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Are collagens the culprits in the development of incisional and inguinal hernia disease?

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Abstract

Incidence curves for the development of inguinal hernia disease and recurrences thereof exhibit a linear rise over the years and therefore suggest multi-factorial underlying causes. Several studies have revealed marked changes in the abundance and composition of interstitial collagens in patients with (recurrent) hernia diseases, adult groin hernia and incisional hernia. These observations led to the hypothesis that hernia formation and the recurrence of incisional hernia may be explained by disordered tissue renewal and by abnormal wound healing, respectively. Interstitial collagens, owing to their long half-lives and biomechanical strength, are most likely critical components of the biological system of tissue remodelling. An overview of the literature is provided, and the consequences for surgical practice are discussed.

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References

  1. Statistik Bf. www.gbe-bund.de

  2. Haapaniemi S (2006) Recurrent hernia: prevention and treatment. In: Schumpelick V (ed) Meshes: benefits and risks. Springer, Berlin Heidelberg (in press)

  3. Flum DR, Horvath K, Koepsell T (2003) Have outcomes of incisional hernia repair improved with time? A population-based analysis. Ann Surg 237:129–135

    Article  PubMed  Google Scholar 

  4. Junqueira LC, Bignolas G, Brentani RR (1979) Picrosirius staining plus polarization microscopy, a specific method for collagen detection in tissue sections. Histochem J 11:447–455

    Article  PubMed  CAS  Google Scholar 

  5. Wirtschafter ZT, Bentley JP (1964) Hernias as a collagen maturation defect. Ann Surg 160:852–859

    PubMed  CAS  Google Scholar 

  6. Wagh P, Read R (1971) Collagen deficiency in the rectus sheath of patients with inguinal herniation. Proc Soc Exp Biol Med 137:382–384

    CAS  Google Scholar 

  7. Conner WT, Peacock EE Jr (1973) Some studies on the etiology of inguinal hernia. Am J Surg 126:732–735

    Article  PubMed  CAS  Google Scholar 

  8. Nikolov S, Beltschev B (1990) Several ultrastructural peculiarities of the fascia transversalis in direct inguinal hernias of senile men. Anat Anz 170:265–272

    PubMed  CAS  Google Scholar 

  9. Rodrigues AJ Jr, de Tolosa EM, de Carvalho CA (1990) Electron microscopic study on the elastic and elastic related fibres in the human fascia transversalis at different ages. Gegenbaurs Morphol Jahrb 136:645–652

    Google Scholar 

  10. Ajabnoor MA, Mokhtar AM, Rafee AA, Taha AM (1992) Defective collagen metabolism in Saudi patients with hernia. Ann Clin Biochem 29:430–436

    PubMed  Google Scholar 

  11. Friedman DW, Boyd CD, Norton P, et al (1993) Increases in type III collagen gene expression and protein synthesis in patients with inguinal hernias (see comments). Ann Surg 218:754–760

    Article  PubMed  CAS  Google Scholar 

  12. Bellon JM, Bujan J, Honduvilla NG, et al (1997) Study of biochemical substrate and role of metalloproteinases in fascia transversalis from hernial processes. Eur J Clin Invest 27:510–516

    Article  PubMed  CAS  Google Scholar 

  13. Klinge U, Zheng H, Si ZY, Schumpelick V, Bhardwaj R, Klosterhalfen B (1999) Synthesis of type I and III collagen, expression of fibronectin and matrix metalloproteinases-1 and -13 in hernial sac of patients with inguinal hernia. Int J Surg Invest 1:219–227

    CAS  Google Scholar 

  14. Klinge U, Zheng H, Si Z, et al (1999) Expression of the extracellular matrix proteins collagen I, collagen III and fibronectin and matrix metalloproteinase-1 and -13 in the skin of patients with inguinal hernia. Eur Surg Res 31:480–490

    Article  PubMed  CAS  Google Scholar 

  15. Pans A (1999) New prospects in the etiology of groin hernias. Chirurgie 124:288–297

    Article  PubMed  CAS  Google Scholar 

  16. Pans A, Albert A, Lapiere CM, Nusgens B (2001) Biochemical study of collagen in adult groin hernias. J Surg Res 95:107–113

    Article  PubMed  CAS  Google Scholar 

  17. Rosch R, Klinge U, Si Z, Junge K, Klosterhalfen B, Schumpelick V (2002) A role for the collagen I/III and MMP-1/-13 genes in primary inguinal hernia? BMC Med Genet 3:2

    Article  PubMed  Google Scholar 

  18. Borquez P, Garrido L, Manterola C, et al (2003) Study of collagen and elastic fibers of connective tissue in patients with and without primary inguinal hernia. Rev Med Chil 131:1273–1279

    PubMed  Google Scholar 

  19. Hosgor M, Karaca I, Ozer E, Suzek D, Ulukus C, Ozdamar A (2004) Do alterations in collagen synthesis play an etiologic role in childhood inguinoscrotal pathologies: an immunohistochemical study. J Pediatr Surg 39:1024–1029

    Article  PubMed  Google Scholar 

  20. Kayaoglu HA, Hazinedaroglu SM, Bulent Erkek A, Kocaturk PA, Kavas GO, Aribal D (2005) Comparison of the plasma and hernia sac tissue copper levels in direct and indirect inguinal hernia patients. Biol Trace Elem Res 108:53–59

    Article  PubMed  CAS  Google Scholar 

  21. Abci I, Bilgi S, Altan A (2005) Role of TIMP-2 in fascia transversalis on development of inguinal hernias. J Invest Surg 18:123–128

    Article  PubMed  Google Scholar 

  22. Taniguchi S, Ueda K, Inoue T, Li TS, Kuga T, Hamano K (2006) Impact of collagen subtype proportions in peritoneal tissues on inguinal hernia formation in adults and infants. Pediatr Surg Int 22:600–604

    Article  PubMed  Google Scholar 

  23. Boemi L, Allison G, Graham W, Krummel T, Ehrlich H (1999) Differences between scar and dermal cultured fibreoblasts derived from a patient with recurrent abdominal incision wound herniation. Plast Reconstr Surg 104:1397

    PubMed  CAS  Google Scholar 

  24. Klinge U, Si ZY, Zheng H, Schumpelick V, Bhardwaj RS, Klosterhalfen B (2000) Abnormal collagen I to III distribution in the skin of patients with incisional hernia. Eur Surg Res 32:43–48

    Article  PubMed  CAS  Google Scholar 

  25. Klinge U, Si ZY, Zheng H, Schumpelick V, Bhardwaj RS, Klosterhalfen B (2001) Collagen I/III and matrix metalloproteinases (MMP) 1 and 13 in the fascia of patients with incisional hernias. J Invest Surg 14:47–54

    Article  PubMed  CAS  Google Scholar 

  26. Si Z, Bhardwaj R, Rosch R, Mertens PR, Klosterhalfen B, Klinge U (2002) Impaired balance of type I and type III procollagen mRNA in cultured fibroblasts of patients with incisional hernia. Surgery 131:324–331

    Article  PubMed  Google Scholar 

  27. Zheng H, Si Z, Kasperk R, et al (2002) Recurrent inguinal hernia: disease of the collagen matrix? World J Surg 26:401–408

    Article  PubMed  Google Scholar 

  28. Jorgensen LN (2003) Collagen deposition in the subcutaneous tissue during wound healing in humans: a model evaluation. APMIS 115 [Suppl]:1–56

    CAS  Google Scholar 

  29. Rosch R, Junge K, Lynen P, et al (2004) A case of bilateral inguinal hernia recurrence in infancy: investigations on collagen metabolism. Hernia 8:160–163

    Article  PubMed  CAS  Google Scholar 

  30. Rosch R, Junge K, Knops M, Lynen P, Klinge U, Schumpelick V (2003) Analysis of collagen-interacting proteins in patients with incisional hernias. Langenbecks Arch Surg 387:427–432

    PubMed  CAS  Google Scholar 

  31. Junge K, Klinge U, Rosch R, et al (2004) Decreased collagen type I/III ratio in patients with recurring hernia after implantation of alloplastic prostheses. Langenbecks Arch Surg 389:17–22

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was supported by the DFG KI 1320/2-1.

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Authors and Affiliations

  1. Department of Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany

    U. Klinge & M. Binnebösel

  2. Department of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany

    P. R. Mertens

Authors
  1. U. Klinge
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  2. M. Binnebösel
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  3. P. R. Mertens
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Correspondence to U. Klinge.

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Klinge, U., Binnebösel, M. & Mertens, P.R. Are collagens the culprits in the development of incisional and inguinal hernia disease?. Hernia 10, 472–477 (2006). https://doi.org/10.1007/s10029-006-0145-8

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