Matrix metalloproteinases -8 and -9 and tissue inhibitor of metalloproteinase-1 in burn patients. A prospective observational study

• Published in: PloS one Vol. 10; no. 5; p. e0125918
• Main Authors: Hästbacka, Johanna, Fredén, Filip, Hult, Maarit, Bergquist, Maria, Wilkman, Erika, Vuola, Jyrki, Sorsa, Timo, Tervahartiala, Taina, Huss, Fredrik
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 06.05.2015; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Anesthesiology; Biomarkers; Biomarkers - blood; Blister - immunology; Blistering; Burn patients; Burns; Burns - blood; Burns - immunology; Comparative analysis; Cytokines; Drug therapy; Female; Gelatinase B; Granulocytes; Hospitals; Humans; Inflammation; Inflammation - immunology; Inhibitors; Injuries; Intensive care; Leukocytes (neutrophilic); Male; Matrix Metalloproteinase 8 - blood; Matrix Metalloproteinase 9 - blood; Matrix metalloproteinases; Maxillofacial surgery; Medicin och hälsovetenskap; Medicine; Metalloproteinase; Middle Aged; Neutrophil collagenase; Neutrophils; Neutrophils - immunology; Observational studies; Pain; Patients; Permeability; Physiological aspects; Plasma; Plastic surgery; Prospective Studies; Proteases; Proteins; Rodents; Sepsis; Tissue inhibitor of metalloproteinase 1; Tissue Inhibitor of Metalloproteinase-1 - blood; Tumor necrosis factor-TNF; Sweden; Finland
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0125918

Matrix metalloproteinases (MMPs) -8 and -9 are released from neutrophils in acute inflammation and may contribute to permeability changes in burn injury. In retrospective studies on sepsis, levels of MMP-8, MMP-9, and tissue inhibitor of metalloproteinase-1 (TIMP-1) differed from those of healthy controls, and TIMP-1 showed an association with outcome. Our objective was to investigate the relationship between these proteins and disease severity and outcome in burn patients. In this prospective, observational, two-center study, we collected plasma samples from admission to day 21 post-burn, and burn blister fluid samples on admission. We compared MMP-8, -9, and TIMP-1 levels between TBSA<20% (N = 19) and TBSA>20% (N = 30) injured patients and healthy controls, and between 90-day survivors and non-survivors. MMP-8, -9, and TIMP-1 levels at 24-48 hours from injury, their maximal levels, and their time-adjusted means were compared between groups. Correlations with clinical parameters and the extent of burn were analyzed. MMP-8, -9, and TIMP-1 levels in burn blister fluids were also studied. Plasma MMP-8 and -9 were higher in patients than in healthy controls (P<0.001 and P = 0.016), but only MMP-8 differed between the TBSA<20% and TBSA>20% groups. MMP-8 and -9 were not associated with clinical severity or outcome measures. TIMP-1 differed significantly between patients and controls (P<0.001) and between TBSA<20% and TBSA>20% groups (P<0.002). TIMP-1 was associated with 90-day mortality and correlated with the extent of injury and clinical measures of disease severity. TIMP-1 may serve as a new biomarker in outcome prognostication of burn patients.