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.

Medicine
|April 17, 2026
PubMed

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.

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