Original CommunicationsImpaired balance of type I and type III procollagen mRNA in cultured fibroblasts of patients with incisional hernia*,**
Section snippets
Clinical specimens
From January to July 1999, a total of 22 patients participated in this study at the Department of Surgery. Informed consent was obtained from all patients.
Skin tissue samples were taken from the abdominal wall of healthy control patients with no previous skin incisions (n = 5; male 4, female 1; average age 61 years); from patients with a stable scar without any sign of herniation (n = 5; male 3, female 2; average age 58 years); from patients with an incisional hernia (n = 7; male 5, female 2;
Immunohistochemical analysis of collagen types I and III in tissue specimen
The immunostaining of the tissue with antibodies against collagen type I and type III showed a similar distribution in all groups. However, there is a slight increased staining for type III collagen in the group with recurrent incisional hernias. After Quantimet analysis, the resulting ratio of collagen I/III was found to be 0.62 ± 0.04 in the skin of the control group; 0.59 ± 0.01 in normal skin scars; 0.54 ± 0.02 in the skin of patients with incisional hernias; and 0.47 ± 0.01 in the skin of
Discussion
Collagen, as the principal component of the extracellular matrix, mainly consists of type I and type III collagen, which constitutes approximately 95% of all known 19 collagen types.8 Type I collagen, with its high tensile strength, is predominantly found in skin, bone, and fascia, whereas type III collagen is predominantly seen in blood vessels and parenchymatous organs. In healthy skin, type I and III collagen exist in a ratio of approximately 4:1.11 Type III collagen threads are thinner than
Conclusion
In the future, the investigation of the collagen gene expression and modulation in tissue of patients with an incisional hernia may help to define a population at risk. The incisional hernia has a known incidence of up to 20% and is the most frequent long-term complication after a laparotomy. Any development of a preventive therapeutic strategy would be of considerable socioeconomic relevance.
References (32)
- et al.
Abnormalities in the biosynthesis of type III prrocollagen in cultured skin fibroblasts from 2 patients with multiple aneurysm
Matrix Biol
(1992) - et al.
Physiology and healing dynamics of chronic cutaneous wounds
Am J Surg
(1998) - et al.
Increased collagen synthesis accompanying elevated mRNA levels in cultured Werner Syndrome
J Invest Dermatol
(1990) - et al.
Regulation of collagen gene expression in keloids and hypertrophic scars
J Surg Res
(1993) - et al.
Single step method of RNA isolation by acid guanidim thio-cynate-phenolchloroform extraction
Ann Biochem
(1987) - et al.
Characterization of collagens and proteoglycans at the insertion of human achilles tendon
Matrix Biol
(1998) - et al.
A reverse transcription-polymerase chain reaction method to analyze porcine cytosine gene expression
Veter Immunol Immunopathol
(1997) - et al.
The primary structure of collagen
Int Rev Connect Tissue Res
(1976) - et al.
Disorder of collagen biosynthesis in patients with cerebral artery aneurysm
Biochim Biophys Acta
(1992) - et al.
Incidence of abdominal wall hernia in aortic surgery
Am J Surg
(1998)
Multiple defects in type III collagen synthesis are associated with the pathogenesis of abdominal aortic aneurysms
Ann NY Acad Sci
Incisional hernia following aortic surgery
Hernia
Diminished type I collagen sythesis and reduced alpha 1(I) collagen messenger RNA in cultured fibroblasts from patients with dominantly inherited (type I) osteogenesis imperfecta
J Clin Invest
Increased risk for inguinal hernia in patients with Ehlers-Danlos syndrome
Surgery
Altered collagen synthesis in fascia transversalis of patients with inguinal hernia
Hernia
Altered steady-stare ratio of type I/III procollagen mRNAs correlates with selectively increased type I procollagen biosynthesis in cultured keloid fibroblasts
Proc Natl Acad Sci U S A
Cited by (0)
- *
Supported by the Federal Ministry of Education and Research (Germany) grant project 01KS9503/9 for the Interdisciplinary Center for Medical Research on Biomaterials and Implant Tissue-Interfaces, The Aachen University of Technology, the German Research Foundation (Kl 1320/2-1), and ETHICON, Norderstedt, Germany.
- **
Reprint requests: Uwe Klinge, MD, Department of Surgery, The Technical University of Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.