Prognostic utility of early plasma matrix metalloproteinases -2 and -9 concentrations after severe traumatic brain injury

Abstract

Objective To determine whether the matrix metalloproteinases-2 and -9 plasma levels were associated with intensive care unit mortality in patients who suffered severe traumatic brain injury, despite the presence of extracerebral injuries. Methods This prospective cohort enrolled 39 male patients who suffered severe traumatic brain injury (Glasgow coma scale: 3 - 8 at hospital admission). The plasma matrix metalloproteinase -2 and matix metalloproteinase -9 levels were determined by ELISA at the time of intensive care unit admission. Results Severe traumatic brain injury was associated with a 46% intensive care unit mortality rate. Higher plasma matrix metalloproteinase -9 concentrations were associated with mortality: 147.94 ± 18.00ng/mL for survivors and 224.23 ± 23.86ng/mL for nonsurvivors (mean ± standard error of the mean, p = 0.022). In contrast, there was no significant association between matrix metalloproteinase -2 levels and intensive care unit mortality: 315.68 ± 22.90ng/mL for survivors and 336.55 ± 24.29ng/mL for nonsurvivors (p = 0.499). Additionally, there were no significant associations between matrix metalloproteinase -2 (p = 0.711) and matrix metalloproteinase -9 (p = 0.092) levels and the presence of associated lesions. Conclusion Increased plasma matrix metalloproteinase -9 levels were associated with intensive care unit mortality following severe traumatic brain injury, regardless of the presence of extracerebral injuries. Conversely, in this same context, plasma matrix metalloproteinase -2 levels were not associated with short-term fatal outcome prediction.

Levels of Matrix Metalloproteinase 9 Are Elevated in Persons With Schizophrenia or Bipolar Disorder: The Role of Modifiable Factors

“…Furthermore, the levels of MMP-9 in the blood and cerebrospinal fluid were found to be correlated with each other and predictive of outcome in individuals with subarachnoid hemorrhage ( 54 ). Elevated blood levels of MMP-9 have also been associated with poorer outcome following ischemic stroke ( 55 ) and traumatic brain injury ( 56 ). Additional studies should be performed for the direct measurement of the CNS effects of increased levels of MMP-9 in individuals with psychiatric disorders.…”

Time trajectories and within-subject correlations of matrix metalloproteinases 3, 8, 9, 10, 12, and 13 serum levels and their ability to predict mortality in polytraumatized patients: a pilot study

“…However, our literature search only identified a few studies focusing on MMPs and trauma. They revealed the involvement of some MMPs in the pathophysiology of brain injury [ 20 – 23 ], spinal cord injury [ 24 – 27 ], and acute respiratory distress syndrome [ 28 ], as well as higher serum MMP9 levels in critically ill patients who did not survive [ 29 ]. Brumann et al showed lower MMP9 serum levels within the first posttraumatic hours in patients with severe polytrauma (Injury Severity Score (ISS) > 33) compared to those with an ISS of 16–33.…”