Document Detail


Serum metalloproteinases MMP-2, MMP-9, and metalloproteinase tissue inhibitors in patients are associated with arteriovenous fistula maturation.
MedLine Citation:
PMID:  21620625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Many vascular surgeons construct arteriovenous fistulas (AVFs) for hemodialysis access as the primary choice access. A significant number of AVFs fail to mature, however, leading to patient frustration and repeated operations. Metalloproteinase (MMP) activity, particularly MMP-2 and MMP-9, may be important for AVF maturation. We therefore sought to identify whether serum MMP levels could serve as a biomarker for predicting future successful AVF maturation.
METHODS: Blood was collected from patients with chronic renal insufficiency at the time of surgery for long-term hemodialysis access. Serum was separated from whole blood and ultracentrifuged at 1000g for 10 minutes. Serum aliquots were frozen at -80°C until used for analysis. Enzyme-linked immunosorbent assay was used to assay levels of MMP-2, MMP-9, and tissue inhibitor of metalloproteinase type 2 (TIMP-2), and TIMP type 4 (TIMP-4). Clinical end points were used to divide patients into failed and matured AVF groups. Successful maturation was considered in patients who had specific duplex findings or 1 month of successful two-needle cannulation hemodialysis. MMP/TIMP ratios were calculated as an index of the MMP axis activity because MMP activity parallels alterations in TIMP levels.
RESULTS: Of 20 enrolled patients, AVF maturation was successful in 13 and failed in 7. Serum levels of MMP-2/TIMP-2 were significantly higher in patients with matured AVFs vs levels in those that failed (P = .003). Similarly, a trend toward increased serum levels of MMP-9/TIMP-4 was found in patients with successful AVF (P = .06).
CONCLUSIONS: MMP-2 and TIMP-2 levels were different among patients whose AVF matured vs those who did not. Further follow-up studies to determine the predictability of AVF maturation using relative patient serum levels of MMP-2 and TIMP-2 should be performed.
Authors:
Eugene S Lee; Qiang Shen; Robert L Pitts; Mingzhang Guo; Mack H Wu; Sue C Sun; Sarah Y Yuan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-05-28
Journal Detail:
Title:  Journal of vascular surgery     Volume:  54     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-08-08     Completed Date:  2011-10-24     Revised Date:  2014-09-12    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  454-9; discussion 459-60     Citation Subset:  IM    
Copyright Information:
Published by Mosby, Inc.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arteriovenous Shunt, Surgical* / adverse effects
Biological Markers / blood
California
Chi-Square Distribution
Enzyme-Linked Immunosorbent Assay
Humans
Matrix Metalloproteinase 2 / blood*
Matrix Metalloproteinase 9 / blood*
Middle Aged
Prospective Studies
Renal Dialysis*
Renal Insufficiency, Chronic / blood,  enzymology,  therapy*
Time Factors
Tissue Inhibitor of Metalloproteinase-2 / blood*
Tissue Inhibitor of Metalloproteinases / blood*
Treatment Outcome
Ultrasonography, Doppler, Duplex
United States
United States Department of Veterans Affairs
Up-Regulation
Grant Support
ID/Acronym/Agency:
HL061507/HL/NHLBI NIH HHS; HL070752/HL/NHLBI NIH HHS; HL096640/HL/NHLBI NIH HHS; R01 GM097270/GM/NIGMS NIH HHS; R01 HL061507/HL/NHLBI NIH HHS; R01 HL061507-12/HL/NHLBI NIH HHS; R01 HL070752/HL/NHLBI NIH HHS; R01 HL070752-10/HL/NHLBI NIH HHS; R01 HL096640/HL/NHLBI NIH HHS; R01 HL096640-03/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/TIMP2 protein, human; 0/Tissue Inhibitor of Metalloproteinases; 0/tissue inhibitor of metalloproteinase-4; 127497-59-0/Tissue Inhibitor of Metalloproteinase-2; EC 3.4.24.24/MMP2 protein, human; EC 3.4.24.24/Matrix Metalloproteinase 2; EC 3.4.24.35/Matrix Metalloproteinase 9
Comments/Corrections

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