All issues > Volume 53(4); 2010

Original Article

Korean J Pediatr. 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 KW Yun¹, Sin Weon SW Sin¹, Jung Ju JJ Lee¹, Soo Ahn SA Chae¹, In Seok IS Lim¹, Eung Sang ES Choi¹, Byoung Hoon BH Yoo¹, Mi-Kyung MK 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

Correspondence Sin Weon SW 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.

Keywords :Kawasaki disease, Matrix metalloproteinase, Tissue inhibitor of metalloproteinases, Coronary vessels