Progress of tissue injury in appendicitis involves the serine proteases uPA and PAI-1.

• OBJECTIVE: Serine proteases and the matrix metalloproteinases (MMPs) are key factors in the proteolytic cascade and participate in extracellular matrix (ECM) degradation. Fibrinolytic activators and inhibitors may have an effect on inflammatory cells, thereby modulating the inflammatory response. It is reasonable to assume that they may be implicated in the tissue injury in acute appendicitis that subsequently leads to appendix perforation. The purpose of this study was to investigate the expression and distribution of urokinase-type plasminogen activator (uPA) and plasminogen-activator inhibitor type 1 (PAI-1) in appendicitis. MATERIAL AND METHODS: Expression of uPA and expression of PAI-1 were measured in tissue specimens from patients with appendicitis (n=30) and in control specimens (n=9), using the quantitative ELISA technique. Distribution of enzymes was studied with immunohistochemistry. The uPA and PAI-1 levels in the subgroups of appendicitis and controls were compared. RESULTS: The overall expressions of uPA and PAI-1 were greater in appendicitis than in control specimens (p <0.001 and p<0.0001, respectively). Expressions of uPA and PAI-1 in phlegmonous (n=15), gangrenous (n=6) and perforated appendicitis (n=9) were all higher than those in controls (n=9), (p<0.01). Moreover, the PAI-1 level was elevated in perforated appendicitis compared with phlegmonous appendicitis (p<0.01). uPA staining was observed in connection with vascular endothelial cells and the serosa stained intensely in specimens from perforated appendicitis. CONCLUSIONS: The expression of uPA and especially the over-expression of PAI-1 seem to correlate to the progression of local inflammatory response in acute appendicitis.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Gastroenterologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Cell- och molekylärbiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Cell and Molecular Biology (hsv//eng)

Keyword

Adult

Appendectomy

Appendicitis

blood

pathology

surgery

Biopsy

Needle

Case-Control Studies

Disease Progression

Enzyme-Linked Immunosorbent Assay

Female

Follow-Up Studies

Gene Expression Regulation

Humans

Immunohistochemistry

In Situ Hybridization

Inflammation Mediators

analysis

metabolism

Intestinal Mucosa

pathology

Male

Middle Aged

Plasminogen Activator Inhibitor 1

genetics

metabolism

Probability

RNA

Messenger

analysis

Reference Values

Sensitivity and Specificity

Serine Endopeptidases

genetics

metabolism

Severity of Illness Index

Statistics

Nonparametric

Urokinase-Type Plasminogen Activator

genetics

metabolism

Young Adult

Appendiciits

Gastroenterology

Pathology

Pathology

Publication and Content Type

ref (subject category)

art (subject category)