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Open Access 01-04-2010 | Research

Matrix-metalloproteinase-2, -8 and -9 in serum and skin blister fluid in patients with severe sepsis

Authors: Fiia P Gäddnäs, Meeri M Sutinen, Marjo Koskela, Taina Tervahartiala, Timo Sorsa, Tuula A Salo, Jouko J Laurila, Vesa Koivukangas, Tero I Ala-Kokko, Aarne Oikarinen

Published in: Critical Care | Issue 2/2010

Abstract

Introduction

Matrix metalloproteinases (MMPs) have various roles in inflammatory states. They seem to be able to modulate endothelial barriers and regulate the activity of chemokines and cytokines. The timely development of the levels during severe sepsis and thereafter have not been investigated. In addition it was of interest to study alterations of MMP-levels in intact skin, as the skin is the largest barrier against external pathogens and MMPs have not been studied at organ level in human sepsis. The aim of this study was to investigate the timely development of serum and skin MMP-2, -8 and -9 levels in human severe sepsis and their association with disease severity and mortality.

Methods

Forty-four patients with severe sepsis and fifteen healthy controls were included in this prospective longitudinal study. The amounts of MMP-2, -8 and -9 were analyzed from serum at days 1, 4, 6, 8, and 10, and from skin suction blister fluid at days 1 and 5 from the beginning of severe sepsis. Additionally, samples from the survivors were obtained after three and six months.

Results

The levels of MMP-2 and -8 were up-regulated in severe sepsis in comparison to healthy controls in skin blister fluid and serum. Compared to the controls MMP-9 levels were lower in sepsis from the fourth day on in serum and both the first and fifth day in skin blister fluid. Active forms of MMP-2 and -9 were present only in severe sepsis. The non-survivors had higher pro- and active MMP-2 levels than the survivors in skin blister fluid samples. Furthermore, MMP-2 levels were more pronounced in blister fluid and serum samples in patients with more severe organ failures. In the survivors at 3 and 6 month follow-up the MMP levels had returned to normal.

Conclusions

MMP-2 and -8 are elevated in serum and blister fluid in severe sepsis, implying that they may play a significant role in the pathogenesis of severe sepsis and organ dysfunctions. Active forms of MMP-2 and 9 were only present in patients with severe sepsis, and higher MMP-2 levels in skin blister and serum were associated with more severe organ dysfunctions.

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Title: Matrix-metalloproteinase-2, -8 and -9 in serum and skin blister fluid in patients with severe sepsis
Authors: Fiia P Gäddnäs
Meeri M Sutinen
Marjo Koskela
Taina Tervahartiala
Timo Sorsa
Tuula A Salo
Jouko J Laurila
Vesa Koivukangas
Tero I Ala-Kokko
Aarne Oikarinen
Publication date: 01-04-2010
Publisher: BioMed Central
Published in: Critical Care / Issue 2/2010
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc8938

At a glance: The STEP trials

Springer Medicine

Matrix-metalloproteinase-2, -8 and -9 in serum and skin blister fluid in patients with severe sepsis

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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