Matrix Metalloproteinase-9 in Critically Ill Preterm Neonates
Noha Hassan Ahmed Siam;
Abstract
Matrix metalloproteinases (MMPs) are involved in a variety of physiologic, growth, development and pathophysiological inflammatory conditions.
The fine equilibrium between degradation and synthesis of the extracellular matrix ( ECM) has been ascribed to matrix metalloproteinases (MMPs) activity.
MMP-9 has been implicated as an important enzyme during inflammation because of its ability to assist leukocyte trafficking through the extracellular matrix. Indeed, MMP-9 was found to stimulate leukocyte migration under the influence of chemotactic factors in vivo.
This present study aimed at a) evaluation of the role matrix metalloproteinase-9 in the pathogenesis of bronchopulmonary dysplasia, necrotizing enterocolitis and neonatal sepsis. b)Studying the relation between matrix metalloproteinase-9 and diseases severity, prognosis, and short term outcome.
This study included 45 preterm diseased neonates and 35 healthy controls of both sexes. The mean ages of enrolled patients were 31.73±1.29 weeks. The preterm patients were classified into three groups (15 preterm patients per group) I, II, III for BPD, NEC, and NS respectively. The patients enrolled in this work, were subjected to the followings:
Full history taking, thorough clinical examination, a group of laboratory investigations including: CBC, CRP, blood culture, blood gases, other investigation relevant to the diagnosis, as well as assessment of serum matrix metalloproteinase-9 by monoclonal sandwich ELISA technique. It was measured twice, on diagnosis & after improvement. Other investigations as imaging study include chest x- ray, abdominal x-ray and abdominal ultrasonography and Doppler.
1) On comparing the clinical data between patients included in the study shows that the mean values of birth weight among studied three groups revealed a statistical significant difference (p<0.001), the NS group had the smallest birth weight.
2) It was found no statistical significant difference (p>0.5) between the three groups as regards gestational age, the NS group had the lowest gestational age.
3) The current study revealed that, the mean values of Apgar score among the three groups revealed that was highly significantly difference (p<0.0001), the lowest Apgar score at 5min. was recorded in BPD group.
4) It was found that, there was statistical significant difference (p<0.01) between the three groups as regards rescuitation methods where, the use of ambu bag was more in BPD group (50%), the using free flow O2 was more in NEC group (66.7%), and also, using ambu bag was the main source of rescuitation in NS group (40%).
5) The results of the current study revealed that the shortest duration of hospital stay was observed with NEC group, and the longest duration of hospital stay was observed with BPD group, and this difference was statistically significantly (p<0.001).
6) Concerning the laboratory findings, our results showed that means of HB 11.59±2, 36 gm/dl & TLC (103 /mm3)10.28±6.74 and platelets counts (103 /mm3) 171.07±71.70.
7) The mean value of CRP was highly elevated among the enrolled patients (36.00±21.96) mg/dl, and there was no significant difference between three groups.
8) Regarding MMP-9 the results of the present study, revealed a highly significantly increased (p<0.0001) of serum levels of MMP-9 at the time of diagnosis (basal) among three groups as compared to control group , with mean values of 1194.67±286.60 ng/ml, 1025.33±277.28 ng/ml and 1250±351.04 ng/ml for BPD, NEC and NS respectively.
9) On discharge the mean value of MMP-9 was highly significantly decreased as compared to control (p<0.001).
10) Moreover, the mean seum levels of MMP-9 were highly significantly different at diagnosis and on discharge in each group separately (p< 0.0001), being lower on discharge.
11) There was a statistical significant positive correlation (p<0.04) between duration of hospital stay and serum MMP-9 (at diagnosis), also, there was highly significantly positive correlation (p <0.004) between MMP-9 and duration of mechanical ventilation in patients with BPD.
12) There was a statistical significant negative correlation (p<0.04) between MMP-9 at diagnosis time and gestational age in NEC group.
13) In NS group, there was no statistical significant correlation between MMP-9 at diagnosis and clinical and laboratory data of patients with NS
The fine equilibrium between degradation and synthesis of the extracellular matrix ( ECM) has been ascribed to matrix metalloproteinases (MMPs) activity.
MMP-9 has been implicated as an important enzyme during inflammation because of its ability to assist leukocyte trafficking through the extracellular matrix. Indeed, MMP-9 was found to stimulate leukocyte migration under the influence of chemotactic factors in vivo.
This present study aimed at a) evaluation of the role matrix metalloproteinase-9 in the pathogenesis of bronchopulmonary dysplasia, necrotizing enterocolitis and neonatal sepsis. b)Studying the relation between matrix metalloproteinase-9 and diseases severity, prognosis, and short term outcome.
This study included 45 preterm diseased neonates and 35 healthy controls of both sexes. The mean ages of enrolled patients were 31.73±1.29 weeks. The preterm patients were classified into three groups (15 preterm patients per group) I, II, III for BPD, NEC, and NS respectively. The patients enrolled in this work, were subjected to the followings:
Full history taking, thorough clinical examination, a group of laboratory investigations including: CBC, CRP, blood culture, blood gases, other investigation relevant to the diagnosis, as well as assessment of serum matrix metalloproteinase-9 by monoclonal sandwich ELISA technique. It was measured twice, on diagnosis & after improvement. Other investigations as imaging study include chest x- ray, abdominal x-ray and abdominal ultrasonography and Doppler.
1) On comparing the clinical data between patients included in the study shows that the mean values of birth weight among studied three groups revealed a statistical significant difference (p<0.001), the NS group had the smallest birth weight.
2) It was found no statistical significant difference (p>0.5) between the three groups as regards gestational age, the NS group had the lowest gestational age.
3) The current study revealed that, the mean values of Apgar score among the three groups revealed that was highly significantly difference (p<0.0001), the lowest Apgar score at 5min. was recorded in BPD group.
4) It was found that, there was statistical significant difference (p<0.01) between the three groups as regards rescuitation methods where, the use of ambu bag was more in BPD group (50%), the using free flow O2 was more in NEC group (66.7%), and also, using ambu bag was the main source of rescuitation in NS group (40%).
5) The results of the current study revealed that the shortest duration of hospital stay was observed with NEC group, and the longest duration of hospital stay was observed with BPD group, and this difference was statistically significantly (p<0.001).
6) Concerning the laboratory findings, our results showed that means of HB 11.59±2, 36 gm/dl & TLC (103 /mm3)10.28±6.74 and platelets counts (103 /mm3) 171.07±71.70.
7) The mean value of CRP was highly elevated among the enrolled patients (36.00±21.96) mg/dl, and there was no significant difference between three groups.
8) Regarding MMP-9 the results of the present study, revealed a highly significantly increased (p<0.0001) of serum levels of MMP-9 at the time of diagnosis (basal) among three groups as compared to control group , with mean values of 1194.67±286.60 ng/ml, 1025.33±277.28 ng/ml and 1250±351.04 ng/ml for BPD, NEC and NS respectively.
9) On discharge the mean value of MMP-9 was highly significantly decreased as compared to control (p<0.001).
10) Moreover, the mean seum levels of MMP-9 were highly significantly different at diagnosis and on discharge in each group separately (p< 0.0001), being lower on discharge.
11) There was a statistical significant positive correlation (p<0.04) between duration of hospital stay and serum MMP-9 (at diagnosis), also, there was highly significantly positive correlation (p <0.004) between MMP-9 and duration of mechanical ventilation in patients with BPD.
12) There was a statistical significant negative correlation (p<0.04) between MMP-9 at diagnosis time and gestational age in NEC group.
13) In NS group, there was no statistical significant correlation between MMP-9 at diagnosis and clinical and laboratory data of patients with NS
Other data
| Title | Matrix Metalloproteinase-9 in Critically Ill Preterm Neonates | Other Titles | ميتالوبروتينيز- 9 ودوره فى الأطفال المبتسريـن ذوى الحالات الحرجة | Authors | Noha Hassan Ahmed Siam | Issue Date | 2016 |
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