Role of Matrix Metalloproteinase 9 and Tissue Inhibitor of Metalloproteinase 1 in Perinatal Asphyxia

Abstract

Hypoxia is generally defined as the partial or complete lack of oxygen in the brain or blood. Hypoxic injury in the fetal and neonatal brain results in neonatal mortality, morbidity or long term sequel such as cerebral palsy, mental retardation, epilepsy and learning disability. In term neonates, 1-4% of infants suffer birth aspHyxia and one third manifest significant neurological deficits.. Matrix Metalloproteinase-9 has been implicated specifically in cerebral ischemia. Recently, it has been suggested that MMPs and TIMP-1 may be upregulated in hippocampus after global brain ischemia. Moreover, reported that inhibition with a broad-spectrum metalloproteinase inhibitor ameliorates dysregulated gelatinase activity and reduces hippocampal neuronal death after transient global cerebal ischemia in mice. This study aimed to evaluate the serum level of MMP-9 and TIMP-1 and delineate its relation to neurological damage among neonates with HIE. For this purpose 50 newborns who were diagnosed as having hypoxic ischemic encepHalopathy were studied, and they were compared to 50 sex and age matched control. The followings were done: 1- Full maternal medical and obstetric histories taking. 2- Detailed antenatal and perinatal history and delivery circumstances. 3- Recording delivery circumstances and resuscitative measures. 4- Clinical examination. 5- Evaluation of multiorgan affection. 6- Laboratory investigations (CBC, CRB, Na, K, Ca, ABG, serum MMP-9, TIMP-1).