Association between serum tissue inhibitor of matrix metalloproteinase-1 levels and mortality in patients with severe brain trauma injury.
<h4>Objective</h4>Matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) play a role in neuroinflammation after brain trauma injury (TBI). Previous studies with small sample size have reported higher circulating MMP-2 and MMP-9 levels in patients with...
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oai:doaj.org-article:50f32a47f7eb45859415c83de83ba4272021-11-18T08:23:41ZAssociation between serum tissue inhibitor of matrix metalloproteinase-1 levels and mortality in patients with severe brain trauma injury.1932-620310.1371/journal.pone.0094370https://doaj.org/article/50f32a47f7eb45859415c83de83ba4272014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24728097/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>Matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) play a role in neuroinflammation after brain trauma injury (TBI). Previous studies with small sample size have reported higher circulating MMP-2 and MMP-9 levels in patients with TBI, but no association between those levels and mortality. Thus, the aim of this study was to determine whether serum TIMP-1 and MMP-9 levels are associated with mortality in patients with severe TBI.<h4>Methods</h4>This was a multicenter, observational and prospective study carried out in six Spanish Intensive Care Units. Patients with severe TBI defined as Glasgow Coma Scale (GCS) lower than 9 were included, while those with Injury Severity Score (ISS) in non-cranial aspects higher than 9 were excluded. Serum levels of TIMP-1, MMP-9 and tumor necrosis factor (TNF)-alpha, and plasma levels of tissue factor (TF) and plasminogen activator inhibitor (PAI)-1 plasma were measured in 100 patients with severe TBI at admission. Endpoint was 30-day mortality.<h4>Results</h4>Non-surviving TBI patients (n = 27) showed higher serum TIMP-1 levels than survivor ones (n = 73). We did not find differences in MMP-9 serum levels. Logistic regression analysis showed that serum TIMP-1 levels were associated 30-day mortality (OR = 1.01; 95% CI = 1.001-1.013; P = 0.03). Survival analysis showed that patients with serum TIMP-1 higher than 220 ng/mL presented increased 30-day mortality than patients with lower levels (Chi-square = 5.50; P = 0.02). The area under the curve (AUC) for TIMP-1 as predictor of 30-day mortality was 0.73 (95% CI = 0.624-0.844; P<0.001). An association between TIMP-1 levels and APACHE-II score, TNF- alpha and TF was found.<h4>Conclusions</h4>The most relevant and new findings of our study, the largest series reporting data on TIMP-1 and MMP-9 levels in patients with severe TBI, were that serum TIMP-1 levels were associated with TBI mortality and could be used as a prognostic biomarker of mortality in TBI patients.Leonardo LorenteMaría M MartínPatricia LópezLuis RamosJosé BlanquerJuan J CáceresJordi Solé-ViolánJorge SoleraJudith CabreraMónica ArguesoRaquel OrtizMaría L MoraSantiago LubilloAlejandro JiménezJuan M Borreguero-LeónAgustín GonzálezJosune OrbeJosé A RodríguezJosé A PáramoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e94370 (2014) |
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Medicine R Science Q Leonardo Lorente María M Martín Patricia López Luis Ramos José Blanquer Juan J Cáceres Jordi Solé-Violán Jorge Solera Judith Cabrera Mónica Argueso Raquel Ortiz María L Mora Santiago Lubillo Alejandro Jiménez Juan M Borreguero-León Agustín González Josune Orbe José A Rodríguez José A Páramo Association between serum tissue inhibitor of matrix metalloproteinase-1 levels and mortality in patients with severe brain trauma injury. |
| description |
<h4>Objective</h4>Matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) play a role in neuroinflammation after brain trauma injury (TBI). Previous studies with small sample size have reported higher circulating MMP-2 and MMP-9 levels in patients with TBI, but no association between those levels and mortality. Thus, the aim of this study was to determine whether serum TIMP-1 and MMP-9 levels are associated with mortality in patients with severe TBI.<h4>Methods</h4>This was a multicenter, observational and prospective study carried out in six Spanish Intensive Care Units. Patients with severe TBI defined as Glasgow Coma Scale (GCS) lower than 9 were included, while those with Injury Severity Score (ISS) in non-cranial aspects higher than 9 were excluded. Serum levels of TIMP-1, MMP-9 and tumor necrosis factor (TNF)-alpha, and plasma levels of tissue factor (TF) and plasminogen activator inhibitor (PAI)-1 plasma were measured in 100 patients with severe TBI at admission. Endpoint was 30-day mortality.<h4>Results</h4>Non-surviving TBI patients (n = 27) showed higher serum TIMP-1 levels than survivor ones (n = 73). We did not find differences in MMP-9 serum levels. Logistic regression analysis showed that serum TIMP-1 levels were associated 30-day mortality (OR = 1.01; 95% CI = 1.001-1.013; P = 0.03). Survival analysis showed that patients with serum TIMP-1 higher than 220 ng/mL presented increased 30-day mortality than patients with lower levels (Chi-square = 5.50; P = 0.02). The area under the curve (AUC) for TIMP-1 as predictor of 30-day mortality was 0.73 (95% CI = 0.624-0.844; P<0.001). An association between TIMP-1 levels and APACHE-II score, TNF- alpha and TF was found.<h4>Conclusions</h4>The most relevant and new findings of our study, the largest series reporting data on TIMP-1 and MMP-9 levels in patients with severe TBI, were that serum TIMP-1 levels were associated with TBI mortality and could be used as a prognostic biomarker of mortality in TBI patients. |
| format |
article |
| author |
Leonardo Lorente María M Martín Patricia López Luis Ramos José Blanquer Juan J Cáceres Jordi Solé-Violán Jorge Solera Judith Cabrera Mónica Argueso Raquel Ortiz María L Mora Santiago Lubillo Alejandro Jiménez Juan M Borreguero-León Agustín González Josune Orbe José A Rodríguez José A Páramo |
| author_facet |
Leonardo Lorente María M Martín Patricia López Luis Ramos José Blanquer Juan J Cáceres Jordi Solé-Violán Jorge Solera Judith Cabrera Mónica Argueso Raquel Ortiz María L Mora Santiago Lubillo Alejandro Jiménez Juan M Borreguero-León Agustín González Josune Orbe José A Rodríguez José A Páramo |
| author_sort |
Leonardo Lorente |
| title |
Association between serum tissue inhibitor of matrix metalloproteinase-1 levels and mortality in patients with severe brain trauma injury. |
| title_short |
Association between serum tissue inhibitor of matrix metalloproteinase-1 levels and mortality in patients with severe brain trauma injury. |
| title_full |
Association between serum tissue inhibitor of matrix metalloproteinase-1 levels and mortality in patients with severe brain trauma injury. |
| title_fullStr |
Association between serum tissue inhibitor of matrix metalloproteinase-1 levels and mortality in patients with severe brain trauma injury. |
| title_full_unstemmed |
Association between serum tissue inhibitor of matrix metalloproteinase-1 levels and mortality in patients with severe brain trauma injury. |
| title_sort |
association between serum tissue inhibitor of matrix metalloproteinase-1 levels and mortality in patients with severe brain trauma injury. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2014 |
| url |
https://doaj.org/article/50f32a47f7eb45859415c83de83ba427 |
| work_keys_str_mv |
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