Levels of Matrix Metalloproteinases in Arthroplasty Patients and Their Correlation With Inflammatory and Thrombotic Activation Processes

Abstract

An imbalance of matrix metalloproteinases (MMPs) and their inhibitors is thought to play a major role in the pathophysiology of joint diseases. The aim of this study is to provide additional insights into the relevance of MMP levels in arthroplasty patients in relation to inflammation and thrombosis. Deidentified plasma samples from 100 patients undergoing total hip arthroplasty or total knee arthroplasty were collected preoperatively, on postoperative day 1, and on postoperative day 3. Tissue inhibitor of MMP 4, tumor necrosis factor α (TNF-α), pro-MMP1, MMP3, MMP9, MMP13, and d-dimer were measured using enzyme-linked immunosorbent assay kits. A biochip array was used to profile interleukin (IL) 2, IL-4, IL-6, IL-8, IL-10, vascular endothelial growth factor (VEGF), interferon gamma, TNF-α, IL-1α, IL-1β, monocyte chemoattractant protein 1, and endothelial growth factor (EGF) levels. The levels of MMP1, MMP9, MMP13, and TNF-α were elevated preoperatively in arthroplasty patients when compared to healthy individuals. The concentrations of MMP1 and MMP9 increased slightly in postsurgical samples. d-Dimer levels were elevated preoperatively, increased postoperatively, and started decreasing on postoperative day 3. Significant correlations between MMP9 with TNF-α, IL-6, IL-8, VEGF, and EGF were identified. Elevated preoperative MMP1, MMP9, and MMP13 concentrations suggest that they may play a role in the pathogenesis of arthritis. There is also evidence of increased coagulation activity and possible upregulation of several MMPs postsurgically. Correlation analysis indicates that MMP9 levels may potentially be related to inflammation and thrombosis in arthroplasty patients.

Levels of Matrix-Degrading Enzymes and Lubricin in Patients With Degenerative Joint Disease Requiring Arthroplasty

“…Previous studies examining MDEs and their relevance to the pathogenesis of DJD have shown results consistent with those that have been observed here. 19 –21 These findings, in addition to previous data, provide evidence that patients with DJD have intrinsic abnormalities that may contribute to the pathogenesis of DJD. Although the popular belief that mechanical loading and shear force on weight-bearing joints is the major contributor to OA, the results of this study support the hypothesis that alterations in the levels of MDEs coupled with the changes in joint lubrication may contribute to osteoarthritic disease progression.…”

Identification of Vinculin as a Potential Diagnostic Biomarker for Acute Aortic Dissection Using Label-Free Proteomics

“…In AAD, blood flow enters into the media of aorta through the tear of the intima, activating the coagulation system, thrombosing in false lumen, subsequently fibrin degrading and releasing D-dimer into the blood circulation [ 29 ]. Recently, it is reported that D-dimer can play a potential role in activating MMPs [ 30 ]. Thus, vinculin and D-dimer may both anticipate the pathophysiology of tissue degradation during AAD via the pathway of MMPs, which is exactly the further investigation purpose in our study.…”

Serum levels of matrix metalloproteinase 9 and toll-like receptor 4 in acute aortic dissection: a case-control study

“…A meta-analysis demonstrated that D-dimer was a useful screening tool for excluding AAD [ 37 ]. Alexander et al found no significant relationship between MMP9 and D-dimer in arthroplasty patients [ 38 ], while Pastorelli et al showed a positive correlation of serum TLR4 with D-dimer in inflammatory bowel diseases [ 39 ]. Moreover, Giachino et al proved that serum MMP9 was significantly correlated with both CRP and D-dimer in patients with AAD [ 40 ].…”