Serum matrix metalloproteinase-9 and tissue inhibitor of 3tetalloproteinase-1 in Egyptian patients with chronic liver disease: correlation with liver fibrosis

ABSTRACT

Chronic liver disease of different etiologies leads to cirrhosis. The main pathological mechanism of progression to cirrhosis is fibro genesis. Recognition of liver fibrosis or cirrhosis is difficult without liver biopsy. There is an urgent demand for a noninvasive reliable serum marker for liver fibrosis. Alterations in circulating matrix metalloproteinase-9 [MMPs] and tissue inhibitor of metalloproteinase-1 [TIMPs] concentrations and their correlation to the inflammatory activity and the histological changes are fairly well established, thus, the rationale of the present study was to evaluate the relationship between serum MMP-9, and TIMP-1 to liver status in patients with chronic liver disease. This study included 50 patients with chronic liver disease, 18 patients with chronic hepatitis, 22 patients with liver cirrhosis and 10 patients with hepatocellular carcinoma [HCC]. Twenty matched age and sex healthy volunteers were enrolled as control group. The obtained data showed that the lowest serum level of MMP-9 was found in chronic hepatitis patients compared to the control [P<0.05]. The MMP-9 serum level decreased during progression of chronic hepatitis to cirrhosis showing the least level in cirrhotic group. The serum TIMP-1 level was significantly higher in cirrhotic group compared to chronic hepatitis [P<0.05] and control [P<0.001] groups. Serum MMP-9 was negatively correlated to both the TIMP-1 level and to the histological severity of chronic hepatitis. There was a positive correlation between serum TIMP-1 and degree of fibrosis [r= 0.73, P< 0.001]. There were a statistically significant increase of MMP-9 [Pc0.001] and TIMP-l [Ppatients compared with normal controls, chronic hepatitis and liver cirrhosis patient groups.

Conclusion:

Serum TIMP-1 is positively correlated with liver fibrosis scoring. It can be used as a non-invasive assay in differential diagnosis of chronic hepatopathies with and without cirrhosis when liver biopsy is contraindicated. Serum MMP-9 level can be used as a useful index for differentiating the HCC patients from other hepatopathies