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Updated: May 3, 2026

Monitoring Neutrophil Elastase and Cathepsin G Activity in Human Sputum Samples
Published on: May 21, 2021
An observational study of matrix metalloproteinase (MMP)-9 in cystic fibrosis
Graham Devereux1, Sandra Steele2, Timothy Jagelman2
1Section of Population Health, University of Aberdeen, Aberdeen AB25 2ZG, UK; Respiratory Medicine, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, UK.
Background:
In cystic fibrosis (CF), cross-sectional studies have reported sputum matrix metalloproteinase (MMP)-9 to be elevated and negatively correlated with FEV1. This longitudinal study examined the association between MMP-9 and tissue inhibitors of metalloproteinases (TIMPs) to prognostic parameters in CF.
Method:
A cross-sectional survey of CF and control subjects; CF patients were followed up for a median of 49 months. MMP-9 and TIMP-1 and TIMP-2 were quantified in sputum and plasma.
Results:
Seventy-three patients with CF, median age 22 years, and 40 controls were recruited. Fifty-three of these CF patients were followed up. Prospectively, in CF subjects, plasma MMP-9 activity was adversely associated with FEV1 (β -1.15 (95% CI -2.10, -0.20), p = 0.019) and rate of FEV1 decline, and plasma TIMP-1 was adversely associated with mortality: hazard ratio 3.66 (1.91-7.04), p < 0.001.
Conclusions:
These associations further justify investigation of MMP-9 and TIMP-1 as biomarkers for short- to medium-term FEV1 decline and mortality in patients with CF.
Insights
Matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in cystic fibrosis (CF) patients show associations with lung function decline and mortality, respectively. Further research is warranted for their use as prognostic biomarkers.
Area of Science:
- Biochemistry
- Pulmonology
- Biomarkers
Background:
- Previous studies indicate elevated sputum matrix metalloproteinase-9 (MMP-9) in cystic fibrosis (CF), negatively correlating with FEV1.
- This study investigates the longitudinal association of MMP-9 and tissue inhibitors of metalloproteinases (TIMPs) with prognostic parameters in CF.
Purpose of the Study:
- To examine the longitudinal association between MMP-9 and TIMPs with prognostic parameters in CF patients.
- To explore MMP-9 and TIMP-1 as potential biomarkers for FEV1 decline and mortality in CF.
Main Methods:
- Longitudinal follow-up of CF patients (median 49 months) and a cross-sectional control group.
- Quantification of MMP-9, TIMP-1, and TIMP-2 in sputum and plasma samples.
Main Results:
- Plasma MMP-9 activity was inversely associated with FEV1 and the rate of FEV1 decline in CF subjects.
- Plasma TIMP-1 showed an adverse association with mortality in CF patients (HR 3.66, p < 0.001).
Conclusions:
- MMP-9 and TIMP-1 warrant further investigation as biomarkers for predicting short- to medium-term FEV1 decline and mortality in CF.
- These findings support the clinical relevance of MMP-9 and TIMP-1 in CF patient prognosis.
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