Background: Groin hernia has become an important social and economic problem of our times. The pathogenesis of the disease is not clear. There are some theories pointing to a multifactoral genesis of these kinds of diseases, all of them assume the attenuation of abdominal fascia, mainly the transversal fascia. The density and continuity of the fascia depend on collagen fiber structure. Metalloproteinases are the group of proteolytic enzymes responsible for extracellular matrix protein and basic blood vessel membrane degradation. These enzymes play an important role in the development of malignant diseases such as colon, breast, lung, and adrenal gland cancers as well as some connective tissue diseases (aortic aneurysm, Ehler-Danlos Syndrome, Marfan’s Syndrome). One of the most important is gelatinase A (Matrix Metalloproteinase 2, MMP-2). The aim of the study was an estimation of the MMP-2 blood levels in patients with groin hernia and answering the question whether changes in MMP-2 activity (derivative of blood concentration) can be correlated with inguinal hernia occurrence.
Material and methods: The study was performed in a group of 70 patients, male, aged 25-74 years (mean 52) with groin hernia. The control group comprised 10 healthy males aged 30-68 years (mean 46).
Results: In our studies we noticed increased blood concentrations of MMP-2 in patients with groin hernia, both direct and indirect in all age groups. The highest blood levels of MMP-2 were observed in young men with a direct hernia rather than those with an indirect one.
Conclusions: Our research is concurrent with other authors. This study confirms the important role of MMP-2 in the pathogenesis of inguinal hernia. These results suggest that the development of direct inguinal hernia is more genetically dependent than indirect hernia. The pathogenesis of indirect hernia seems to be connected with increased abdominal pressure e.g. during hard work.