Expression of Matrix Metalloproteinases -1, -2 and -9 Associated with Pelvic Organ Prolapse : Experimental Analytical Study of The Uterosacral Ligaments of Congolese Women from The City of Kananga in DR Congo

Author(s): Antoine Tshimbundu Kayembe, Patrick Kahindo Muyayalo, Andy Mbangama Muela, Rahma Raschid Tozin

Objective : The objective of this study is to determine the level of expression of MMP-1, MMP-2 and -9 in prolapsed tissues of the uterosacral ligament and identify the types of MMP most associated with pelvic organ prolapse during the mass campaign in the city of Kananga in the Democratic Republic of Congo.

Methods : This is an experimental analytical study based on immunohistochemical examination of the uterosacral ligaments of 100 consenting patients divided into 2 groups and admitted to the gynecology departments of Bon-Berger hospitals in Tshikaji and Saint-Georges in Katoka, from January 1 to July 31, 2023. Case selection is based on non-probability convenience sampling. The Anova test, the Chi-square test and logistic regression with adjustment are used in statistical analyses.

Results: The expression of MMP-1, -2 and -9 in the uterosacral ligaments is significantly increased in the study group with a mean immunoreactivity of 40.38±19.10%(P=0.000) for MMP-1, 35.20±20.50%(P=0.000) for MMP-2 and 45.94±17.80%(P=0.000) for MMP-9. Positive immunoreactivities to matrix metalloproteinases-1, -2 and -9 are significantly associated with the occurrence of pelvic organ prolapse. Positive immunoreactivity to matrix metalloproteinase-1 (aOR: 6.36, 95%CI:1.167-34.64, P: 0.033) and matrix metalloproteinase-9 (aOR: 5.37, 95%CI:1.519-23.786, p: 0.011) are more determining in the occurrence of pelvic organ prolapse in the city of Kananga.

Conclusion: The expression of matrix metalloproteinase-1, - and -9 is increased in prolapsed uterosacral ligaments and associated with this condition and matrix metalloproteinase-1 and 9 are determining in the occurrence of pelvic organ prolapse in our city of Kananga.