Objective: To study semi-quantitatively mRNA expression of matrix metalloproteinase-9 (MMP-9) and its inhibitor, tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), in vaginal wall connective tissue in women with stress urinary incontinence (SUI) compared to continent controls, and to explore the relationship between MMP-9, TIMP-1 and SUI.
Methods: Vaginal wall tissues were obtained from 24 women with SUI who were followed-up (12 cases are > 60 years old and 12 cases < or = 60 years old). Seven patients undergoing total hysterectomy for carcinoma in situ of cervix without urinary incontinence served as control group. RNA was extracted and quantified. Semi-quantitative competitive reverse transcription was carried out with oligo-nucleotide primers to quantify MMP-9 and TIMP-1 mRNA expression.
Results: We used GeneSnap to analyze the data. MMP-9 in three groups (> 60, < or = 60 years and control) was 0.56 +/- 0.20, 0.56 +/- 0.19, 0.37 +/- 0.18, significantly decreased (P < 0.05). There was no difference between > 60 and < or = 60 year age groups (P > 0.05). TIMP-1 in three groups was 0.23 +/- 0.11, 0.31 +/- 0.12, 0.41 +/- 0.13, significantly increased (P < 0.05). There was a great difference between > 60 and < or = 60 year age groups in TIMP expression (P > 0.05). The ratio of MMP-9/TIMP-1 in > 60, < or = 60 year age groups and control group was 2.49 +/- 1.82, 1.82 +/- 1.58, 0.90 +/- 1.38, significantly decreased (P < 0.05).
Conclusion: Stress urinary incontinent women demonstrate a significant increase in MMP-9 mRNA expression and significant decrease in TIMP-1 mRNA expression. In SUI patients, proportion of MMP-9 and TIMP-1 was overbalanced. Both these findings are consistent with increased collagen breakdown and may play an important role in the onset and development of SUI.
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