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循环基质金属蛋白酶-2、-9 和金属蛋白酶组织抑制剂-2 模式改变与 HCV 相关慢性肝炎患者的组织学特征的关系。

Altered pattern of circulating matrix metalloproteinases -2,- 9 and tissue inhibitor of metalloproteinase-2 in patients with HCV-related chronic hepatitis. Relationship to histological features.

机构信息

Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, Italy.

出版信息

Panminerva Med. 2009 Dec;51(4):191-6.

PMID:20195229
Abstract

AIM

The aim of this paper was to assess circulating levels of metalloprotease2 (MMP2), metalloprotease9 (MMP9) and tissue inhibitor of metalloprotease2 (TIMP2) in patients with HCV-related chronic hepatitis to verify whether there was a relationship between these molecules and biochemical and histological features.

METHODS

Forty-nine neodiagnosed and untreated patients affected by chronic C hepatitis and twenty healthy control subjects were investigated. In overall study series, circulating levels of MMP2, MMP9 and TIMP2 were assessed by ELISA commercial kit (R&D Systems). Patients with chronic hepatitis undergone to liver biopsy and histological features were examined according to Histological Activity Index (HAI).

RESULTS

Mean values of MMP2 (1989+/-207 ng/mL. vs 1112+/-120 ng/mL), MMP9 (62.44+/-11.9 ng/mL vs 39.67+/-4.6 ng/mL) and TIMP2 (48.3+/-8.1 ng/mL vs 15.16+/-4.1 ng/mL) were significantly higher (P<0.001) in patients than in controls. Among investigated molecules, only MMP2 was independently related to inflammation and fibrosis according to grading (P=0.036) and staging (P=0.032) score. Moreover, MMP2 but not MMP9 and TIMP2 was related to AST (P=0.015), ALT (P=0.049) and AST/platelet ratio index (P=0.001). No relationship (P>0.05) was found between MMP2 and MMP9 or TIMP2.

CONCLUSIONS

Our study confirms an altered pattern of metalloproteases and their tissue inhibitors in subjects with chronic C hepatitis and such alterations can contribute to development of liver fibrosis. In addition MMP2 is related to inflammation and fibrosis as assessed by liver biopsy and laboratory features. The serial detection of MMP2 could help to monitor evolution of disease and to predict onset of cirrhosis.

摘要

目的

本研究旨在评估丙型肝炎相关慢性肝炎患者循环中金属蛋白酶 2(MMP2)、金属蛋白酶 9(MMP9)和金属蛋白酶组织抑制剂 2(TIMP2)的水平,以验证这些分子与生化和组织学特征之间是否存在关系。

方法

共纳入 49 例未经治疗的新诊断丙型肝炎慢性患者和 20 例健康对照者。采用 ELISA 试剂盒(R&D Systems)检测 MMP2、MMP9 和 TIMP2 的循环水平。所有慢性肝炎患者均接受肝活检,根据组织学活动指数(HAI)评估组织学特征。

结果

与对照组相比,患者的 MMP2(1989±207ng/mL. vs 1112±120ng/mL)、MMP9(62.44±11.9ng/mL vs 39.67±4.6ng/mL)和 TIMP2(48.3±8.1ng/mL vs 15.16±4.1ng/mL)的平均值显著升高(P<0.001)。在这些研究的分子中,只有 MMP2 与炎症和纤维化的分级(P=0.036)和分期(P=0.032)评分独立相关。此外,MMP2 与 AST(P=0.015)、ALT(P=0.049)和 AST/血小板比值指数(P=0.001)相关,但 MMP9 和 TIMP2 与这些实验室参数均无关(P>0.05)。

结论

本研究证实,慢性丙型肝炎患者中金属蛋白酶及其组织抑制剂的模式发生改变,这种改变可能有助于肝纤维化的发展。此外,MMP2 与肝活检和实验室特征评估的炎症和纤维化有关。MMP2 的连续检测有助于监测疾病的进展,并预测肝硬化的发生。

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