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Clinical significance of matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 and 2 in Kawasaki disease

Korean Journal of Pediatrics 2010;53(4):510-518.
Published online April 15, 2010.
Clinical significance of matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 and 2 in Kawasaki disease
Ki Wook Yun1, Sin Weon Sin1, Jung Ju Lee1, Soo Ahn Chae1, In Seok Lim1, Eung Sang Choi1, Byoung Hoon Yoo1, Mi-Kyung Lee2
1Department of Pediatrics, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
2Department of Laboratory Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Ko
가와사끼병에서 Matrix metalloproteinase 9과 Tissue inhibitor of metalloproteinase 1, 2의 임상적 중요성
윤기욱1, 윤신원1, 이정주1, 채수안1, 임인석1, 최응상1, 유병훈1, 이미경2
1중앙대학교 의과대학 소아과학교실
2중앙대학교 의과대학 진단검사의학과
Correspondence: 
Sin Weon Sin, Email: yswmd@cau.ac.kr
Abstract
Purpose
: Kawasaki disease (KD) is a systemic vasculitis, a leading cause of pediatric acquired heart disease. Histopathological findings of coronary artery lesion (CAL) in KD indicate destruction of the coronary artery wall with diffuse vasculitis. Matrix metalloproteinases (MMPs) and their endogenous tissue inhibitors (TIMPs) might play central roles in this process. Special attention to MMP-9 has recently been emerging. This study was performed to investigate the clinical significance of MMP-9 and its inhibitors, TIMP-1 and TIMP-2, in KD.
Methods
: We compared 47 KD patients with 14 febrile controls. Serum MMP-9 and TIMP-1, TIMP-2 were measured by ELISA and compared according to clinical stages and coronary involvement.
Results
: In acute stage, MMP-9 and TIMP-1 were significantly higher, whereas TIMP-2 was lower, in KD than those in febrile controls (P <0.05). The elevated MMP-9 levels in acute phase significantly decreased during the subacute and convalescent phases (P <0.05). During acute phase, the MMP-9, TIMP-1, and MMP-9/TIMP-2 levels in the CAL group were lower than those in the non-CAL group, but they increased significantly in the subacute phase (P <0.05). MMP-9 has a positive correlation with TIMP-1 in the acute and subacute phases, and negative correlation with TIMP-2 in the subacute and convalescent phases (P <0.05).
Conclusion
: These results suggest that MMP-9, TIMP-1, and the imbalance in MMP-9 and TIMP-2 might play important roles on the pathophysiology of KD and especially on the development of CAL. However, further larger studies are needed.
Key Words: Kawasaki disease, Matrix metalloproteinase, Tissue inhibitor of metalloproteinases, Coronary vessels


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