title: Evaluation of serum matrix metalloproteinases as biomarkers for detection of neurological symptoms in carotid artery disease.
abstract: OBJECTIVE
  Relevant soluble matrix metalloproteinases (MMPs), their inhibitors, tissue inhibitor of metalloproteinases (TIMPs), and serological factors were analyzed as possible biomarkers for neurological symptoms in patients with carotid artery stenosis.
  
  
  RESULTS
  Asymptomatic (n = 76) and symptomatic (n = 69) patients were evaluated. Serum levels of collagenases (MMP-1, -8), gelatinases (MMP-2, -9), stromelysin (MMP-3), matrilysin (MMP-7), and TIMP-1, -2 were determined by enzyme-linked immunosorbant assay (ELISA). Furthermore, fibrinogen, C-reactive protein (CRP), leukocytes, and further serological parameters were measured. Circulating MMP-7, -8, -9, and TIMP-1 were significantly enhanced in symptomatic individuals with P < .001 for MMP-7 and P < .05 for MMP-8, -9, and TIMP-1. Significant correlations were found between various MMPs with highest correlation coefficient of r = .749 between MMP-8 and -9. In addition, MMP-1, -3, -7, -9 correlated significantly with leukocytes, MMP-1, and TIMP-1 with thrombocytes, MMP-8 with fibrinogen, and MMP-7 with creatinine. Combination of more than one biomarker led to significantly enhanced positive predictive value (PPV) for neurological symptom compared to single MMP (MMP-7 + MMP-9: PPV = 73.1%, MMP-7 + MMP-8 + MMP-9: PPV = 73.8% vs. PPV = 62.5%; P < .001).
  
  
  CONCLUSIONS
  Thus, using appropriate analytical approaches, we showed for the first time the possibility to use set of relevant biomarkers as predictors of neurological symptoms. Such biomarkers together with current diagnostic techniques may further contribute to recognize vulnerable lesions to define patients at risk.
authors.affiliation: Department of Vascular Surgery, Rechts der Isar Medical Center, Technical University of Munich, Germany. heiderpeter@t-online.de
authors.forename: Peter
authors.initials: P
authors.lastname: Heider
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Pelisek
authors.forename: Holger
authors.initials: H
authors.lastname: Poppert
authors.forename: Hans-Henning
authors.initials: HH
authors.lastname: Eckstein
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000601:surgery; D002561:Cerebrovascular Disorders / Q000201:enzymology* / Q000209:etiology; D016894:Endarterectomy, Carotid; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D020782:Matrix Metalloproteinases / Q000097:blood*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D018570:Risk Assessment; D012720:Severity of Illness Index; D019714:Tissue Inhibitor of Metalloproteinases / Q000097:blood; D018615:Ultrasonography, Doppler, Color
chemical_list: D015415:Biomarkers; D019714:Tissue Inhibitor of Metalloproteinases; D020782:Matrix Metalloproteinases