title: Matrix metalloproteinases 2 and 9 as diagnostic markers in the progression to Chagas cardiomyopathy.
abstract: BACKGROUND
  Infection with the Trypanosoma cruzi parasite is endemic in parts of Central and South America. Approximately 30% of those infected develop Chagas cardiomyopathy, the most common cause of heart failure in this region. No suitable biomarker is available that reflects the evolution of the disease. Although there is substantial evidence of a strong inflammatory reaction following infection that could activate matrix metalloproteinases (MMPs), their role in the development of Chagas cardiomyopathy is unknown.
  
  
  METHODS
  A cross-sectional study was conducted in Bucaramanga, Colombia, from 2002 to 2006, including 144 patients at different stages of Chagas disease and 44 control patients. The potential enzyme activities of MMP-2 and MMP-9 in plasma samples were determined by gelatin zymography. Clinical data including T cruzi serology, electrocardiograms, and echocardiograms were recorded for all patients.
  
  
  RESULTS
  Densitometric analysis of potential enzyme activities in plasma samples showed a significant increase of 72-kd MMP-2 (P < .001) and 92-kd MMP-9 (P < .001) in T cruzi seropositive patients compared with control subjects. Matrix metalloproteinase 9 showed significantly increased activity in patients with abnormal electrocardiogram (P < .004) and with dilated cardiomyopathy compared (P < .001) with controls. Analysis of the MMP-2 and MMP-9 results in relation to clinical data revealed that abnormal heart relaxation correlated positively with high MMP-2 levels in patients with dilated cardiomyopathy (r = 0.75, P < .01).
  
  
  CONCLUSIONS
  Plasma MMP-2 and MMP-9 both appear to be useful biomarkers for detecting the advent and progression of cardiomyopathy in T cruzi-infected individuals.
authors.affiliation: Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.
authors.forename: Norma Leticia
authors.initials: NL
authors.lastname: Bautista-López
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Morillo
authors.forename: Patricio
authors.initials: P
authors.lastname: López-Jaramillo
authors.forename: Roberto
authors.initials: R
authors.lastname: Quiroz
authors.forename: Carlos
authors.initials: C
authors.lastname: Luengas
authors.forename: Sandra Y
authors.initials: SY
authors.lastname: Silva
authors.forename: Jacques
authors.initials: J
authors.lastname: Galipeau
authors.forename: Manoj Mathew
authors.initials: MM
authors.lastname: Lalu
authors.forename: Richard
authors.initials: R
authors.lastname: Schulz
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood*; D002598:Chagas Cardiomyopathy / Q000097:blood / Q000145:classification / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood*; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D014349:Trypanosoma cruzi / Q000276:immunology
chemical_list: D015415:Biomarkers; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9