Correlation of Matrix Metalloproteinase-9 and Tissue Inhibitor Matrix Metalloproteinase-1 on Lactate Concentration in Sepsis patients Admitted to Intensive Care Unit

Bastian Lubis; Putri Amelia; Vincent Viandy

doi:10.3889/oamjms.2022.8700

Authors

Bastian Lubis Department of Anesthesiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0002-1839-4146
Putri Amelia Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0001-9941-2555
Vincent Viandy Department of Anesthesiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0003-0461-4117

DOI:

https://doi.org/10.3889/oamjms.2022.8700

Keywords:

Sepsis, Lactate, Matrix metalloproteinase-9, Tissue inhibitor matrix metalloproteinase-1

Abstract

BACKGROUND: Lactate level has been used not only as a biomarker for diagnosis and guiding treatment of sepsis but also as predictor of poor clinical outcomes. Elevated lactate does not specifically reflect cellular damage and this condition can be seen in other metabolic disorders. Matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) are two new promising biomarkers that have been reported to elevate significantly in sepsis. These two biomarkers can reflect physiological changes in tissue and cellular levels.

AIM: This study aims to identify the correlation of MMP-9, TIMP-1, and MMP-9/TIMP-1 on lactate levels in sepsis patients.

METHODS: This was a cross-sectional study conducted in two hospitals, Adam Malik General Hospital, Medan, and Grand Medistra Hospital, Deli Serdang, between April 2020 and May 2021. The inclusion criteria in this study were adult sepsis patients who were admitted to ICU, with Sequential Organ Failure Assessment (SOFA) or quick SOFA score ≥ 2. We recorded the characteristics, MMP-9, TIMP-1, and lactate concentration before given any intervention. The data were then analyzed to find the correlation.

RESULTS: Sixty-four patients were included in this study which consisted of almost equal men and women. The mean age of the subjects was 52.16 ± 16.25 years old. There was no correlation between MMP-9 and TIMP-1 toward lactate concentration (p = 0.466 and p = 0.65, respectively).

CONCLUSION: Our study showed no correlation between MMP-9 and TIMP-1 toward lactate concentration.

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Author Biography

Putri Amelia, Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

References

Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021;47:1181-247. https://doi.org/10.1007/s00134-021-06506-y PMid:34599691 DOI: https://doi.org/10.1007/s00134-021-06506-y

Joshi R, de Witt B, Mosier JM. Optimizing oxygen delivery in the critically ill: The utility of lactate and central venous oxygen saturation (ScvO2) as a roadmap of resuscitation in shock. J Emerg Med. 2014;47:493-500. https://doi.org/10.1016/j.jemermed.2014.06.016 PMid:25124137 DOI: https://doi.org/10.1016/j.jemermed.2014.06.016

Andersen LW, Mackenhauer J, Roberts JC, Berg KM, Cocchi MN, Donnino MW. Etiology and therapeutic approach to elevated lactate levels. Mayo Clin Proc. 2013;88:1127-40. https://doi.org/10.1016/j.mayocp.2013.06.012 PMid:24079682 DOI: https://doi.org/10.1016/j.mayocp.2013.06.012

Galliera E, Tacchini L, Romanelli MM. Matrix metalloproteinases as biomarkers of disease: Updates and new insights. Clin Chem Lab Med. 2015;53:349-55. https://doi.org/10.1515/cclm-2014-0520 PMid:25153404 DOI: https://doi.org/10.1515/cclm-2014-0520

Van den Steen PE, Dubois B, Nelissen I, Rudd PM, Dwek RA, Opdenakker G. Biochemistry and molecular biology of gelatinase B or matrix metalloproteinase-9 (MMP-9). Crit Rev Biochem Mol Biol. 2002;37:375-536. https://doi.org/10.1080/10409230290771546 PMid:12540195 DOI: https://doi.org/10.1080/10409230290771546

Niño ME, Serrano SE, Niño DC, McCosham DM, Cardenas ME, Villareal VP, et al. TIMP1 and MMP9 are predictors of mortality in septic patients in the emergency department and intensive care unit unlike MMP9/TIMP1 ratio: Multivariate model. PLoS One. 2017;12(2):e0171191. https://doi.org/10.1371/journal.pone.0171191 PMid:28192449 DOI: https://doi.org/10.1371/journal.pone.0171191

Bojic S, Kotur-Stevuljevic J, Aleksic A, Gacic J, Memon L, Simic-Ogrizovic S. Matrix metalloproteinase-9 and tissue inhibitor of matrix metalloproteinase-1 in sepsis after major abdominal surgery. Dis Markers. 2018;2018:5064684. https://doi.org/10.1155/2018/5064684 PMid:29861795 DOI: https://doi.org/10.1155/2018/5064684

Lorente L, Martin MM, Sole-Violan J, Blanquer J, Labarta L, Díaz C, et al. Association of sepsis-related mortality with early increase of TIMP-1/MMP-9 ratio. PLoS One. 2014;9(4):e94318. https://doi.org/10.1371/journal.pone.0094318 PMid:24727739 DOI: https://doi.org/10.1371/journal.pone.0094318

Jordakieva G, Budge-Wolfram RM, Budinsky AC, Nikfardjam M, Delle-Karth G, Girard A, et al. Plasma MMP-9 and TIMP-1 levels on ICU admission are associated with 30-day survival. Wien Klin Wochenschr. 2021;133(3-4):86-95. https://doi.org/10.1007/s00508-019-01592-x PMid:31932967 DOI: https://doi.org/10.1007/s00508-019-01592-x

Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, et al. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Intensive Care Med. 2004;30(4):536-55. https://doi.org/10.1007/s00134-004-2210-z PMid:14997291 DOI: https://doi.org/10.1007/s00134-004-2210-z

Akkose S, Ozgurer A, Bulut M, Koksal O, Ozdemir F, Ozguc H. Relationships between markers of inflammation, severity of injury, and clinical outcomes in hemorrhagic shock. Adv Ther. 2007;24:955-62. https://doi.org/10.1007/BF02877699 PMid:18029320 DOI: https://doi.org/10.1007/BF02877699

Attaná P, Lazzeri C, Chiostri M, Picariello C, Gensini GF, Valente S. Lactate clearance in cardiogenic shock following ST elevation myocardial infarction: A pilot study. Acute Card Care. 2012;14(1):20-6. https://doi.org/10.3109/17482941.2011.655293 PMid:22356569 DOI: https://doi.org/10.3109/17482941.2011.655293

Mortlock S. Matrix metalloproteinase-9: Defining a normal reference range. Sch J App Med Sci. 2016;4:4146-50.

Serrano-Gomez S, Burgos-Angulo G, Niño-Vargas DC, Niño ME, Cárdenas ME, Chacón-Valenzuela E, et al. Predictive value of matrix metalloproteinases and their inhibitors for mortality in septic patients: A cohort study. J Intensive Care Med. 2020;35(1):95-103. https://doi.org/10.1177/0885066617732284 PMid:28931365 DOI: https://doi.org/10.1177/0885066617732284

Lauhio A, Hästbacka J, Pettilä V, Tervahartiala T, Karlsson S, Varpula T, et al. Serum MMP-8,-9 and TIMP-1 in sepsis: High serum levels of MMP-8 and TIMP-1 are associated with fatal outcome in a multicentre, prospective cohort study. Hypothetical impact of tetracyclines. Pharmacol Res. 2011;64(6):590-4. https://doi.org/10.1016/j.phrs.2011.06.019 PMid:21742038 DOI: https://doi.org/10.1016/j.phrs.2011.06.019