Healing Chambers of America's, 995 Gateway Center Way, San Diego, CA, USA.
J Cardiovasc Transl Res. 2010 Dec;3(6):683-7. doi: 10.1007/s12265-010-9221-7. Epub 2010 Sep 8.
Matrix metalloproteinease-9 (MMP-9) is involved in a host of processes. Many of its processes are physiologically beneficial as well as detrimental. The over-expression of this enzyme has been implicated as a contributory factor to some of the sequalae associated with cerebral ischemia, cell death, non-healing wounds, traumatic brain injury, aneurysms, and plaque instability in atherosclerosis. Several studies have examined the effect of hyperbaric oxygen (HBO) on MMP-9 expression. Because this proteinase is involved in both chronic and acute pathology, we wanted to investigate an acute expression model and see if, and how quickly, its expression would respond to HBO therapy. Our patient was scheduled to have elective surgery with an overnight stay followed by a series of HBO exposures. The patient served as her own control. An MMP-9 and urine pH was obtained prior to surgery to establish a baseline. On days 1, 3, and 4 post-op, samples were obtained before and after hyperbaric exposure. The patient was exposed to 100% O2 at 2.5 ATA for 60 min during each treatment for 5 days. The patient's MMP-9 values were dramatically elevated after surgery as compared to the baseline readings. The percentage increase from baseline was 400%. Our patient showed a significant reduction in MMP-9 expression after each hyperbaric exposure with the greatest decrease seen on post-op day 1 and subsequent exposures showing slightly less expression. Reduction in MMP-9 expression ranged from 46% on day 1 to 30% on post-op day 4. This case study suggests that if done relatively soon after a vascular or tissue insult, HBO can reduce MMP-9 expression. Chronic vascular pathologies, such as atherosclerotic plaque and aneurysms where over-expression of MMP-9 may result in acute coronary syndrome (ACS) or cerebral vascular accidents (CVAs), may be mitigated by a series of HBO treatments that reduce MMP-9 expression. Causality and/or contributory effects of MMP-9 expression in both pathologic and physiologic processes needs to be further elucidated. The understanding of how HBO therapy modulates these may provide an additional insight into mechanisms and future potential therapies for pathologic conditions such as those described above.
基质金属蛋白酶-9（MMP-9）参与了许多生理过程。其许多过程既有生理益处，也有不利影响。这种酶的过度表达已被认为是与脑缺血、细胞死亡、愈合不良伤口、创伤性脑损伤、动脉瘤和动脉粥样硬化斑块不稳定等一些后遗症有关的一个促成因素。几项研究已经研究了高压氧（HBO）对 MMP-9 表达的影响。由于这种蛋白酶参与了慢性和急性病理过程，我们想研究一个急性表达模型，看看它的表达是否以及多快会对 HBO 治疗产生反应。我们的患者计划接受择期手术，住院过夜，然后进行一系列 HBO 暴露。患者本人就是自己的对照。在手术前获得 MMP-9 和尿液 pH 值以建立基线。在手术后第 1、3 和 4 天，在高压氧暴露前后获取样本。患者在每次治疗中都在 2.5ATA 下暴露于 100%O2 60 分钟，共 5 天。与基线读数相比，患者手术后的 MMP-9 值明显升高。从基线的百分比增加了 400%。我们的患者在每次高压氧暴露后 MMP-9 表达均显著降低，术后第 1 天降低最明显，随后的暴露显示表达略低。MMP-9 表达的降低范围从术后第 1 天的 46%到第 4 天的 30%。这项病例研究表明，如果在血管或组织损伤后相对较快地进行，HBO 可以降低 MMP-9 的表达。慢性血管病理，如动脉粥样硬化斑块和动脉瘤，其中 MMP-9 的过度表达可能导致急性冠状动脉综合征（ACS）或脑血管意外（CVA），可能通过一系列降低 MMP-9 表达的 HBO 治疗得到缓解。MMP-9 表达在病理和生理过程中的因果关系和/或促成作用需要进一步阐明。了解 HBO 治疗如何调节这些因素可能为上述病理状况提供对机制和未来潜在治疗方法的额外了解。
