title: The imbalance between matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 in acute pancreatitis.
abstract: BACKGROUND
  The balanced activity of matrix metalloproteinases and their tissue inhibitors is an important, albeit still not completely understood, determinant of extracellular matrix homeostasis, a factor involved in the pathogenesis of acute pancreatitis (AP).
  
  
  OBJECTIVE
  The aim of this study was to compare serum concentrations of matrix metalloproteinase 9 (MMP-9) and its tissue inhibitor (TIMP-1) in patients with AP of various severity and to investigate their relationship with prognostic indicators of AP severity, e.g., polymorphonuclear leukocyte elastase (PMN-E).
  
  
  METHODS
  The study included 37 patients with mild (n = 18) or severe AP (n = 19) and 15 healthy controls. Serum concentrations of MMP-9 and TIMP-1 were determined on admission (day 1) and on days 2, 3, 5 and 10.
  
  
  RESULTS
  Throughout the study period, the serum MMP-9 concentration in patients with severe AP was significantly higher than those in individuals with mild AP and in healthy controls. In turn, the serum MMP-9 concentrations in persons with mild AP did not differ significantly from those of the controls. The serum TIMP-1 concentrations in both groups were significantly higher than in the controls. Beginning from the 2(nd) day of hospital stay, the serum TIMP-1 concentration in patients with severe AP was significantly higher than in individuals with mild AP. There were significant correlations between: MMP-9 and PMN-E, TIMP-1 and PMN-E, and MMP-9 and TIMP-1.
  
  
  CONCLUSIONS
  A disturbed balance between MMP-9 and TIMP-1 observed during the early stages of severe AP suggests that endogenous TIMP-1 is unable to prevent excessive activation and release of MMP-9. MMP-9 may represent a new marker of AP severity.
authors.affiliation: Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Poland.
authors.forename: U
authors.initials: U
authors.lastname: Wereszczynska-Siemiatkowska
authors.affiliation: Department of Anaesthesiology and Intensive Care, Medical University of Bialystok, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Siemiatkowski
authors.affiliation: Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Swidnicka-Siergiejko
authors.affiliation: Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Poland.
authors.forename: B
authors.initials: B
authors.lastname: Mroczko
authors.affiliation: Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Dabrowski
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000378:metabolism*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood*
chemical_list: D015415:Biomarkers; C560822:TIMP1 protein, human; D019715:Tissue Inhibitor of Metalloproteinase-1; D020780:Matrix Metalloproteinase 9