Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diverging results have been published concerning collagen metabolism in uterovaginal prolapse (UP). We have investigated collagen turnover in urogenital tissue in urologically healthy women with (UP patients) and without UP or any history of UP (controls). Markers of collagen turnover, carboxy-terminal propeptide of type I procollagen (PICP), amino-terminal propeptide of procollagen III (PIIINP) and carboxy-terminal telopeptide of type I collagen (ICTP) were assayed in urogenital tissue homogenates and serum. Tissue and serum concentrations of collagen turnover markers were related to UP and to menopausal/estrogen status. UP patients were significantly older than the controls. UP patients had significantly higher tissue PICP and PIIINP and significantly lower tissue ICTP levels than the controls, but the difference in ICTP disappeared after matching for menopausal/estrogen status and age. There were no associations between tissue collagen turnover markers on the one hand and menopausal/estrogen status or age on the other. The higher tissue concentrations of PICP and especially PIIINP in tissue from women with UP compared to controls, suggest an increased collagen breakdown in UP. This pattern differs from that in stress urinary incontinent women without UP, where tissue levels of collagen turnover markers are low, indicating reduced collagen breakdown.
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PMID:Markers of collagen synthesis and degradation in urogenital tissue and serum from women with and without uterovaginal prolapse. 1823 Jun 25

Pelvic organ prolapse (POP) is a common, debilitating disorder affecting millions of women. Uterosacral ligaments (USLs) are the main supportive structures of the uterus and vagina and are often attenuated in women with POP. Although the mechanical strength of USLs is known to be dependent on collagen synthesis and catabolism and the degradation protein MMP2 has been implicated in POP, the molecular mechanisms involved in the development of POP are currently unknown. Homeobox (HOX) genes are transcriptional regulators that orchestrate embryonic development of the urogenital tract. We demonstrated here that HOXA11 was essential for organogenesis of the USL by showing that USLs were absent in Hoxa11-null mice. We compared expression of HOXA11, collagen type I, collagen type III, MMP2, and MMP9 in USLs of women with and without POP. Expression of HOXA11 and both collagens was dramatically decreased while MMP2 was increased in women with POP. Constitutive expression of Hoxa11 in murine fibroblasts resulted in significantly increased expression of collagen type III and decreased expression of MMP2. These results identified HOXA11 as an essential gene for the development of the USL and suggested that women with POP might have weakened connective tissue due to changes in a signaling pathway involving HOXA11, collagen type III, and MMP2.
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PMID:HOXA11 is critical for development and maintenance of uterosacral ligaments and deficient in pelvic prolapse. 1827 72

Gynecological literature pertaining to prolapse or stress urinary incontinence published over the past four decades was reviewed to determine whether signs of herniosis, the systemic connective tissue co-morbidity known to play a significant role in abdominal herniation, were present and differed from controls. A total of eight indications were reported: (1) Genetic factors, i.e., family history and race, were predictive. (2) An increase in the incidence was observed in association with heritable diseases of collagen and their formes frustes (e.g., joint laxity). (3) Recurrence rate after repair was high (30%). (4) Fragmentation and degeneration of smooth muscle and collagen fibers were observed histologically. (5) Biochemistry demonstrated a decline of 24-40% in collagen content of skin, round ligament, cardinal ligament, periurethral vaginal wall, cervix, pubocervical, cervicococcygeal, and vesicovaginal fasciae. (6) In patients with stress urinary incontinence, collagen content decreased 60%. This change was independent of age, parity, menopausal status, and weight. (7) Matrix metalloproteinase (MMP-2 and MMP-9) activity increased fourfold and that of their inhibitor TIMP-1 decreased. (8) Cigarette smoking, an acquired factor, increased the incidence of stress urinary incontinence. This commonality with the etiology of abdominal herniae explains why gynecologists have decreased their emphasis on childbirth injury and, like herniologists, have moved to discard the dogma "prolapse" as a designate for extraperitoneal herniation in the pelvis.
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PMID:Signs of herniosis in women with vaginal prolapse and/or stress incontinence. 1841 38

Using a specific myofibroblast contraction test, we try to predict future utero-vaginal prolapse development in young primiparae women. We compare myofibroblast cultures of the vaginal wall in primiparae women (group 1), young multiparae women (group 2) and older multiparae women (group 3) who were operated on for severe utero-vaginal prolapse. A myofibroblast-mediated collagen gel contraction assay determined a contraction factor that was compared in the three groups of women. The myofibroblasts contraction factor after 24 and 48 hours was significantly higher in group 1 women (2.4 +/- 0.6/4.4 +/- 1.9) compared to group 2 (1.6 +/- 0.3/ 1.8 +/- 0.1) andgroup 3 (1.6 +/- 0.3/1.8 +/- 0.3), but showed no differences in group 1 women without (2.1 +/- 0.5/3.5 +/- 1.9) and with (2.7 +/- 0.6/5.1 +/- 1.7) cystocoele. Vaginal myofibroblasts of young women show better contraction forces than young women with severe utero-vaginal prolapse. The latter have a myofibroblast contraction factor similar to those of older post-menopausal women operated for the same condition.
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PMID:The contractile properties of vaginal myofibroblasts: is the myofibroblasts contraction force test a valuable indication of future prolapse development? 1851 96

A 37-year-old woman presented with a 2-month history of fullness and ptosis of the left upper eyelid. Examination revealed a 6-cm x 2-cm mass in the left brow and upper eyelid, and a diffuse mass in the lower eyelid. Marked ptosis of the left upper eyelid and elevation of the left lower eyelid were noted. CT showed masses with a bone-like density in the left eyelid and periorbital soft tissue. A through history revealed that the patient had received calcium hydroxylapatite filler injection for nose augmentation 3 days prior to the development of the eyelid masses. The eyelid masses were excised and pathologically confirmed as calcium hydroxylapatite microspherules surrounded by collagen and histiocytes. Two months after surgery, the eyelid masses and ptosis of the left upper eyelid were completely resolved. To our knowledge, this is the first reported case of eyelid mass after injection of calcium hydroxylapatite facial filler for nose augmentation.
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PMID:Eyelid mass secondary to injection of calcium hydroxylapatite facial filler. 1880 74

The authors report the unique case of a 20-year-old patient with prolapsed uterus didelphys with noncanalized horns, who complained of primary amenorrhea. Clinical examination revealed a rudimentary noncanalized cervix with a third degree prolapse and no palpable uterus. A small prolapsing remnant of a uterus didelphys with 2 noncanalized uterine horns was excised by laparotomy. Ultrastructural examination of subepithelial cervical connective tissue revealed collagen of normal structure, but of low concentration. The etiologies of both the Mullerian ducts anomalies and the genital prolapse are probably multifactorial. Low collagen concentration indicates a constitutional tissue weakness contributing to the development of genital prolapse.
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PMID:Noncanalized horns of uterus didelphys with prolapse: a unique case in a young woman. 1909 56

Few studies are performed on the sustainability of the pelvic floor extracellular matrix important for preventing development of pelvic organ prolapse (POP). Collagens I and III, the elastin-associated proteins fibrillin-1 and fibulin-5 and the small leucine-rich repeat proteoglycans (SLRPs) decorin, lumican and fibromodulin are involved in giving the tissue its mechanical properties. Para-urethral biopsies were obtained from 15 women, 6 pre- and 9 post-menopausal, with POP. Real-time reverse transcription-polymerase chain reaction and immunohistochemistry for collagen I, collagen III, fibrillin-1, fibulin-5, decorin, lumican and fibromodulin were performed and compared with 14 controls, 8 pre- and 6 post-menopausal. Statistical comparisons controlled for age changes in gene expressions. A 16-fold decrease in decorin mRNA expression, P = 0.0001, and 8-fold in lumican mRNA expression, P = 0.001, were discovered in premenopausal POP compared with matched controls. In all women with POP, there were lower gene expressions of fibromodulin, P = 0.004, and fibulin-5, P = 0.001, compared with all controls. All proteins were detectable by immunohistochemistry, showing a weaker staining for decorin in premenopausal POP. For the first time, we show substantially decreased gene signal for production of SLRPs, regulators of collagen fiber assembly and impairment in elastic fiber assembly by down-regulation of fibulin-5 in POP.
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PMID:Gene expressions of small leucine-rich repeat proteoglycans and fibulin-5 are decreased in pelvic organ prolapse. 1925 63

The physiopathology of urogenital prolapse is multifactorial, a combination of the interaction between constitutional and acquired factors resulting in the weakening of perineal support. Genetic modifications contribute to the occurrence of prolapse (proof level 2). Differences relating to types of collagen and their proportions, the construction of smooth muscle fibres and nervous structures, have been described between women with and without prolapse. But the relationship of cause and effect is not always clear. It would appear that the reduction in the expression of the elastine gene and the perturbation of metabolism may be at the origin of the cause of a prolapse. However, the intense activity of tissue remodeling is probably the consequence of biomechanical pressure born by the prolapse. Muscular or neuropathic lesions of the levator ani have been widely researched and documented. In the case of prolapse, these were isolated exceptions and most often associated with dehiscence of support tissue.
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PMID:[Physiopathology of genitourinary prolapse]. 1996 60

Mechanical stability of the urogenital tract depends on intact collagen fibers. Because of difficulties in quantitating collagen, some authors have investigated collagen breakdown by measuring matrix metalloproteinases expression. We biopsied 68 post-menopausal women during operation to evaluate matrix metalloproteinase-1 (MMP-1) expression in uterosacral ligament biopsies from women with pelvic organ prolapse (POP) (n = 34) and controls with normal pelvic support (n = 34). The controls were matched to the POP group by age, body mass index, parity and duration of postmenopausal state. Immunohistochemistry for MMP-1 was performed on formalin fixed and paraffin embedded sections. Women with POP had a significantly higher MMP-1 expression (p = 0.047) which confirms an association, although not a causal relation, between POP and increased MMP-1 expression.
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PMID:Increased expression of matrix metalloproteinase-1 in uterosacral ligament tissue from women with pelvic organ prolapse. 2010 91

Pelvic organ prolapse (POP) is accompanied by an altered composition of the extracellular matrix (ECM). However, it is unclear whether the changed ECM is the cause or the consequence of POP, as stretching of the tissue may have an effect on the composition of the ECM. To address this question, we analyzed the connective tissues of the uterine artery wall of postmenopausal women with and without POP. The uterine artery wall is stretched in patients with POP, but this stretching is unlikely to cause the POP. Twenty-one women (13 with POP and 8 without POP) hospitalized for hysterectomy were included in this study. Tissue samples from the uterine artery were analyzed for collagen (types I, III, IV, V and VI) and other ECM proteins (fibronectin, laminin, tenascin, vitronectin and elastin) using immunofluorescence microscopy. Results revealed that uterine artery samples of women with prolapse showed a significantly weaker immunoreactivity to type VI collagen, vitronectin and elastin and a stronger immunostaining for type III collagen and tenascin as compared to control samples. Our results suggest that the ECM may be altered in response to mechanical stretch. Changes in the ECM composition as observed in POP may not necessarily be the reason for the development of pelvic floor relaxation in postmenopausal women.
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PMID:Changes of glycoprotein and collagen immunolocalization in the uterine artery wall of postmenopausal women with and without pelvic organ prolapse. 2018 34


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