Matrix metalloproteinases and their inhibitors: promising novel biomarkers in severe sepsis?
The multicenter study conducted by Lorente and coworkers published in the previous issue of Critical Care demonstrates that matrix metalloproteinase (MMP)-9 and MMP-10 and their inhibitor tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) are promising novel biomarkers to predict severity and outcome of sepsis. In recent years MMPs have emerged as biomarkers in a variety of diseases, such as sepsis, coronary artery disease, cancer, heart failure, chronic lung disease and rheumatoid arthritis. MMPs constitute a family of proteinases that are expressed during developmental, physiological, and pathophysiological processes, for example as a response to infection. Excessive inflammation following infection may cause tissue damage, and MMPs are implicated in causing this immunopathology. The activity of MMPs is regulated by secretion of specific inhibitors (TIMPs). Studies using MMP inhibitors and MMP knockout mice indicate that MMPs play an essential role in infection and in the host response to infection. The measurement of MMP-9 and MMP-10 and their inhibitor TIMP-1 in the intensive care setting could be an attractive noninvasive tool for determination of outcome of septic patients.
Hoffmann
Ursula
U
1st Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany. Ursula.Hoffmann@umm.de
Brueckmann
Martina
M
Borggrefe
Martin
M
D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D053506:Matrix Metalloproteinase 10 / Q000378:metabolism*; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism*; D061965:Matrix Metalloproteinase Inhibitors; D020782:Matrix Metalloproteinases / Q000172:deficiency / Q000378:metabolism*; D051379:Mice; D018345:Mice, Knockout; D011237:Predictive Value of Tests; D018805:Sepsis / Q000201:enzymology* / Q000401:mortality; D012720:Severity of Illness Index; D019714:Tissue Inhibitor of Metalloproteinases / Q000378:metabolism
D015415:Biomarkers; D061965:Matrix Metalloproteinase Inhibitors; D019714:Tissue Inhibitor of Metalloproteinases; D020782:Matrix Metalloproteinases; D053506:Matrix Metalloproteinase 10; D020780:Matrix Metalloproteinase 9