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Plasma Matrix Metalloproteinase-9 and Tissue Inhibitor of Matrix Metalloproteinase-1 as Prognostic Biomarkers in
Izabela Duda1, Łukasz Krzych2, Halina Jędrzejowska-Szypułka3
1Medical University of Silesia School of Medicine in Katowice, Katowice, Poland.
Abstract:
Matrix metalloproteinase 9 (MMP-9) plays an important role in inflammatory and pathological processes by enabling the inflow of leukocytes to the site of infection or tissue damage. MMP-9 and tissue inhibitor of metalloproteinase 1 (TIMP-1) have been described as potential prognostic biomarkers in various clinical settings. The aim of the study was to evaluate the usefulness of plasma levels of MMP-9 and TIMP-1 as well as the MMP-9/ TIMP-1 ratio in predicting the outcome in patients admitted to the intensive care unit (ICU). The study included 56 critically ill patients with multiple organ failure. Plasma levels of MMP-9 and TIMP-1 were determined on hospitalization day 1, 2, 3 and 7. Nineteen (35.7%) patients died. The level of TIMP-1 was statistically significantly higher on day 1 and 7 of hospitalization in non-survivors, as compared to survivors (p=0.01). A statistically significant positive correlation was found between MMP-9 and TIMP-1. The MMP-9/TIMP-1 ratio was comparable in both groups during of observation (0.62 on day 1). The MMP-9/TIMP-1 ratio was positively correlated with the level of lactate and negatively correlated with platelet count. Likewise, TIMP-1 was positively correlated with the level of lactate. The level of MMP-9 was higher in the non-survivor group only on day 7 of observation. In conclusion, although TIMP-1 and MMP-9 concentrations were higher in non-survivors and the MMP-9/TIMP-1 ratio was related to some parameters of critical illness, further research is needed to verify whether they can serve as reliable biomarkers for early prognostication of ICU patients.
Insights
Tissue inhibitor of metalloproteinase 1 (TIMP-1) levels were higher in non-survivors of critical illness. While matrix metalloproteinase 9 (MMP-9) and the MMP-9/TIMP-1 ratio showed correlations, further research is needed for their use as prognostic biomarkers in intensive care unit (ICU) patients.
Area of Science:
- Biochemistry
- Critical Care Medicine
- Pathophysiology
Background:
- Matrix metalloproteinase 9 (MMP-9) facilitates leukocyte migration in inflammatory and pathological processes.
- MMP-9 and its inhibitor, tissue inhibitor of metalloproteinase 1 (TIMP-1), are potential prognostic biomarkers.
- Critical illness, particularly multiple organ failure, presents challenges in predicting patient outcomes.
Purpose of the Study:
- To evaluate plasma MMP-9 and TIMP-1 levels and their ratio for predicting outcomes in intensive care unit (ICU) patients.
- To assess the correlation of MMP-9 and TIMP-1 with clinical parameters in critically ill patients.
Main Methods:
- Plasma MMP-9 and TIMP-1 levels were measured in 56 critically ill patients with multiple organ failure on days 1, 2, 3, and 7 of hospitalization.
- Statistical analysis was performed to compare levels between survivors and non-survivors and to identify correlations with clinical data.
Main Results:
- Non-survivors had significantly higher TIMP-1 levels on days 1 and 7 (p=0.01).
- MMP-9 levels were higher in non-survivors only on day 7.
- The MMP-9/TIMP-1 ratio correlated positively with lactate and negatively with platelet count; TIMP-1 correlated positively with lactate.
Conclusions:
- Elevated TIMP-1 levels may indicate a poorer prognosis in ICU patients.
- While MMP-9 and the MMP-9/TIMP-1 ratio show associations with critical illness parameters, their reliability as early prognostic biomarkers requires further investigation.
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