MMP-9 levels in elderly patients with cognitive dysfunction after carotid surgery

Gaudet, John G.; Yocum, Gene T.; Lee, Susie S.; Granat, Anna; Mikami, Maya; Connolly, E. Sander; Heyer, Éric

doi:10.1016/j.jocn.2009.07.103

Cited by 23 publications

(14 citation statements)

References 24 publications

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“…Serum MMP-9 levels have been shown to be positively correlated with the severity of cognitive impairment [19]. Gaudet reported that POCD in elderly patients after cardiac surgery was related to increased MMP-9 levels [20]. The present study showed that the serum MMP-9 levels at T1, T2, T3, and T4 in the POCD group were significantly higher than the levels at T0, while the levels in the non-POCD group returned to preoperative levels at T3.…”

Section: Discussionmentioning

confidence: 99%

Relationships between adiponectin and matrix metalloproteinase-9 (MMP-9) serum levels and postoperative cognitive dysfunction in elderly patients after general anesthesia

et al. 2016

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ObjectiveThe aim of this study was to evaluate the relationships between the serum levels of adiponectin (ADP) and matrix metalloproteinase-9 (MMP-9) and postoperative cognitive dysfunction (POCD) in elderly patients after general anesthesia.MethodsThe cognitive functions of 98 elderly patients who were scheduled to undergo selective hip replacement surgery under general anesthesia were assessed using the Montreal Cognitive Assessment (MoCA) 3 days before surgery and on postoperative Days 1, 2, 3, and 7. The serum levels of ADP and MMP-9 were determined at the same time points, and the presence of POCD on postoperative Day 3 was recorded. The patients were divided into a POCD group and non-POCD group.ResultsPostoperative cognitive dysfunction was observed in 28 patients (28.5 %). Serum MMP-9 levels significantly increased and serum ADP levels significantly decreased in the POCD group at each postoperative time point and in the non-POCD group on postoperative Days 1 and 2 compared to the presurgical levels. Serum MMP-9 levels were significantly higher and serum ADP levels were significantly lower in the POCD group compared with those in the non-POCD group at each time point. In the POCD patients, serum MMP-9 levels were significantly and negatively correlated and serum ADP levels were significantly and positively correlated with the MoCA scores.ConclusionsThe increased serum MMP-9 levels and decreased serum ADP levels in elderly patients after general anesthesia might be involved in the POCD pathophysiological process.

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Section: Discussionmentioning

confidence: 99%

Relationships between adiponectin and matrix metalloproteinase-9 (MMP-9) serum levels and postoperative cognitive dysfunction in elderly patients after general anesthesia

et al. 2016

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“…121 A prospective cohort study identified that patients with cognitive dysfunction after carotid surgery had higher pre-and postoperative plasma levels of MMP-9 than those without cognitive symptoms. 122 Postoperative increments of MMP-9 can represent systemic inflammatory response, local release of the protein due to atherosclerotic plaque manipulation, microembolization, or transient ischaemia with resulting BBB damage. 123 However, the finding of higher preoperative concentrations in patients who developed POCD may represent also a higher 'baseline' inflammatory state or silent areas of ischaemia associated with subclinical BBB dysfunction.…”

Section: Metalloproteinasesmentioning

confidence: 99%

Neurological biomarkers in the perioperative period

Cata

Abdelmalak

Farag

2011

British Journal of Anaesthesia

101

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The rapid detection and evaluation of patients presenting with perioperative neurological dysfunction is of great clinical relevance. Biomarkers have been defined as biological molecules that can be used as an indicator of new onset or progression of a biological process or effect of treatment. Biomarkers have become increasingly important in this setting to supplement other modalities of diagnosis such as EEG, sensory- or motor-evoked potential, transcranial Doppler, near-infrared spectroscopy, or imaging methods. A number of neuro-proteins have been identified and are currently under investigation for potential to provide insights into injury severity, outcome, and the ability to monitor cellular damage and molecular events that occur during neurological injury. S100B is a protein released by glial cells and is considered a marker of blood-brain barrier dysfunction. Clinical studies in patients undergoing cardiac and non-cardiac surgery indicate that serum levels of S100B are increased intraoperatively and after operation. The neurone-specific enolase has also been extensively investigated as a potential marker of neuronal injury in the context of cardiac and non-cardiac surgery. A third biomarker of interest is the Tau protein, which has been linked to neurodegenerative disorders. Tau appears to be more specific than the previous two biomarkers since it is only found in the central nervous system. The metalloproteinase and ubiquitin C terminal hydroxylase-L1 (UCH-L1) are the most recently researched markers; however, their usefulness is still unclear. This review presents a comprehensive overview of S100B, neuronal-specific enolase, metalloproteinases, and UCH-L1 in the perioperative period.

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“…Markers examined by our group that have been shown to correlate with CD include S100β, 3 monocyte chemoattractant protein 1 (MCP-1), 20 induced nitric oxide synthase (iNOS), 36 APOE-E4, 17 and matrix metalloproteinase 9 (MMP9). 10 We have also identified specific SNPs that have correlated with CD. The presence of at least one APOE -E4 allele has been associated with increased risk of CD at 1 month after CEA.…”

Section: Discussionmentioning

confidence: 97%

Complement polymorphisms and cognitive dysfunction after carotid endarterectomy

Heyer

Kellner

Malone

et al. 2013

JNS

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Object The role of genetic polymorphisms in the neurological outcome of patients after carotid endarterectomy (CEA) remains unclear. There are single nucleotide polymorphisms (SNPs) that predispose patients to postoperative cognitive dysfunction (CD). We aim to assess the predictability of three complement cascade-related SNPs for CD in patients having CEAs. Methods In 252 patients undergoing CEA, genotyping was performed for the following polymorphisms: complement component 5 (C5) rs17611, mannose-binding lectin 2 (MBL2) rs7096206, and complement factor H (CFH) rs1061170. Differences among genotypes were analyzed via the chi-square test. Patients were evaluated with a neuropsychometric battery for CD 1 day and 1 month after CEA. A multiple logistic regression model was created. All variables with univariate p < 0.20 were included in the final model. Results The C5 genotypes A/G (OR 0.26, 95% CI 0.11–0.60, p = 0.002) and G/G (OR 0.22, 95% CI 0.09–0.52, p < 0.001) were significantly associated with lower odds of exhibiting CD at 1 day after CEA compared with A/A. The CFH genotypes C/T (OR 3.37, 95% CI 1.69–6.92, p < 0.001) and C/C (OR 3.67, 95% CI 1.30–10.06, p = 0.012) were significantly associated with higher odds of exhibiting CD at 1 day after CEA compared with T/T. Statin use was also significantly associated with lower odds of exhibiting CD at 1 day after CEA (OR 0.43, 95% CI 0.22–0.84, p = 0.01). No SNPs were significantly associated with CD at 1 month after CEA. Conclusions The presence of a deleterious allele in the C5 and CFH SNPs may predispose patients to exhibit CD after CEA. This finding supports previous data demonstrating that the complement cascade system may play an important role in the development of CD. These findings warrant further investigation.

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MMP-9 levels in elderly patients with cognitive dysfunction after carotid surgery

Cited by 23 publications

References 24 publications

Relationships between adiponectin and matrix metalloproteinase-9 (MMP-9) serum levels and postoperative cognitive dysfunction in elderly patients after general anesthesia

Relationships between adiponectin and matrix metalloproteinase-9 (MMP-9) serum levels and postoperative cognitive dysfunction in elderly patients after general anesthesia

Neurological biomarkers in the perioperative period

Complement polymorphisms and cognitive dysfunction after carotid endarterectomy

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