Pleura Laboratory-Pulmonary Division, Heart Institute (InCor), University of Sao Paulo Medical School, Rua Dr. Eneas de Carvalho Aguiar, 44, Cerqueira César, São Paulo, 05403-000, Brazil.
Clinical Laboratory and LIM 03-Department of Pathology, Hospital das Clínicas, University of Sao Paulo Medical School, São Paulo, Brazil.
Lung. 2016 Dec;194(6):1021-1027. doi: 10.1007/s00408-016-9945-5. Epub 2016 Sep 27.
Matrix metalloproteinases (MMPs) are responsible for the breakdown of the extracellular matrix and play an important role in the inflammatory processes of pleural exudates. The imbalance between MMPs and their inhibitors (TIMPs) is present in various pathological processes.
To evaluate the profile of MMPs and TIMPs in pleural effusions of different etiologies correlated with inflammatory markers.
The patients with pleural effusion due to tuberculosis (TB), cancer (CA) or transudate were prospectively evaluated. Pleural fluid was submitted to cytological, biochemical, cytokines, MMP, and TIMP analysis. Statistical analysis was performed using ANOVA and Spearman's correlation, and p < 0.05 was considered significant.
One hundred and fourteen patients were enrolled, 80 exudates (41 TB and 39 CA) and 34 transudates. The levels of MMP-8 and MMP-9 were higher in exudates compared to transudates. The level of MMP-8 was significantly higher in TB than in CA. TIMP-1 levels were higher in exudates. IL-6, VEGF, and TGF-β showed differences between exudates and transudates. However, IL-6 level was higher in TB than in CA. We found a significant correlation between MMPs and TIMPs with inflammation markers. MMP-1 was correlated with LDH levels. MMP-8 was correlated with LDH, total cell count, neutrophils, and ADA as well as MMP-1 levels. MMP-9 was correlated with IL-6, TGF-β, and VEGF. TIMP-1 was correlated with MMP-9 and IL-6.
MMPs and TIMPs are expressed in pleural fluid of different etiologies and correlate with inflammatory mediators. MMPs may be useful in determining the cause of fluid, but more studies are needed to determine the spectrum of diseases associated with the various isoforms of MMPS and TIMPs.
基质金属蛋白酶（MMPs）负责细胞外基质的分解，在胸腔渗出液的炎症过程中发挥重要作用。MMPs 与其抑制剂（TIMPs）之间的失衡存在于各种病理过程中。
评估不同病因胸腔积液中 MMPs 和 TIMPs 的谱与炎症标志物相关。
前瞻性评估了结核（TB）、癌症（CA）或漏出液引起的胸腔积液患者。胸腔积液进行细胞学、生化、细胞因子、MMP 和 TIMP 分析。采用 ANOVA 和 Spearman 相关性进行统计学分析，p<0.05 为差异有统计学意义。
共纳入 114 例患者，80 例渗出液（41 例 TB 和 39 例 CA）和 34 例漏出液。与漏出液相比，渗出液中 MMP-8 和 MMP-9 的水平更高。TB 中的 MMP-8 水平显著高于 CA。渗出液中 TIMP-1 水平较高。IL-6、VEGF 和 TGF-β在渗出液和漏出液之间存在差异。然而，TB 中的 IL-6 水平高于 CA。我们发现 MMPs 和 TIMPs 与炎症标志物之间存在显著相关性。MMP-1 与 LDH 水平相关。MMP-8 与 LDH、总细胞计数、中性粒细胞和 ADA 以及 MMP-1 水平相关。MMP-9 与 IL-6、TGF-β和 VEGF 相关。TIMP-1 与 MMP-9 和 IL-6 相关。
MMPs 和 TIMPs 在不同病因的胸腔积液中表达，并与炎症介质相关。MMPs 可能有助于确定液体的病因，但需要更多的研究来确定与各种 MMPs 和 TIMPs 同工型相关的疾病谱。
