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PLoS One. 2017 Feb 13;12(2):e0171191. doi: 10.1371/journal.pone.0171191. eCollection 2017.

TIMP1 and MMP9 are predictors of mortality in septic patients in the emergency department and intensive care unit unlike MMP9/TIMP1 ratio: Multivariate model.

Author information

1
Department of Public Health, Medicine Program, Faculty of Health Sciences, Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia.
2
Department of Pharmacology, Medicine Program, Faculty of Health Sciences, Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia.
3
Microbiology and Inmunology Department, Medicine Program, Faculty of Health Sciences, Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia.
4
Biotechnology Department, Enterprise Technology Center, Fundación Cardiovascular de Colombia, Bucaramanga, Santander, Colombia.
5
Department of Medical Clinics, Emergency unit, Faculty of Medicine, Universidade de Sao Paulo, Ribeirao preto, Sao Paulo, Brazil.
6
Department of Internal Medicine, School Of Medicine, Universidad de Antioquia, Medellin, Antioquia, Colombia.
7
Department of Pharmacology, Faculty of Medicine, Universidade de Sao Paulo, Ribeirao preto, Sao Paulo, Brazil.
8
Departments of Pediatrics and Pharmacology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.

Abstract

INTRODUCTION:

Matrix metalloproteinases and tissue inhibitors of metalloproteinases could be promising biomarkers for establishing prognosis during the development of sepsis. It is necessary to clarify the relationship between matrix metalloproteinases and their tissue inhibitors. We conducted a cohort study with 563 septic patients, in order to elucidate the biological role and significance of these inflammatory biomarkers and their relationship to the severity and mortality of patients with sepsis.

MATERIALS AND METHODS:

A multicentric prospective cohort was performed. The sample was composed of patients who had sepsis as defined by the International Conference 2001. Serum procalcitonin, creatinine, urea nitrogen, C-Reactive protein, TIMP1, TIMP2, MMP2 and MMP9 were quantified; each patient was followed until death or up to 30 days. A descriptive analysis was performed by calculating the mean and the 95% confidence interval for continuous variables and proportions for categorical variables. A multivariate logistic regression model was constructed by the method of intentional selection of covariates with mortality at 30 days as dependent variable and all the other variables as predictors.

RESULTS:

Of the 563 patients, 68 patients (12.1%) died within the first 30 days of hospitalization in the ICU. The mean values for TIMP1, TIMP2 and MMP2 were lower in survivors, MMP9 was higher in survivors. Multivariate logistic regression showed that age, SOFA and Charlson scores, along with TIMP1 concentration, were statistically associated with mortality at 30 days of septic patients; serum MMP9 was not statistically associated with mortality of patients, but was a confounder of the TIMP1 variable.

CONCLUSION:

It could be argued that plasma levels of TIMP1 should be considered as a promising prognostic biomarker in the setting of sepsis. Additionally, this study, like other studies with large numbers of septic patients does not support the predictive value of TIMP1 / MMP9.

PMID:
28192449
PMCID:
PMC5305237
DOI:
10.1371/journal.pone.0171191
[Indexed for MEDLINE]
Free PMC Article

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