title: Levels of Matrix Metalloproteinases in Arthroplasty Patients and Their Correlation With Inflammatory and Thrombotic Activation Processes.
abstract: An imbalance of matrix metalloproteinases (MMPs) and their inhibitors is thought to play a major role in the pathophysiology of joint diseases. The aim of this study is to provide additional insights into the relevance of MMP levels in arthroplasty patients in relation to inflammation and thrombosis. Deidentified plasma samples from 100 patients undergoing total hip arthroplasty or total knee arthroplasty were collected preoperatively, on postoperative day 1, and on postoperative day 3. Tissue inhibitor of MMP 4, tumor necrosis factor α (TNF-α), pro-MMP1, MMP3, MMP9, MMP13, and d-dimer were measured using enzyme-linked immunosorbent assay kits. A biochip array was used to profile interleukin (IL) 2, IL-4, IL-6, IL-8, IL-10, vascular endothelial growth factor (VEGF), interferon gamma, TNF-α, IL-1α, IL-1β, monocyte chemoattractant protein 1, and endothelial growth factor (EGF) levels. The levels of MMP1, MMP9, MMP13, and TNF-α were elevated preoperatively in arthroplasty patients when compared to healthy individuals. The concentrations of MMP1 and MMP9 increased slightly in postsurgical samples. d-Dimer levels were elevated preoperatively, increased postoperatively, and started decreasing on postoperative day 3. Significant correlations between MMP9 with TNF-α, IL-6, IL-8, VEGF, and EGF were identified. Elevated preoperative MMP1, MMP9, and MMP13 concentrations suggest that they may play a role in the pathogenesis of arthritis. There is also evidence of increased coagulation activity and possible upregulation of several MMPs postsurgically. Correlation analysis indicates that MMP9 levels may potentially be related to inflammation and thrombosis in arthroplasty patients.
authors.affiliation: Department of Pathology and Pharmacology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Kyle
authors.initials: K
authors.lastname: Alexander
authors.affiliation: Department of Orthopedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Banos
authors.affiliation: Department of Pathology and Pharmacology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Schuharazad
authors.initials: S
authors.lastname: Abro
authors.affiliation: Department of Pathology and Pharmacology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Hoppensteadt
authors.affiliation: Department of Pathology and Pharmacology, Loyola University Medical Center, Maywood, IL, USA jfareed@luc.edu.
authors.forename: Jawed
authors.initials: J
authors.lastname: Fareed
authors.affiliation: Department of Orthopedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Harold
authors.initials: H
authors.lastname: Rees
authors.affiliation: Department of Orthopedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: William
authors.initials: W
authors.lastname: Hopkinson
mesh_terms: D000328:Adult; D001168:Arthritis / Q000097:blood* / Q000201:enzymology / Q000601:surgery; D001178:Arthroplasty; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000201:enzymology; D008137:Longitudinal Studies; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008666:Metalloendopeptidases / Q000097:blood*; D059035:Perioperative Period; D013927:Thrombosis / Q000097:blood / Q000201:enzymology
chemical_list: D016207:Cytokines; D008666:Metalloendopeptidases; D020780:Matrix Metalloproteinase 9
keywords: arthroplasty; coagulation; inflammation; matrix metalloproteinases; thrombosis