Hyperbaric oxygen effect on MMP-9 after a vascular insult.
Matrix metalloproteinease-9 (MMP-9) is involved in a host of processes. Many of its processes are physiologically beneficial as well as detrimental. The over-expression of this enzyme has been implicated as a contributory factor to some of the sequalae associated with cerebral ischemia, cell death, non-healing wounds, traumatic brain injury, aneurysms, and plaque instability in atherosclerosis. Several studies have examined the effect of hyperbaric oxygen (HBO) on MMP-9 expression. Because this proteinase is involved in both chronic and acute pathology, we wanted to investigate an acute expression model and see if, and how quickly, its expression would respond to HBO therapy. Our patient was scheduled to have elective surgery with an overnight stay followed by a series of HBO exposures. The patient served as her own control. An MMP-9 and urine pH was obtained prior to surgery to establish a baseline. On days 1, 3, and 4 post-op, samples were obtained before and after hyperbaric exposure. The patient was exposed to 100% O2 at 2.5 ATA for 60 min during each treatment for 5 days. The patient's MMP-9 values were dramatically elevated after surgery as compared to the baseline readings. The percentage increase from baseline was 400%. Our patient showed a significant reduction in MMP-9 expression after each hyperbaric exposure with the greatest decrease seen on post-op day 1 and subsequent exposures showing slightly less expression. Reduction in MMP-9 expression ranged from 46% on day 1 to 30% on post-op day 4. This case study suggests that if done relatively soon after a vascular or tissue insult, HBO can reduce MMP-9 expression. Chronic vascular pathologies, such as atherosclerotic plaque and aneurysms where over-expression of MMP-9 may result in acute coronary syndrome (ACS) or cerebral vascular accidents (CVAs), may be mitigated by a series of HBO treatments that reduce MMP-9 expression. Causality and/or contributory effects of MMP-9 expression in both pathologic and physiologic processes needs to be further elucidated. The understanding of how HBO therapy modulates these may provide an additional insight into mechanisms and future potential therapies for pathologic conditions such as those described above.
Cummins
Francis J
FJ
Healing Chambers of America's, 995 Gateway Center Way, San Diego, CA, USA. FCumminsJr_DO@msn.com
Gentene
Laurie J
LJ
D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015971:Gene Expression Regulation, Enzymologic; D006801:Humans; D006863:Hydrogen-Ion Concentration; D006931:Hyperbaric Oxygenation; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D013997:Time Factors; D014556:Urine / Q000737:chemistry; D057772:Vascular System Injuries / Q000201:enzymology / Q000209:etiology / Q000628:therapy* / Q000652:urine
D020780:Matrix Metalloproteinase 9
Brain Res. 2006 Mar 3;1076(1):231-7
16480689
Gerontology. 2007;53(2):63-73
17047333
Ann Anat. 2005 Nov;187(5-6):473-85
16320827
Knee Surg Sports Traumatol Arthrosc. 2007 Apr;15(4):443-52
17187281
J Neurosci. 2000 Sep 15;20(18):7037-42
10995849
Cardiol Rev. 2009 Nov-Dec;17(6):280-2
19829177
Wound Repair Regen. 2009 Mar-Apr;17(2):179-84
19320885
Am J Cardiol. 2004 Jun 15;93(12):1533-5
15194029
Arterioscler Thromb Vasc Biol. 2007 Jan;27(1):15-26
17082488
Arterioscler Thromb Vasc Biol. 2000 Jun;20(6):1637-43
10845883
Am J Physiol Cell Physiol. 2000 Feb;278(2):C292-302
10666024
Acta Neurochir Suppl. 2010;106:47-9
19812919
J Neuroinflammation. 2009 Nov 04;6:32
19889224
Neuropathol Appl Neurobiol. 2006 Feb;32(1):40-50
16409552
J Neurotrauma. 2009 Nov;26(11):1935-41
19469687
Cancer Lett. 2009 Oct 18;284(1):80-5
19427114
Undersea Hyperb Med. 2010 May-Jun;37(3):141-50
20568543
Stroke. 2009 Aug;40(8):2836-42
19556529
Crit Rev Oral Biol Med. 1993;4(2):197-250
8435466
Neurol Res. 2009 Mar;31(2):114-21
19298750
Matrix Suppl. 1992;1:245-55
1480034
Mol Med. 2008 Mar-Apr;14(3-4):175-83
18079998
Atherosclerosis. 2007 Jul;193(1):28-35
16973170
Acta Neurochir Suppl. 2008;105:191-6
19066108
Stroke. 2002 Nov;33(11):2711-7
12411666
Glia. 2009 Jan 1;57(1):24-38
18661553
Arthritis Rheum. 2008 Mar;58(3):854-63
18311803
Eur J Vasc Endovasc Surg. 2005 Sep;30(3):259-62
16009575
J Am Coll Cardiol. 2010 Mar 23;55(12):1240-1249
20298932
Neurosurgery. 2009 Oct;65(4):702-8
19834375
J Orthop Res. 2011 Jan;29(1):14-9
20661932
Int Wound J. 2008 Oct;5(4):543-51
18808434
J Cereb Blood Flow Metab. 2000 Dec;20(12):1681-9
11129784