特发性肺纤维化和结节病患者基质金属蛋白酶的变化及其临床意义

Objective To detect the levels of matrix metalloprotease(MMP)-1 and MMP-7 in the serum and the bronchoalveolar lavage fluid(BALF)of patients with idiopathic pulmonary fibrosis(IPF)and sarcoidosis(Stage Ⅱ),and therefore to investigate the significance of these changes in the pathogenesis of IPF. Methods Forty-four clinically confirmed cases of IPF were recruited,with the patients'age ranging from 46 to 70 years(58±9 years).Twenty patients with sarcoidosis,aged 35 to 65(50±12)years,were also studied.Enzyme-linked immunoabsorbent assay was used to detect the levels of MMP-1 and MMP-7 in the serum and the BALF samples. Results In the serum of patients with IPF,the level of MMP-1 3.78 (0.14-13.44) μLg/L]was lower than that in patients with sarcoidosis7.79(4.67-10.68)μg/L(z=-3.53,P<0.01)],but the level of MMP-77.83(3.57-14.37) μg/L]was higher than that in patients with sarcoidesis4.04(0.06-9.94)μg/L(z=-3.84,P<0.01)].In the BALF of patients with IPF,the level of MMP-1 1.09(0.04-5.14)μg/L]was lower than that in patients with sarcoidosis 2.08(0,05-4.16)μg/L(z=-1.53,P>0.05)],but the level of MMP-73.75(1.10-9.87)μg/L]was highet than that in patients with sarcoidosis1.16(0.02-4.47)μg/L(x=-5.33,P<0.01)].The serum level of MMP-7 in patients with IPF was negatively correlated with the diffusing capacity of carbon monoxide(r=-0.56,P<0.01)and the percentage of neutrophils(r=-0.47,P<0.01).The level of MMP-7 in the BALF showed a negative correlation with diffusing capacity of carbon monoxide(r=-0.31,P <0. 05). Conclusions The results suggest that MMP-1 may be increased in the inflammatory phase as compared to the matrix remodeling phase of lung fibrosis, while MMP-7 may be increased in the matrix remodeling phase rather than in the inflammatory phase. MMP-7 may act as an important indicator for the severity of IPF.

Change of matrix metalloproteinase-1 and matrix metalloproteinase-7 in serum and bronchoalveolar lavage fluid of patients with idiopathic pulmonary fibrosis and sarcoidosis