Matrix metalloproteinase-9 as a marker for acute ischemic stroke: a systematic review

Area of Science:

• Neurology
• Biochemistry
• Medical Diagnostics

Background:

• Matrix metalloproteinases (MMPs), particularly MMP-9, are implicated in cerebral ischemia.
• MMP expression is linked to blood-brain barrier disruption, edema, and hemorrhagic transformation in animal models.
• Understanding MMP roles is crucial for stroke diagnostics and therapeutics.

Purpose of the Study:

• To evaluate Matrix metalloproteinase-9 (MMP-9) as a potential biomarker for acute ischemic stroke (AIS).
• To determine the correlation between MMP-9 levels and infarct volume, stroke severity, and functional outcomes.
• To assess MMP-9's predictive value for hemorrhagic transformation following tissue plasminogen activator (t-PA) treatment.

Main Methods:

• Systematic literature review of MEDLINE and EMBASE databases.
• Inclusion of all relevant reports without year restriction.
• Analysis of data from 22 studies encompassing 3,289 patients.

Main Results:

• Significantly higher MMP-9 levels were observed in AIS patients compared to healthy controls.
• Elevated MMP-9 values correlated with larger infarct volumes, increased stroke severity, and worse functional outcomes.
• MMP-9 levels predicted the development of intracerebral hemorrhage in patients treated with t-PA.

Conclusions:

• Matrix metalloproteinase-9 (MMP-9) serves as a potential biomarker for ongoing brain ischemia.
• MMP-9 levels are significantly increased post-stroke and correlate with key clinical indicators.
• MMP-9 is a valuable predictor of hemorrhagic complications in t-PA treated AIS patients.