Interleukin-17 and matrix metalloprotease-9 expression in the mycetoma granuloma
Emmanuel Edwar Siddig1,2,3, Ali Mahmoud Mohammed Edris2, Sahar Mubarak Bakhiet4
1The Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan.
Abstract:
Mycetoma is a persistent, progressive granulomatous inflammatory disease caused either by fungi or by bacteria. Characteristic of this disease is that the causative agents organise themselves in macroscopic structures called grains. These grains are surrounded by a massive inflammatory reaction. The processes leading to this host tissue reaction and the immunophenotypic characteristics of the mycetoma granuloma are not known. Due to the massive immune reaction and the tissue remodeling involved, we hypothesised that the expression levels of interleukin-17 (IL-17) and matrix metalloprotease-9 (MMP-9) in the mycetoma granuloma formation were correlated to the severity of the disease and that this correlation was independent of the causative agent responsible for the granuloma reaction. To determine the expression of IL-17 and MMP-9 in mycetoma lesions, the present study was conducted at the Mycetoma Research Centre, Sudan. Surgical biopsies from 100 patients with confirmed mycetoma were obtained, and IL-17 and MMP-9 expression in the mycetoma granuloma were evaluated immunohistochemically. IL-17 was mainly expressed in Zones I and II, and far less in Zone III. MMP-9 was detected mainly in Zones II and III, and the least expression was in Zone I. MMP-9 was more highly expressed in Actinomadura pelletierii and Streptomyces somaliensis biopsies compared to Madurella mycetomatis biopsies. MMP-9 levels were directly proportional to the levels of IL-17 (p = 0.001). The only significant association between MMP9 and the patients' characteristics was the disease duration (p<0.001). There was an insignificant correlation between the IL-17 levels and the patients' demographic characteristics.
Insights
Interleukin-17 (IL-17) and matrix metalloprotease-9 (MMP-9) are key inflammatory markers in mycetoma granulomas. Their expression correlates with disease severity and duration, independent of the causative agent.
Area of Science:
- Immunology
- Pathology
- Dermatology
Background:
- Mycetoma is a chronic inflammatory disease characterized by grains formed by causative agents.
- The immunophenotypic characteristics and inflammatory processes in mycetoma granulomas are not fully understood.
- Interleukin-17 (IL-17) and matrix metalloprotease-9 (MMP-9) are implicated in inflammatory and tissue remodeling processes.
Purpose of the Study:
- To investigate the expression of IL-17 and MMP-9 in mycetoma granulomas.
- To determine the correlation between IL-17 and MMP-9 expression and mycetoma disease severity.
- To assess the relationship between these markers and the causative agents or patient characteristics.
Main Methods:
- Immunohistochemical evaluation of IL-17 and MMP-9 expression in surgical biopsies from 100 mycetoma patients.
- Analysis of marker expression in different zones of the granuloma.
- Statistical analysis to correlate marker levels with disease duration, causative agents, and demographic data.
Main Results:
- IL-17 was primarily expressed in granuloma Zones I and II, while MMP-9 was mainly found in Zones II and III.
- MMP-9 expression was higher in bacterial mycetoma (Actinomadura pelletierii, Streptomyces somaliensis) compared to fungal mycetoma (Madurella mycetomatis).
- MMP-9 levels showed a direct positive correlation with IL-17 levels (p = 0.001) and disease duration (p<0.001).
Conclusions:
- IL-17 and MMP-9 are significantly expressed in mycetoma granulomas and their levels correlate with disease severity and duration.
- The findings suggest a role for IL-17 and MMP-9 in the pathogenesis of mycetoma, irrespective of the etiological agent.
- Further research into these markers could inform therapeutic strategies for mycetoma management.
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