MMP2 and Hernia: Research indicates that in patients with recurrent hernias, collagen metabolism is disrupted in three key ways: a reduced collagen I-to-III ratio (with a higher proportion of weaker type III collagen), lower collagen quality (thinner fibers contributing to structural weakness), and increased collagen degradation (elevated matrix metalloproteinase-2 activity, which preferentially breaks down type I collagen) [155,156].