Genetic and biologic risk factors associated with hernia formation: A review

Chris Amro; Ellen F Niu; Ellie Deianni; Laurie Smith; Maylene Qiu; Jared Torkington; Robyn B Broach; Lillias H Maguire; Scott M Damrauer; Kamal Itani; John P Fischer

doi:10.1016/j.amjsurg.2024.02.029

Genetic and biologic risk factors associated with hernia formation: A review

Am J Surg. 2024 Feb 27:S0002-9610(24)00125-9. doi: 10.1016/j.amjsurg.2024.02.029. Online ahead of print.

Authors

Affiliations

¹ Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA; Hansjörg Wyss Department of Plastic Surgery, NYU Langone, New York, NY. Electronic address: Chris.amro@pennmedicine.upenn.edu.
² Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
³ Department of Colorectal Surgery, Cardiff and Vale University Health Board, Cardiff, UK.
⁴ Biomedical Library, University of Pennsylvania, Philadelphia, PA, USA.
⁵ Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
⁶ Department of Surgery, VA Boston Health Care System, Boston, MA, USA; Department of Surgery, Boston University, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.

PMID: 38519402
DOI: 10.1016/j.amjsurg.2024.02.029

Abstract

Background: This systematic review aims to identify genetic and biologic markers associated with abdominal hernia formation.

Methods: Following PRIMSA-guidelines, we searched PubMed, MEDLINE, Embase, Scopus, and COCHRANE databases.

Results: Of 5946 studies, 65 were selected, excluding parastomal hernias due to insufficient data. For inguinal hernias, five studies unveiled 92 susceptible loci across 66 genes, predominantly linked to immune responses. Eleven studies observed elevated MMP-2 levels, with seven highlighting greater MMP-2 in direct compared to indirect inguinal hernias. One incisional hernia study identified unique gene-expression profiles in 174 genes associated with inflammation and cell-adhesion. In hiatal hernias, several genetic risk loci were identified. For all hernia categories, type I/III collagen ratios diminished.

Conclusions: Biological markers in inguinal hernias appears consistent. Yet, the genetic predisposition in incisional hernias remains elusive. Further research to elucidate these genetic and biological intricacies can pave the way for more individualized patient care.

Keywords: Abdominal hernia; Biological factor; Genetic marker; Patient care; Systematic review; Therapeutic interventions.

Published by Elsevier Inc.

Publication types

Review