Related Experiment Video
Updated: Apr 19, 2026

Author Spotlight: Exploring the Role of Inflammation in the Co-occurrence of Primary Sjogren's Syndrome and Lung Adenocarcinoma
Published on: September 20, 2024
The causal effect of matrix metalloproteinase 9 on interstitial lung disease risk mediated by effector memory double
Qijie Ren1, Fengyuan Sun, Leilei Yang
1Department of Rheumatology and Immunology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Abstract:
Matrix metalloproteinases (MMPs) have been implicated in the pathogenesis of interstitial lung disease (ILD). However, the causal role of MMPs in ILD pathogenesis remains to be elucidated. This study aimed to investigate the causal effects of circulating MMPs on ILD risk and to evaluate whether immune cell phenotypes mediate this relationship. A comprehensive Mendelian randomization (MR) and mediation analysis was conducted using publicly available data of genome-wide association study (GWAS) summary statistics. Genetic instruments for 6 MMPs (MMP-1, MMP-2, MMP-3, MMP-7, MMP-9, and MMP-12) and 731 immune cell traits were selected. Inverse-variance weighted (IVW) was the primary analytical method, supplemented by other MR techniques. Sensitivity analyses included MR-Egger regression, Cochran Q test, and MR-PRESSO to assess pleiotropy and heterogeneity. Mediation analysis was performed to quantify the proportion of the effect mediated by significant immune cells. Genetically predicted MMP-9 levels showed a significant positive causal effect on ILD risk (odds ratio [OR] = 1.034, 95% confidence interval [CI]: 1.006-1.064, P = .018). Among 731 immune cell phenotypes, 8 were identified as causal for ILD, including effector memory double negative T cells (EM DNT; OR = 1.170, P = .001). MMP-9 was further found to increase the abundance of EM DNT (OR = 1.041, 95% CI: 1.009-1.074, P = .012). Mediation analysis indicated that EM DNT mediated 18.5% of the total effect of MMP-9 on ILD. Sensitivity analyses revealed no evidence of horizontal pleiotropy or significant heterogeneity. This study provides genetic evidence supporting a causal role of MMP-9 in the development of ILD, partially mediated through EM DNT. These findings suggest that MMP-9 and EM DNT could be potential therapeutic targets for preventing or treating ILD.
Insights
Matrix metalloproteinase-9 (MMP-9) causally increases interstitial lung disease (ILD) risk, partly mediated by effector memory double negative T cells (EM DNT). These findings highlight MMP-9 and EM DNT as potential therapeutic targets for ILD.
Area of Science:
- Genetics
- Immunology
- Pulmonology
Background:
- Matrix metalloproteinases (MMPs) are implicated in interstitial lung disease (ILD) pathogenesis.
- The precise causal role of MMPs and their mediation by immune cells in ILD require further investigation.
Purpose of the Study:
- To investigate the causal effects of circulating MMPs on ILD risk using Mendelian randomization (MR).
- To evaluate the mediating role of immune cell phenotypes in the relationship between MMPs and ILD.
Main Methods:
- A comprehensive MR and mediation analysis was performed using genome-wide association study (GWAS) summary statistics.
- Genetic instruments for 6 MMPs and 731 immune cell traits were analyzed.
- Inverse-variance weighted (IVW) method was primary, with sensitivity analyses for pleiotropy and heterogeneity.
Main Results:
- Genetically predicted MMP-9 levels showed a significant positive causal effect on ILD risk (OR=1.034, P=0.018).
- Effector memory double negative T cells (EM DNT) were identified as a causal immune cell phenotype for ILD (OR=1.170, P=0.001).
- MMP-9 significantly increased EM DNT abundance (OR=1.041, P=0.012), with EM DNT mediating 18.5% of MMP-9's effect on ILD.
Conclusions:
- This study provides genetic evidence for a causal role of MMP-9 in ILD development.
- The effect of MMP-9 on ILD is partially mediated by EM DNT, suggesting a novel pathway.
- MMP-9 and EM DNT represent potential therapeutic targets for ILD prevention and treatment.

