Immunoexpression of matrix metalloproteinases MMP-1, MMP-2, MMP-9 and MMP-14 in extragenital endometriosis and eutopic endometrium

Abstract

Introduction: Endometriosis is a comon, benign, inflamatory, pathology, represented by the ectopic location of functional endometrial glands and stroma outside the uterine cavity [1, 2]. Matrix metalloproteinase (MMP) represents a large family zinc-dependent endopeptidases, involved in the degradation of the extracellular matrix in the process of endometrial cell implantation and are classified by their substrate specificity [7, 8]. Matrix metalloproteinases (MMPs) are essential in orchestrating proper physiological functioning of the endometrium; hence, alteration of MMP activities is considered as a critical factor for the development of endometriosis. MMPs are involved in the cellular event of epithelial-mesenchymal transition [10, 22]. Purpose: The aim of this study was to evaluate the immunohistochemical expression of matrixmetalloproteinases MMP1, MMP2, MMP9 and MMP14 in surgical excision specimens, collected from women with extragenital endometriosis compared to their expression in the normal endometrium. Material and methods: The patient group consist 42 women with endometriosis, age range of 21-63 years (median 40), diagnosed and surgically treated at Department of Surgery, Obstetrics and Gynecology from Gherghe Paladi Municipal Clinical Hospital, Sfantul Arhanghel Mihail Municipal Clinical Hospital, Chisinau, the Republic of Moldova and Emergency County Hospital, Craiova, Romania. Location included: the anterior abdominal wall after caesarean operation – 20, inguinal hernia – 7, umbilical hernia – 4, perineal region – 1, appendix – 4, colon – 5, and ileum – 1case. Results: The classical histopatological examination of the general expression of MMP-1, MMP-2, MMP-9 and MMP-14 revealed a diverse variability. For MMP-2, MMP-9, MMP-14 markers, the reaction positivity was variable not only from one case to another but also within each case, the latter being characterized by the identification of different areas within endometriosis. Immunohistochemical analysis has demonstrated the significant enhance of MMP-9 and MMP- 14 expressions in endometriosis and in endometrium. The distinctive feature of MMP-9 and MMP-14 expression in endometriosis was considerable increase of its activity precisely on the border of endometriotic lesion and the peritoneum. Conclusions: The MMP-9 and MMP-14 activity significant elevation, established on ectopic endometrium of women with endometriosis. Study of MMP-1, MMP-2, MMP-9 and MMP-14 activities in endometriotic lesions from women with endometriosis is perspective for further investigation in order to determine a possible role of matrix metalloproteinases in the development of invasiviness process in case of extragenital endometriosis.