Division of Pediatric Allergy and Immunology, Faculty of Medicine, University of Cukurova, Adana, Turkey.
Pediatr Pulmonol. 2009 Oct;44(10):1010-6. doi: 10.1002/ppul.21096.
Bronchiectasis (BE) is still an important cause of chronic supurative respiratory diseases in developing countries. Neutrophil-derived proteases such as neutrophil elastase and matrix metalloproteases (MMPs) are implicated in causing airway damage in chronic pulmonary disease. In this study, we aimed to evaluate the MMP-9 and its natural tissue inhibitors of metalloproteinases (TIMP-1) levels utilizing the exhaled breath condensate (EBC) method and their relationship with radiological findings and pulmonary functions in children with BE.Thirty-eight children with BE and 12 healthy children were included: Group 1 (cystic fibrosis [CF] BE), Group 2 (non-CF BE), Group 3 (control group). High-resolution computerized tomography (HRCT) scores were calculated according to the anatomic extent of BE. Pulmonary function tests were performed, and MMP-9 and TIMP-1 levels in EBC were analyzed by ELISA.Exhaled breath condensate MMP-9 level was 48.9 +/- 26.8 ng/ml for Group 1, and for Group 2, 42.8 +/- 18.1 ng/ml; and for Group 3, 30 +/- 3.7 ng/ml. Although no statistically significant difference was found between the Groups 1 and 2, a significant difference was detected between these groups and controls. No statistically significant difference was found in TIMP-1 levels regarding all groups. EBC MMP-9 levels were inversely correlated with pulmonary functions test, and positively with HRCT scores and annual number of pulmonary infections.In conclusion, this study showed that EBC of children with both CF BE and non-CF BE contained higher levels of MMP-9 in comparison to controls. We suggest that EBC MMP-9 level may be a useful marker of airway injury in patients with BE however prospective studies are needed.
支气管扩张症（BE）仍然是发展中国家慢性化脓性呼吸道疾病的重要原因。中性粒细胞衍生的蛋白酶，如中性粒细胞弹性蛋白酶和基质金属蛋白酶（MMPs），与慢性肺部疾病中的气道损伤有关。在这项研究中，我们旨在利用呼出气冷凝液（EBC）方法评估 MMP-9 及其天然金属蛋白酶抑制剂（TIMP-1）水平，并评估其与 BE 患儿的放射学发现和肺功能的关系。
纳入 38 例 BE 患儿和 12 例健康儿童：第 1 组（囊性纤维化[CF] BE），第 2 组（非 CF BE），第 3 组（对照组）。根据 BE 的解剖范围计算高分辨率计算机断层扫描（HRCT）评分。进行肺功能检查，并通过 ELISA 分析 EBC 中的 MMP-9 和 TIMP-1 水平。
第 1 组 EBC MMP-9 水平为 48.9±26.8ng/ml，第 2 组为 42.8±18.1ng/ml，第 3 组为 30±3.7ng/ml。尽管第 1 组和第 2 组之间无统计学差异，但与对照组相比，差异显著。三组间 TIMP-1 水平无统计学差异。EBC MMP-9 水平与肺功能测试呈负相关，与 HRCT 评分和每年肺部感染次数呈正相关。
综上所述，本研究表明 CF BE 和非 CF BE 患儿的 EBC 中 MMP-9 水平高于对照组。我们认为 EBC MMP-9 水平可能是 BE 患者气道损伤的有用标志物，但需要进一步的前瞻性研究。
