Association of Serum MMP-9 Level and Lung Function in New Pulmonary Tuberculosis Case

Abstract

Background: Histopathological abnormalities of pulmonary tuberculosis (TB) include caseous granuloma formation, tissue damage, and cavity formation, all of which could lead to per-manent changes in the pulmonary anatomy. In pulmonary TB, an increase in serum Matrix Metallo-proteinase (MMP)-9 correlates with disease severity and worse prognosis. This study aims to ana-lyze the association between serum MMP-9 levels and the values of FVC, FEV1, and FEV1/FVC. Methods: A cross-sectional study involving patients with pulmonary tuberculosis was conducted at the Tuberculosis Outpatient Clinic, Dr. Soetomo Academic Hospital, Surabaya, Indonesia. Spirome-try and serum MMP-9 levels were examined in new pulmonary TB patients prior to anti-tuberculosis therapy. The relationship between serum MMP-9 levels and results of spirometry ex-amination was then analyzed. Results: There were 44 new pulmonary TB cases with a mean age of 37.90 ± 15.15 years. The pa-tients who experienced symptoms in <1 month were 20.5%, ≥ 1 month were 59.1%, and ≥ 2 months were 20.4%. The mean MMP-9 serum level was 11.27 ± 5.47 ng/ml. Spirometry results were: FVC 1.83 ± 0.69 L, FVC predicted 56.24 ± 18.74%, FEV1 1.71 ± 0.72 L/sec, FEV1 predicted 60.85 ± 21.30%, and FEV1/FVC 104.16 ± 17.45%. In pulmonary TB patients with symptoms experienced in <1 month, a significant relationship between MMP-9 and FVC levels was found with r = -0.839 (p = 0.005). Conclusion: There is a correlation between serum MMP-9 level and restrictive pulmonary impair-ment in new pulmonary TB cases with symptoms experienced in <1 month.