopausal women with pelvic organ prolapse. Alpha-1-antitrypsin was significantly less in postmenopausal women with pelvic organ prolapse than in postmenopausal women without pelvic organ prolapse. The activities of neutrophil elastase, matrix metalloproteinase-2 and matrix metalloproteinase-9 were increased in women with pelvic organ prolapse, and these trends were similar to neutrophil elastase and matrix metalloproteinase-2 expression even after adjustment for age, parity and menopausal status. CONCLUSIONS: After menopause increased elastolytic protease has a significant role in the development of pelvic organ prolapse
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/92819
DOI
10.1016/j.juro.2010.12.040
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Laboratory Medicine
1. 연구논문 > 1. College of Medicine > Dept. of Obstetrics & Gynecology
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S0022534710053826
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