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Matrix Metalloproteinases in Obesity After Gastric Bypass Surgery—an Experimental Study

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Abstract

Matrix metalloproteinases (MMPs) are enzymes involved in the modulation of extracellular matrix (ECM) and adipocytes and preadipocyte differentiation. The pathophysiology of obesity has characterized by many cellular and molecular processes such as inflammatory processes, macrophage infiltration of adipose tissue, and remodeling of ECM via MMP. The purpose of the study was to determine if we can consider MMPs as a marker of effectiveness in bariatric surgery and if sulodexide administration pre- and postoperative has a benefit in terms of tissue remodeling of weight loss. An experimental study has performed using 40 obese Wistar rats (10 rats in the control group and 30 obese rats in study groups). Those in the study group were divided into three groups and underwent gastric bypass (B group), sulodexide administration (S group), gastric bypass, and sulodexide administration (BS group). Sulodexide was administered because of its antithrombotic effect in the procoagulant status of obese subjects. The pre- and postoperative weight, glucose level, cholesterol, triglycerides, MMP-2, and MMP-9 were analyzed. We compared the results to see if bariatric surgery modifies the MMPs status and if there is a correlation between the weight loss and the other parameters and also if sulodexide has any contribution to the results. The MMP-2 and MMP-9 activities were detectable, but MMP-2 was significantly higher than MMP-9. MMP-2 correlates with body weight parameters before surgery and after surgery, after significant bodyweight reduction as a result of bariatric surgery (r = 0.478, p = 0.017). There is a strong correlation between the weight loss, glucose level, and cholesterol and the values of MMP-2 (r = 0.92, p = 0.022, respectively, r = 0.759, p = 0.033). MMP-9 is correlated with weight loss and triglycerides level. But it was not as sensitive as MMP-2. Sulodexide administration in group S had a positive influence on the MMP-2 and MMP-9 compared with the values of groups B and C but without statistical significance. MMP-2 and MMP-9 are the two most important ECM enzymes involved in adipose tissue remodeling after bariatric surgery. The correlations between cholesterol, triglycerides, glucose, weight loss, excess weight, and body mass index (BMI) parameters and MMPs level demonstrate the direct relationship of these enzymes in obesity. Although we believe that more in-depth studies are required, MMPs may be considered a marker of the effectiveness of bariatric surgery.

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Acknowledgments

This study acknowledges Mioara Paraschiv and Dr. Bogdan Marinescu from the University of Agronomic Sciences and Veterinary Medicine, Faculty of Veterinary Medicine, Bucharest, who assured the care and supervision of rats during the experiments.

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Authors and Affiliations

  1. Emergency Clinical Hospital “St. John”, Bucharest, Romania

    Radu Mihail Mirica, Mihai Ionescu, Octav Ginghina, Razvan Iosifescu & Nicolae Iordache

  2. Department of General Surgery, “St. John” Hospital University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania

    Radu Mihail Mirica, Octav Ginghina, Razvan Iosifescu & Nicolae Iordache

  3. Emergency Clinic Hospital for Children “Grigore Alexandrescu”, Bucharest, Romania

    Alexandra Mirica

  4. Department Physiology and Neuroscience, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania

    Adrian Rosca & Leon Zagrean

  5. Department of Biochemistry, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania

    Laura Gaman

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  1. Radu Mihail Mirica
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  2. Mihai Ionescu
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  9. Nicolae Iordache
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Correspondence to Alexandra Mirica.

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The study presents the written agreement of the ethics committee of the University of Medicine and Pharmacy “Carol Davila” Bucharest to complete the Ph.D. thesis.

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All applicable institutional and/or national guidelines for the care and use of animals were followed.

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Mirica, R.M., Ionescu, M., Mirica, A. et al. Matrix Metalloproteinases in Obesity After Gastric Bypass Surgery—an Experimental Study . Indian J Surg (2020). https://doi.org/10.1007/s12262-020-02462-x

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