INTRODUCTION:An imbalance between proteases and antiproteases may play a role in emphysema, which is characterized by increased degradation of extracellular matrix, and in airway remodeling in chronic bronchitis and asthma, in which there is increased collagen deposition. Matrix Metalloproteinases (MMPs) play a role in tissue remodeling in diseases such as asthma, bronchiectasis, rheumatoid arthritis , mesothilioma and in wound healing.Aim:The present study aimed to investigate the serum concentrations of Matrix Metalloproteinase (MMP)9 and Tissue Inhibitors of Metalloproteinase (TIMP)1 in COPD and asthmatic patients in order to determine their relationship with airway obstruction.Subjects and methods:This prospective randomized controlled study was carried out on 90 subjects,randomized into three groups: 30 patients with chronic bronchitis(COPD group) ,30 patients with bronchial asthma and, age and sex matched 30 healthy volunteers as a control group. This study was carried out in the Chest Department of Benha University Hospital.Medical history, clinical examination, complete blood picture, liver function tests, kidney function tests, fasting blood sugar, radiological examination including visual HRcT score, ventillatory pulmonary function tests and serum concentration of Matriex Metalloproteinase (MMP)9 and Tissue Inhibitors of Metalloproteinase (TIMP)1 measurement.Results: Our findings demonstrated that the circulating TIMP-1 levels were significantly higher in stable COPD patients than in control and asthmatic subjects, and was significantly negatively correlated with forced expiratory volume on 1st second/ forced vital capacity in COPD patients. The molar ratio between MMP-9-TIMP-1 was significantly lower in COPD patients than in control subjects. In patients with COPD, the serum TIMP-1 concentration was significantly increased during disease exacerbation. Conclusion: our study revealed that serum tissue inhibitors of Metalloproteinase-1 concentration can be used as a serum marker of airway obstruction and exacerbation in Chronic Obstructive Pulmonary disease patients.RECOMMENDATIONS:1-Serum tissue inhibitors of Metalloproteinase-1 concentration can be used as a serum marker of airway obstruction in COPD patients.2-Serum (TIMP)1 concentration can be used also as a marker for exacerbation and improvement in COPD patients.3-Further studies are necessary to clarify specific cell types that may be involved in the production and secretion of circulating tissue inhibitor of Metalloproteinase-1 and matrix Metalloproteinase-9 in chronic obstructive pulmonary disease patients. |
