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Updated: Mar 8, 2026
Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
Plasma matrix metalloproteinase-9 levels predict intensive care unit mortality early after severe traumatic brain
Daniel Simon1,2,3, Joice Evaldt1, Débora Dreher Nabinger2
1a Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde.
Objectives:
Matrix metalloproteinase-9 (MMP-9) is an inducible metalloproteinase that can degrade the cerebrovascular matrix leading to disruption of the blood-brain barrier and exacerbation of oedema in neurotrauma. Therefore, our aim was to determine whether MMP-9 plasma levels were associated with intensive care unit (ICU) mortality after severe traumatic brain injury (TBI) despite the presence of extracerebral injuries.
Methods:
This cohort enrolled 80 patients who suffered severe TBI (Glasgow Coma Scale: 3-8 at hospital admission). The plasma MMP-9 level was determined by enzyme-linked immunosorbent assay assay at ICU admission.
Results:
Severe TBI was associated with a 32.5% ICU mortality rate. There was no association between the presence of extracerebral injuries (72.5% of the patients) and ICU mortality (P = 0.419). Higher plasma MMP-9 concentrations were associated with fatal outcome: 181.1 ± 16.0 ng/mL for survivors and 257.0 ± 23.2 ng/mL for nonsurvivors (mean ± S.E.M., P = 0.009). In contrast, there was no significant difference between MMP-9 levels and associated lesions: 220.8 ± 26.3 ng/mL for isolated TBI and 196.8 ± 15.8 ng/mL for patients with extracerebral injuries (P = 0.397).
Conclusion:
Increased plasma MMP-9 levels predicted short-term fatal outcome following severe TBI, regardless the presence of extracerebral injuries.
Insights
Higher matrix metalloproteinase-9 (MMP-9) plasma levels predict intensive care unit (ICU) mortality in severe traumatic brain injury (TBI) patients. This association holds true even when extracerebral injuries are present.
Area of Science:
- Neuroscience
- Biochemistry
- Critical Care Medicine
Background:
- Matrix metalloproteinase-9 (MMP-9) degrades cerebrovascular matrix, disrupting the blood-brain barrier and worsening edema in neurotrauma.
- Elevated MMP-9 is implicated in TBI pathophysiology.
Purpose of the Study:
- To investigate the association between MMP-9 plasma levels and ICU mortality in severe TBI patients.
- To determine if extracerebral injuries influence this association.
Main Methods:
- A cohort of 80 severe TBI patients (Glasgow Coma Scale 3-8) was studied.
- Plasma MMP-9 levels were measured using enzyme-linked immunosorbent assay upon ICU admission.
Main Results:
- The ICU mortality rate for severe TBI was 32.5%.
- Higher MMP-9 levels were significantly associated with fatal outcomes (257.0 ± 23.2 ng/mL in non-survivors vs. 181.1 ± 16.0 ng/mL in survivors, P=0.009).
- Extracerebral injuries (present in 72.5% of patients) were not associated with mortality (P=0.419) or MMP-9 levels (P=0.397).
Conclusions:
- Increased plasma MMP-9 levels are a predictor of short-term mortality in severe TBI.
- This predictive value is independent of the presence of extracerebral injuries.
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