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Matrix metalloproteinases and their inhibitors in pediatric severe acute pancreatitis

David S Vitale1,2, Patrick Lahni1,3, Lindsey Hornung4

  • 1Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Plos One
|February 14, 2022
PubMed

Insights

Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) may help identify children at risk for severe acute pancreatitis (SAP). Elevated MMP-9 and TIMP-1 levels at presentation indicate higher risk for developing SAP.

Area of Science:

  • Biochemistry
  • Pediatric Gastroenterology
  • Biomarker Discovery

Background:

  • Acute pancreatitis (AP) incidence is rising in children and adults.
  • Identifying patients at high risk for severe acute pancreatitis (SAP) is critical due to mortality and cost.
  • Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) are implicated in AP pathogenesis.

Purpose of the Study:

  • To investigate the role of MMPs and TIMPs in predicting SAP risk in pediatric patients.
  • To identify specific MMPs and TIMPs associated with the progression of AP to SAP.

Main Methods:

  • Prospective collection of plasma samples from pediatric AP patients and healthy controls.
  • Utilized bead-based multiplex assays to measure levels of 12 MMPs and TIMPs.
  • Analyzed biomarker levels in patients with mild AP, moderately severe AP, and SAP.

Main Results:

  • MMP-9 and TIMP-1 levels were significantly elevated in pediatric patients who developed SAP.
  • A multivariable logistic regression model incorporating MMP-9 and TIMP-1 accurately predicted SAP (AUROC 0.87).

Conclusions:

  • Elevated MMP-9 and TIMP-1 levels at AP presentation are associated with SAP development in children.
  • MMPs and TIMPs show potential as predictive biomarkers for SAP in pediatric pancreatitis.
  • Further validation studies are required to confirm their clinical utility.
Abstract

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