Matrix metalloproteinases-1, -2 expression in uterosacral ligaments from women with pelvic organ prolapse

ObjectiveThis study investigated matrix metalloproteinase-1 (MMP-1) and matrix metalloproteinase-2 (MMP-2) immunohistochemical expression in uterosacral ligament biopsies from women with pelvic organ prolapse (POP), and controls with normal pelvic support.DesignProspective observational experimental study.SettingA tertiary Urogynecology Unit and Institute of Pathology, University Hospital Split, Croatia.PopulationWomen referred for hysterectomy for prolapse or benign gynecological disease.MethodsEighty postmenopausal women were included in the study after Ethical Committee approval and informed consent. During surgery, uterosacral ligament biopsies were obtained from patients with POP (n = 40) and women without evidence of pelvic floor weakening (n = 40). Immunohistochemistry for MMP-1 and MMP-2 was performed on formaline fixed and paraffin embedded sections. Statistical evaluations were made by Student t-test or χ2 test.Main outcome measuresImmunohistochemical expression of MMP-1 and MMP-2 in the uterosacral ligaments of women with and without genital prolapse.ResultsForty women with POP and 40 controls without POP were included. The controls were matched to the women with POP in age, body mass index, parity and duration of postmenopausis. A significant increase in MMP-1 immunohistochemical expression was seen in uterosacral ligament tissue from women with POP (P = 0.029). In contrast, there was no difference in immunohistochemical expression of MMP-2 between women with POP and those without (P = 0.899).ConclusionThese data suggest that MMP-1 may be marker of collagen degradation. Increased MMP-1 immunohistochemical expression in uterosacral ligaments is associated with urogenital prolapse.