title: Tissue inhibitor of metalloproteinase-1 is responsible for residual pleural thickening in pleural tuberculosis.
abstract: Residual pleural thickening (RPT) is the most frequent complication associated with pleural tuberculosis, and may occur even after successful anti-tuberculosis medications. Matrix metalloproteinases (MMPs) are zinc-dependent proteinases capable of degrading all components of the extracellular matrix. The proteolytic action of MMPs may be involved in the pathogenesis of tuberculosis. MMP-9, secreted by monocytes and lymphocyte, may lead to long-term fibrosis. The aim of the present study was to determine whether MMP-2 and/or MMP-9 and their specific inhibitors, tissue inhibitors of metalloproteinase 1 (TIMP-1) and TIMP-2, could be used to predict RPT. This retrospective study enrolled 52 patients diagnosed with pleural tuberculosis. Levels of MMP-2, MMP-9, TIMP-1, and TIM-2 were determined in the pleural fluid by ELISA. The RPT was measured on chest X-ray at the completion of treatment and the final follow-up. The average periods of anti-tuberculosis medication and the follow-up after completion of treatment were 6.7 and 7.6 months, respectively. MMP-2 or MMP-9 levels had no significant correlation to RPT. The patients with RPT > 2 mm at the completion of anti-tuberculosis medication and the final follow-up had higher TIMP-1 levels (p = 0.00 and p = 0.001, respectively). However, patients with RPT > 2 mm at the completion of anti-tuberculosis medication had lower TIMP-2 levels (p = 0.005). In a logistic regression model, elevated TIMP-1 levels at the completion of anti-tuberculosis medications were associated with RPT. In conclusion, higher TIMP-1 levels are responsible for the development of RPT and may be helpful for predicting RPT in pleural tuberculosis.
authors: Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University, School of Medicine.
authors: Ki-Eun
authors: KE
authors: Hwang
authors: Young-Jun
authors: YJ
authors: Shon
authors: Byong-Ki
authors: BK
authors: Cha
authors: Mi-Jeong
authors: MJ
authors: Park
authors: Min-Su
authors: MS
authors: Chu
authors: Young-Jun
authors: YJ
authors: Kim
authors: Eun-Taik
authors: ET
authors: Jeong
authors: Hak-Ryul
authors: HR
authors: Kim
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020782:Matrix Metalloproteinases / Q000378:metabolism; D008875:Middle Aged; D015999:Multivariate Analysis; D010994:Pleura / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000473:pathology*; D011859:Radiography; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000378:metabolism*; D014396:Tuberculosis, Pleural / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000201:enzymology* / Q000473:pathology*
chemical_list: D000995:Antitubercular Agents; D019715:Tissue Inhibitor of Metalloproteinase-1; D020782:Matrix Metalloproteinases