THE ROLE OF MATRIX METALLOPROTEINASES AND THEIR TISSUE INHIBITORS IN THE DEVELOPMENT OF COMPLICATIONS OF KIDNEY DISEASE IN CHILDREN

Abstract

The relevance of studying the role of matrix metalloproteinases (MMP) and tissue inhibitors (TIMP) in the pathology of the urinary system is determined, by the significant prevalence, prone to recurrent course of kidney disease in children. It is known that MMP-1 has pro-inflammatory action, MMP-2 and MMP-9 inhibits inflammation. TIMP-1 and TIMP-2 restricted cleavage of collagen. Disbalance between MMP and TIMP accompanied by the accumulation of extracellular matrix, increases the risk of chronic renal failure.The purpose of the study – to assess the role of MMP and TIMP involved in the processes of inflammation and resulting to renal dysfunction in glomerulonephritis and pyelonephritis in children.Material and methods. Surveyed of 15 children with a diagnosis of acute glomerulonephritis, 25 – chronic glomerulonephritis, 40 – chronic obstructive secondary pyelonephritis and 20 healthy children. In the group of patients with chronic glomerulonephritis renal function was impaired in 10 patients with chronic pyelonephritis – in 20 patients. The content of MMP-1, -2, -9 and TIMP-1, TIMP-2 in the serum of children was determined by ELISA.Results. It was found that in acute and chronic glomerulonephritis in children increases the content of MMP-1, MMP-2 is almost not changed, while the content of MMP-9 is reduced, which characterizes the presence of inflammation. In chronic pyelonephritis in a more pronounced reduction of MMP-9, antiinflammatory. The most significant changes were found in patients with impaired renal function. In all groups of patients experienced an increase in the level of TIMP-1 and TIMP-2.Conclusion. Thus, increasing the level of tissue inhibitors, elevated levels of MMP-1, decreased MMP-9, contributes to the progression of the disease and the development of inflammation and the accumulation of extracellular matrix proteins of interstitial kidney tissue, resulting in sclerotic and fibrotic changes.