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Activated matrix metalloproteinase 8 in serum predicts severity of acute pancreatitis
A Turunen1, K Kuuliala2, A Kuuliala2
1Abdominal Center, Department of Abdominal Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Objectives:
Severe acute pancreatitis (SAP) has high morbidity and mortality but there are no widely accepted predictive biomarkers in clinical use. Matrix metalloproteinases (MMPs) are active in tissue destruction and inflammatory responses. We studied whether serum levels of activated MMP-8 (aMMP-8), MMP-9 and their regulators tissue inhibitor of matrix metalloproteinases (TIMP)-1, myeloperoxidase (MPO) and human neutrophil elastase (HNE) could predict the development of SAP.
Methods:
The study comprised 214 AP patients (revised Atlanta classification: 142 mild, MAP; 54 moderately severe, MSAP; 18 SAP) referred to Helsinki University Hospital. A venous blood sample was taken within 72 h from the onset of symptoms. Serum levels of aMMP-8 were determined using immunofluorometric assay, and those of MMP-9, TIMP-1, MPO and HNE using enzyme-linked immunosorbent assay. AP groups were compared using Jonckheere-Terpstra test and predictive value for SAP was analyzed using receiver operating characteristics (ROC) analysis.
Results:
Serum aMMP-8 levels were higher in SAP (median 657 ng/ml, interquartile range 542-738 ng/ml) compared to MSAP (358 ng/ml, 175-564 ng/ml; p < 0.001) and MAP (231 ng/ml, 128-507 ng/ml; p < 0.001). Similar trend was seen with TIMP-1 and MPO. In ROC analysis aMMP-8, MPO and TIMP-1 emerged as potential markers for the development of SAP (areas under ROC curves 0.83, 0.71 and 0.69, respectively).
Conclusions:
Serum aMMP-8 measured early in the course of AP (within 72 h of symptom onset) predicted the development of SAP.
Insights
Activated matrix metalloproteinase-8 (aMMP-8) measured within 72 hours of symptom onset can predict severe acute pancreatitis (SAP). Early detection of SAP using aMMP-8 may improve patient outcomes.
Area of Science:
- Biochemistry
- Clinical Diagnostics
- Gastroenterology
Background:
- Severe acute pancreatitis (SAP) presents significant morbidity and mortality.
- Current clinical practice lacks widely accepted biomarkers for predicting SAP development.
- Matrix metalloproteinases (MMPs) are implicated in tissue destruction and inflammatory processes.
Purpose of the Study:
- To investigate serum levels of activated MMP-8 (aMMP-8), MMP-9, and their regulators (TIMP-1, MPO, HNE) as potential predictors of SAP.
- To assess the diagnostic value of these biomarkers in patients with acute pancreatitis (AP).
Main Methods:
- Serum samples from 214 AP patients (142 mild AP, 54 moderately severe AP, 18 SAP) were analyzed within 72 hours of symptom onset.
- Quantitative assays (immunofluorometric and ELISA) were used to measure aMMP-8, MMP-9, TIMP-1, MPO, and HNE.
- Statistical analysis included Jonckheere-Terpstra test and receiver operating characteristic (ROC) analysis to evaluate predictive value.
Main Results:
- Serum aMMP-8 levels were significantly higher in SAP patients compared to MSAP and MAP patients (p < 0.001).
- A similar increasing trend was observed for TIMP-1 and MPO levels across AP severity groups.
- ROC analysis identified aMMP-8, MPO, and TIMP-1 as potential predictors for SAP development, with areas under the ROC curve of 0.83, 0.71, and 0.69, respectively.
Conclusions:
- Early measurement of serum aMMP-8 (within 72 hours of symptom onset) effectively predicts the development of severe acute pancreatitis.
- aMMP-8 shows promise as a valuable early diagnostic biomarker for SAP.
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