In GOLD 2017 updated report was pointed that lung function level does not depend on patients’ category of future risk. That is why continuing of COPD additional risk precursors discussion is still actual.
COPD is associated with increased numbers of inflammatory cells and fibroblasts and the up-regulation of proteases such as matrix metalloproteinases (MMPs) resulting in fibrosis of small airways and destruction of the parenchyma. But these markers also constitute innovative direct or indirect targets to modify cardiovascular tissue remodelling in atherosclerosis and heart failure. That is why it is important to understand could really MMP-2 and MMP-9 be markers of bronchial inflammation including patients with COPD.
The aim of our work was to determine the role of initial and dynamic levels of inflammatory markers MMP-2 and MMP-9 as indicators of COPD severity, stability and treatment effectiveness.
We observe patients with verified stable COPD. The levels of MMP-2 and -9 in plasma were determined by ELISA. Investigations were done firstly on screening (visit 1). Then correction of basic anti-inflammatory treatment was done according to national and European guidelines. Repeated studies were done on visit 2 (after 3 months of basic treatment), on visit 3 (after 6 months of basic treatment), on visit 4 (after 12 months of regular basic treatment). Comparison group was patients with verified cardiac disease. Control group was healthy people).
In general levels of inflammatory markers MMP-2 and MMP-9 in COPD patients on visit 1 were significantly higher than in control group, but in subgroups they were almost identical. After 3 months of adequate treatment level of MMP-2 dropped slightly, kept at this level for six months, and in one year it decreased significantly and reached the level of the control group. On the base of regular treatment both MMP-2 and MMP-9 decreased from visit to visit and after 12 month they have been normalized. This fact indicates that these markers could be parameters of effective basic treatment in patients with COPD.
Increasing of such inflammatory biomarkers as MMP-2 and MMP-9 are useful index of COPD which indicates on needing of regular basic treatment and dynamic decreasing and normalizing of MMP-2 and MMP-9 during basic treatment are signs of successful therapy during their long-term follow-up.