Measuring serum matrix metalloproteinase-9 levels in peripheral blood after subarachnoid hemorrhage to predict cerebral vasospasm

Abstract

PurposeWe aimed to investigate serum levels of matrix metalloproteinase-9 in both subarachnoid hemorrhage and control groups for prediction of cerebral vasospasm in this study.MethodsVenous serum matrix metalloproteinase-9 levels were prospectively measured four times (days 1, 3, 7, and 14) for 34 consecutive patients with subarachnoidal hemorrhage (n = 27) and for elective aneurysm clipping (control, n = 7).ResultsVasospasm developed in 11/34 (32.4 %) patients between 3 and 10 days after subarachnoid hemorrhage (median 5.58 days), mean peak serum matrix metalloproteinase-9 compared with the non-vasospasm cohort. Matrix metalloproteinase-9 levels were higher in subarachnoid hemorrhage patients than in the controls.ConclusionIncreased serum matrix metalloproteinase-9 could be an accurate biomarker to predict the onset of cerebral vasospasm after subarachnoid hemorrhage.

Minocycline protects against delayed cerebral ischemia after subarachnoid hemorrhage via matrix metalloproteinase‐9 inhibition

“…Four other studies examined the relationship between MMP‐9 levels and radiographic vasospasm in SAH patients. Of these, three reported an association between higher levels of blood MMP‐9 and cerebral vasospasm, while the other reported a nonsignificant trend toward higher CSF MMP‐9 levels and cerebral vasospasm. Taken together, these preclinical and clinical studies suggest, but do not definitively establish, a role for MMP‐9 in the pathophysiology of vasospasm and DCI after SAH.…”

“…MMP‐9 is a type IV collagenase that is involved in the cleavage of a variety of substrates on the cell membrane and extracellular matrix. It has been strongly implicated in the pathophysiology of BBB disruption and cerebral edema in several acute CNS injury paradigms including ischemic stroke, traumatic brain injury, and more recently SAH . However, the role of MMP‐9 in SAH‐induced cerebral vasospasm and DCI is poorly understood.…”

“…However, the role of MMP‐9 in SAH‐induced cerebral vasospasm and DCI is poorly understood. Numerous studies have shown that MMP‐9 levels and/or activity are increased following SAH, both in patients and in animal models . Regarding its role in EBI, several investigators have found that pharmacologically inhibiting MMP‐9 via SB3CT and minocycline reduces EBI and improves neurological deficits after SAH, although both these pharmacologic agents are known to inhibit other matrix metalloproteinases such as MMP‐2.…”

Clinical and experimental aspects of aneurysmal subarachnoid hemorrhage

“…Matrix metalloproteinase (MMP) is strongly involved in the pathophysiology of blood‐brain barrier disruption and CNS injury . MMP‐9 levels are increased following SAH, and several studies have suggested a role for MMP‐9 in early brain injury after SAH and correlation between MMP‐9 levels and vasospasm in animal models …”

“…[111][112][113] MMP-9 levels are increased following SAH, and several studies have suggested a role for MMP-9 in early brain injury after SAH and correlation between MMP-9 levels and vasospasm in animal models. [114][115][116][117][118][119] Fischer et al 120 evaluated blood samples in 20 patients with aSAH and showed that MMP-9 was higher in aSAH patients compared to healthy controls (P < .001) and an increase in MMP correlated with occurrence of vasospasm (P < .05).…”