title: Serum matrix metalloproteinases in patients resuscitated from cardiac arrest. The association with therapeutic hypothermia.
abstract: OBJECTIVE
  To study the systemic levels of matrix metalloproteinases (MMP) -7, -8 and -9 and their inhibitor TIMP-1 in cardiac arrest patients and the association with mild therapeutic hypothermia treatment on the serum concentration of these enzymes.
  
  
  METHODS
  MMP-7, -8 and -9 and tissue inhibitor of metalloproteinases-1 (TIMP-1) were analysed in blood samples obtained from 51 patients resuscitated from cardiac arrest. The samples were taken at 24 and 48 h from restoration of spontaneous circulation (ROSC). The biomarker levels were compared between patients (N=51) and healthy controls (N=10) and between patients who did (N=30) and patients who did not (N=21) receive mild therapeutic hypothermia.
  
  
  RESULTS
  MMP-7 (median 0.47 ng/ml), MMP-8 (median 31.16 ng/ml) and MMP-9 (median 253.00 ng/ml) levels were elevated and TIMP-1 levels suppressed (median 78.50 ng/ml) in cardiac arrest patients as compared with healthy controls at 24h from ROSC. Hypothermia treatment associated with attenuated elevation of MMP-9 (p=0.001) but not MMP-8 (p=0.02) or MMP-7 (p=0.69). Concentrations of MMPs -7, -8 and -9 correlated with the leukocyte count but not with C-reactive protein (CRP) or neurone-specific enolase (NSE) levels.
  
  
  CONCLUSIONS
  We demonstrated that the systemic levels of MMP-7, -8 and -9 but not TIMP-1 are elevated in cardiac arrest patients in the 48 h post-resuscitation period relative to the healthy controls. Patients who received therapeutic hypothermia had lower MMP-9 levels compared to non-hypothermia treated patients, which generates hypothesis about attenuation of inflammatory response by hypothermia treatment.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki, Finland. johanna.hastbacka@hus.fi
authors.forename: Johanna
authors.initials: J
authors.lastname: Hästbacka
authors.forename: Marjaana
authors.initials: M
authors.lastname: Tiainen
authors.forename: Marja
authors.initials: M
authors.lastname: Hynninen
authors.forename: Elina
authors.initials: E
authors.lastname: Kolho
authors.forename: Taina
authors.initials: T
authors.lastname: Tervahartiala
authors.forename: Timo
authors.initials: T
authors.lastname: Sorsa
authors.forename: Anneli
authors.initials: A
authors.lastname: Lauhio
authors.forename: Ville
authors.initials: V
authors.lastname: Pettilä
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications; D015415:Biomarkers / Q000097:blood; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006323:Heart Arrest / Q000201:enzymology* / Q000209:etiology / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D020782:Matrix Metalloproteinases / Q000097:blood*; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D020782:Matrix Metalloproteinases