Serial change of Matrix Metalloproteinases (MMPs) and their inhibitors in Kawasaki Disease (KD)

  • Dr Sin-Weon Yun, Department of Pediatrics, College of Medicine, Chung-Ang University, Korea
  • Dr Mi Kyung Lee, Department of Laboratory Medicine, College of Medicine, Chung-Ang University, Korea
  • Dr Jung-Ju Lee, Department of Pediatrics, College of Medicine, Chung-Ang University, Korea
  • Dr Soo-Ahn Chae, Department of Pediatrics, College of Medicine, Chung-Ang University, Korea
  • Dr In-Seok Lim, Department of Pediatrics, College of Medicine, Chung-Ang University, Korea
  • Dr Dong-Keun Lee, Department of Pediatrics, College of Medicine, Chung-Ang University, Korea
  • Dr Eung-Sang Choi, Department of Pediatrics, College of Medicine, Chung-Ang University, Korea
  • Dr Byoung- Hoon Yun, Department of Pediatrics, College of Medicine, Chung-Ang University, Korea

    • Objective: Histopathological findings of coronary artery lesion (CAL) in KD indicate destruction of coronary artery wall with diffuse vasculitis. Matrix Metalloproteinases (MMPs) and their endogenous tissue inhibitors of MMPs (TIMPs) play central roles in this process. This study was performed to investigate the pathophysiologic role of MMPs and TIMPs in KD.
    Methods: We compared 48 patients with typical KD and 15 control group. Serum MMP1, 2, 9 and TIMP1, 2 were measured by ELISA and compared accordong to clinical stages, responsiveness to IVIG and cardiac involvement.
    Results: In acute stage MMP2, MMP9, TIMP1, TIMP2 were significantly increased in KD than febrile control (P<0.05). MMP1 and MMP1/TIMP1 are significantly increased into subacute phase, and significantly decreased into convalescent phase(P<0.05). MMP2 and MMP2/TIMP2 expressions are significantly lower in acute phase and significantly elevated into subacute and convalescent phase(P<0.05). Acute MMP9 levels are significantly decreased into subacute and convalescent phase(P<0.05). In acute phase, CAL group, MMP1, TIMP1 were lower than non CAL group, but, significantly increased in the subacute phase(P<0.05). In the CAL group, MMP1/TIMP1 ratio was persistently increased into convalescent phase(P<0.05).
    MMPs and TIMPs has positive correlation with total WBC count and CRP and negative correlation with hemoglobin level and albumin level in the subacute phase(P<0.05).
    Conclusions: These results suggest MMPs and MMP/TIMP might play an important role in the pathophysiology of KD and IVGG responsiveness and CAL. However further larger study will be needed.