Effect of Protease Inhibitors in Healing of the Vaginal Wall.

Maria Florian-Rodriguez, Kathleen Chin, Jennifer Hamner, Jesus Acevedo, Patrick Keller, R Ann Word

Scientific reports 2019 Aug 26

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Impaired elastogenesis and increased degradation of elastic fibers has been implicated in the pathogenesis of pelvic organ prolapse. Loss of the elastogenic organizer, fibulin-5 (FBLN5), leads to pelvic organ prolapse in mice. The objective of this study was to investigate the regulation of FBLN5 after surgical injury of the vaginal wall using the rat as a preclinical animal model. Both endogenous and recombinant FBLN5 were degraded after surgical injury. Estrogen did not alter the dramatic loss of vaginal FBLN5 in the acute phase after injury (12-48 h), but resulted in rescue of the poor recovery of FBLN5 levels in the late phase (7 d) of healing in ovariectomized animals. In contrast with estrogen, the general MMP inhibitor, actinonin, abrogated injury-induced degradation of FBLN5 significantly. Further, actinonin rescued the negative effects of injury on biomechanics, histomorphology, and elastic fibers. Control of excessive matrix degradation by local application of actinonin at the time of surgery may lead to improved elastic fiber regeneration and wound healing, thereby potentially enhancing pelvic floor recovery after reconstructive surgery for prolapse.

Citation

Maria Florian-Rodriguez, Kathleen Chin, Jennifer Hamner, Jesus Acevedo, Patrick Keller, R Ann Word. Effect of Protease Inhibitors in Healing of the Vaginal Wall. Scientific reports. 2019 Aug 26;9(1):12354