MMP's, TIMP's, PIIINP und Hyaluronan im Serum und Gewebe von Patientinnen mit Kapselfibrose nach alloplastischer Mammaaugmentation

Matrix metalloproteinases (MMPs) and their inhibitors, tissue-inhibitors of metalloproteinases, TIMPs, are in a physiological balance and part of the engineering of the extracellular matrix. Is this system disturbed an imbalance results and therefore fibrotic processes concerning liver fibrosis and lung fibrosis for example. In these cases the MMP:TIMP ratio is decreased. This imbalance can also play a role in the developing of capsular fibrosis after breast augmentation with Trilucent™-implants. In this study the concentration of MMP-1, MMP-2, MMP-9, TIMP-1, TIMP-2 and PIIINP and hyaluronan, both noninvasive marker for fibrotic processes, were determined in sera of 17 patients (average age 40 + 12) using enzyme-linked immunosorbent assay. After a breast augmentation with Trilucent™-implants they had developed capsular fibrosis. The results were correlated to the classification of the 4 grades of Baker. Control group were patients with a mammaplasty reduction (average age 37 + 15). The results were analysed using the Mann-Whitney-Test and Spearman rank correlation. Samples of the capsule tissue of all patients were obtained and histologically and immunhistochemically analysed. Patients with a capsular fibrosis had significant (p < 0.05) increased concentrations of TIMP-1 (566 + 210 ng/ml) and TIMP-2 (165 + 50 ng/ml) as well as hyaluronan (34 + 14 ng/ml) and showed a correlation to the grades of Baker while there were no differences to the concentrations in the sera of the control group for MMP-1, MMP-9 and PIIINP. The MMP/TIMP ratio was decreased with 1.1 + 0.4 for the patients with mammaplasty augmentation to 1.5 + 0.4 for the patients with mammaplasty reduction. The increased concentration of MMP-2 (315 + 100 ng/ml) could be a result of the chronic inflammatory process and the induction of TGF-beta1 a cytokine involved in fibrogenesis. Histological there was a thicker capsule tissue correlating to Baker and inflammatory cells and refracting material and immunhistochemically a intensive stain for TIMP-1 and TIMP-2 and local for MMP-2. The physiological balance is disturbed in capsular fibrosis after mammaplasty augmentation with alloplastic implants and a decreased MMP/TIMP ratio. Hyaluronan could be an appropriate noninvasive marker, PIIINP less.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2010

Author dc:creator

• Repper, Dimitrios Markus

Contributors dc:contributor

• Pallua, Norbert

• info:eu-repo/classification/ddc/610
• Mammaaugmentation
• Fibrose
• Kontraktur
• Medizin
• Matrix-Metalloproteinasen
• matrix metalloproteinases
• tissue inhibitors of metalloproteinases
• contracture
• capsular fibrosis
• breast augmentation

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-124695%22

OAI identifier oai:identifier

oai:publications.rwth-aachen.de:63251