Title |
Unbalanced Metalloproteinase-9 and Tissue Inhibitors of Metalloproteinases Ratios Predict Hemorrhagic Transformation of Lesion in Ischemic Stroke Patients Treated with Thrombolysis: Results from the MAGIC Study
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Published in |
Frontiers in Neurology, May 2015
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DOI | 10.3389/fneur.2015.00121 |
Pubmed ID | |
Authors |
Benedetta Piccardi, Vanessa Palumbo, Mascia Nesi, Patrizia Nencini, Anna Maria Gori, Betti Giusti, Giovanni Pracucci, Paolina Tonelli, Eleonora Innocenti, Alice Sereni, Elena Sticchi, Danilo Toni, Paolo Bovi, Mario Guidotti, Maria Rosaria Tola, Domenico Consoli, Giuseppe Micieli, Rossana Tassi, Giovanni Orlandi, Francesco Perini, Norina Marcello, Antonia Nucera, Francesca Massaro, Maria Luisa DeLodovici, Giorgio Bono, Maria Sessa, Rosanna Abbate, Domenico Inzitari |
Abstract |
Experimentally, metalloproteinases (MMPs) play a detrimental role related to the severity of ischemic brain lesions. Both MMPs activity and function in tissues reflect the balance between MMPs and tissue inhibitors of metalloproteinases (TIMPs). We aimed to evaluate the role of MMPs/TIMPs balance in the setting of rtPA-treated stroke patients. Blood was taken before and 24-h after rtPA from 327 patients (mean age 68 years, median NIHSS 11) with acute ischemic stroke. Delta median values of each MMP/TIMP ratio [(post rtPA MMP/TIMP-baseline MMP/TIMP)/(baseline MMP/TIMP)] were analyzed related to symptomatic intracranial hemorrhage (sICH) according to NINDS criteria, relevant hemorrhagic transformation (HT) defined as confluent petechiae within the infarcted area or any parenchymal hemorrhage, stroke subtypes (according to Oxfordshire Community Stroke Project) and 3-month death. The net effect of each MMP/TIMP ratio was estimated by a logistic regression model including major clinical determinants of outcomes. Adjusting for major clinical determinants, only increase in MMP9/TIMP1 and MMP9/TIMP2 ratios remained significantly associated with sICH (odds ratio [95% confidence interval], 1.67 [1.17-2.38], p = 0.005; 1.74 [1.21-2.49], p = 0.003, respectively). Only relative increase in MMP9/TIMP1 ratio proved significantly associated with relevant HT (odds ratio [95% confidence interval], 1.74 [1.17-2.57], p = 0.006) with a trend toward significance for MMP9/TIMP2 ratio (p = 0.007). Our data add substantial clinical evidence about the role of MMPs/TIMPs balance in rtPA-treated stroke patients. These results may serve to generate hypotheses on MMPs inhibitors to be administered together with rtPA in order to counteract its deleterious effect. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Switzerland | 1 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 33 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 6 | 18% |
Professor > Associate Professor | 6 | 18% |
Student > Ph. D. Student | 4 | 12% |
Student > Master | 3 | 9% |
Other | 2 | 6% |
Other | 4 | 12% |
Unknown | 8 | 24% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 12 | 36% |
Biochemistry, Genetics and Molecular Biology | 3 | 9% |
Agricultural and Biological Sciences | 3 | 9% |
Neuroscience | 3 | 9% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 3% |
Other | 1 | 3% |
Unknown | 10 | 30% |