Dymanics of matrix-metalloproteinase 9 after brain trauma--results of a pilot study.
BACKGROUND
Secondary brain injury contributes to poor outcome for patients sustaining brain trauma. Matrix metalloproteinase-9 (MMP-9) is a potential marker, as well as effector of secondary brain injury. This enzyme degrades components of extracellular matrix, and thus it can contribute to blood-brain barrier disruption.


METHODS
We studied dynamics of MMP-9 in jugular venous blood of 15 patients sustaining either an isolated head injury or a head injury as a part of major trauma, and requiring intensive care (Glasgow Coma Scale <8 at the time of admission). Blood samples were taken at the 1st, 3rd and 5th day, levels of MMP-9 in plasma were assessed using ELISA. Outcome quality was assessed at the time of discharge from our hospital.


RESULTS
Our results show an increase of MMP-9 levels on the 1st day after the brain trauma, followed by a drop on the 3rd day and a rise on day 5. This biphasic time-course was observed in all patients, but no statistically significant differences between each group (major trauma vs. isolated brain trauma, good outcome vs. poor outcome) were found.


CONCLUSIONS
Initially increased MMP-9 levels in the 1st posttraumatic day is probably related to transient blood-brain barrier dysruption. The decrease of MMP-9 levels observed on the 3rd day can be explained by restoration of blood-brain barrier integrity and its reduced permeability. The second rise of MMP-9 levels observed in the 5th day probably indicates a developing secondary brain injury during which MMP-9 is produced in the brain as a part of an inflammatory response.


RESULTS
of our study suggest that MMP-9 could play an important role in pathogenesis of secondary brain injury.
Kolar
Martin
M
Department of Anesthesiology and Critical Care Medicine, Charles University in Prague, Third Faculty of Medicine, Ruska 87, 100 34 Prague, 10, Czech Republic. martinuv.mail@seznam.cz
Pachl
Jan
J
Tomasova
Helena
H
Haninec
Pavel
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D017711:Nonlinear Dynamics; D010865:Pilot Projects; D013997:Time Factors; D055815:Young Adult
D020780:Matrix Metalloproteinase 9