Plasma matrix metalloproteinase-9 levels predict intensive care unit mortality early after severe traumatic brain injury.
Matrix metalloproteinase-9 (MMP-9) is an inducible metalloproteinase that can degrade the cerebrovascular matrix leading to disruption of the blood-brain barrier and exacerbation of oedema in neurotrauma. Therefore, our aim was to determine whether MMP-9 plasma levels were associated with intensive care unit (ICU) mortality after severe traumatic brain injury (TBI) despite the presence of extracerebral injuries.



This cohort enrolled 80 patients who suffered severe TBI (Glasgow Coma Scale: 3-8 at hospital admission). The plasma MMP-9 level was determined by enzyme-linked immunosorbent assay assay at ICU admission.



Severe TBI was associated with a 32.5% ICU mortality rate. There was no association between the presence of extracerebral injuries (72.5% of the patients) and ICU mortality (P = 0.419). Higher plasma MMP-9 concentrations were associated with fatal outcome: 181.1 ± 16.0 ng/mL for survivors and 257.0 ± 23.2 ng/mL for nonsurvivors (mean ± S.E.M., P = 0.009). In contrast, there was no significant difference between MMP-9 levels and associated lesions: 220.8 ± 26.3 ng/mL for isolated TBI and 196.8 ± 15.8 ng/mL for patients with extracerebral injuries (P = 0.397).



Increased plasma MMP-9 levels predicted short-term fatal outcome following severe TBI, regardless the presence of extracerebral injuries.
a Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde.|b Laboratório de Biomarcadores do Trauma.|c Curso de Medicina , Universidade Luterana do Brasil , Canoas , Brazil.
Daniel
D
Simon
a Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde.
Joice
J
Evaldt
b Laboratório de Biomarcadores do Trauma.
Débora Dreher
DD
Nabinger
b Laboratório de Biomarcadores do Trauma.
Mariano Feraboli
MF
Fontana
b Laboratório de Biomarcadores do Trauma.
Mirelli Gabardo
MG
Klein
b Laboratório de Biomarcadores do Trauma.
Julia
J
do Amaral Gomes
a Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde.|b Laboratório de Biomarcadores do Trauma.|c Curso de Medicina , Universidade Luterana do Brasil , Canoas , Brazil.
Andrea
A
Regner
D000293:Adolescent; D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000097:blood* / Q000401:mortality*; D002648:Child; D015331:Cohort Studies; D015600:Glasgow Coma Scale; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D055815:Young Adult
D020780:Matrix Metalloproteinase 9
MMP-9; Severe TBI; biomarker; outcome