Changes in matrix metalloproteinases and their inhibitors in the tears and blood serum of patients with herpetic keratoconjunctivitis under the influence of antiherpetic antibodies and nimesulide

Abstract

Aim. The aim of the study was to study changes in matrix metalloproteinases and their tissue inhibitors in the tears and blood serum of patients with herpetic keratoconjunctivitis under the influence of antiherpetic antibodies and nimesulide. Materials and methods.65 adult patients with herpetic keratoconjunctivitis (HKC) caused by the herpes simplex virus type 1 (HSV-1) were examined. The etiological diagnosis of HKC was confirmed by polymerase chain reaction. The control group consisted of 32 patients who received basic treatment with acyclovir and interferon in the affected eye. The main group consisted of 33 patients who received antiherpetic immunoglobulin and nimesulide in addition to basic therapy. Immunoglobulin was administered intramuscularly and instilled into the affected eye, and nimesulide was administered orally. The control group consisted of 38 practically healthy adults. Matrix metalloproteinases MMP-1, MMP-8, and MMP-9 and their tissue inhibitors TIMP-1 and TIMP-2 were determined by solid-phase enzyme immunoassay in the tear fluid and blood serum of patients. The results of the study were processed according to the Student's criterion. Results. With HKC in the affected eye, in the acute phase of the disease, there are: an increase in the concentrations of MMP-1, MMP-8, MMP-9, both in the tear fluid and in the blood serum of patients; a decrease in the concentrations of TIMP-1 and TIMP-2 in the tear fluid, with unchanged levels of these compounds in the blood serum; violation of the balance in the corresponding MMP/TIMP systems to the advantage of MMP. In the convalescence phase, these shifts in the concentrations of MMPs, TIMPs and the balance between them significantly decrease, but their complete normalization does not occur, which is most significant for tear fluid than for the blood serum of convalescents. The combination of antiherpetic immunoglobulin and nimesulide helps to inhibit the exces production of MMP-1, MMP-8, MMP-9 in the lacrimal fluid of the causal eye and in the blood serum of patients, optimizes the level of TIMP-1, TIMP-2 and balance in the corresponding MMPs/TIMPs systems. Conclusion. In the acute phase of SCC, MMPs activity prevails, in the convalescence phase, TIMPs activity prevails. The combination of antiherpetic immunoglobulin and nimesulide has a positive effect on the state of MMPs and TIMPs in the lacrimal fluid of the causal eye and in the blood serum of patients.