Matrix metalloproteinase 2 (MMP-2) levels are increased in active acromegaly patients
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During follow-up of acromegaly patients, there is a discordance rate of 30% between the measurements of growth hormone and insulin-like growth factor-1 levels. Further tests are required to determine disease activity in patients with discordant results. This study was planned to investigate an association of serum levels of matrix metalloproteinase-2, matrix metalloproteinase-9, and cathepsin B with disease activity in acromegaly patients.
In this study, 64 acromegaly patients followed in our clinic were divided into two groups according to the 2010 consensus criteria for cure of acromegaly as patients with active disease (n = 24) and patients with controlled disease (n = 40). Serum matrix metalloproteinase-2, matrix metalloproteinase-9, and cathepsin B levels were measured by the enzyme-linked immunosorbent assay method.
The mean serum matrix metalloproteinase-2 level was significantly higher in the active acromegaly patients than in the controlled acromegaly patients (150.1 ± 54.5 ng/mL vs. 100.2 ± 44.6 ng/mL; p < 0.0001). There was no significant difference between the active and controlled acromegaly patients regarding serum matrix metalloproteinase-9 and cathepsin B levels (p = 0.205 and p = 0.598, respectively). Serum matrix metalloproteinase-2 levels of 118.3 ng/mL and higher had a sensitivity of 75% and a specificity of 77.5% in determining active disease. The risk of active acromegaly was 3.3 fold higher in the patients with a matrix metalloproteinase-2 level of >118.3 ng/mL than in the patients with a matrix metalloproteinase-2 level of <118.3 ng/mL.
In this study, serum matrix metalloproteinase-2 level is increased in the active acromegaly patients and a threshold value in determining active disease was defined for serum matrix metalloproteinase-2 level. This study is the first to compare acromegaly patients having active or controlled disease in terms of matrix metalloproteinase-2 and matrix metalloproteinase-9 levels. The results need to be confirmed by a study that will be conducted in a larger patient group also including a healthy control group to demonstrate the value of this novel marker in disease activity.
KeywordsAcromegaly Cathepsin B Matrix metalloproteinase-2 Matrix metalloproteinase-9
We thank Biochemistry Department for laboratory measurements of research assays. The research was funded by Research Fund of Kocaeli University.
Conflict of interest
The authors declare that they have no competing interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Medical Faculty of Kocaeli University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 2.S. Melmed, A. Colao, A. Barkan, M. Molitch, A.B. Grossman, D. Klienberg, D. Clemmons, P. Chanson, E. Laws, J. Schlechte, M.L. Vance, K. Ho, A. Giustina; Acromegaly Consensus Group., guidelines for acromegaly management: an update. J. Clin. Endocrinol. Metab. 94, 1509–1517 (2009)CrossRefGoogle Scholar
- 3.E.O. Machado, G.F. Taboada, L.V. Neto, F.R. van Haute, L.L. Corrêa, G.A. Balarini, Y. Shrank, M. Goulart, M.R. Gadelha, Prevalence of discordant GH and IGF-I levels in acromegalics at diagnosis, after surgical treatment and during treatment with octreotide LAR. Growth. Horm. IGF Res. 18, 389–393 (2008)CrossRefGoogle Scholar
- 15.M. Páez Pereda, M.F. Ledda, V. Goldberg, A. Chervín, G. Carrizo, H. Molina, A. Müller, U. Renner, O. Podhajcer, E. Arzt, G.K. Stalla, High levels of matrix metalloproteinases regulate proliferation and hormone secretion in pituitary cells. J. Clin. Endocrinol. Metab. 85, 263–269 (2000)PubMedGoogle Scholar
- 20.A.N. Paisley, C.J. O’Callaghan, K.C. Lewandowski, C. Parkinson, M.E. Roberts, W.M. Drake, J.P. Monson, P.J. Trainer, H.S. Randeva, Reductions of circulating matrix metalloproteinase 2 and vascular endothelial growth factor levels after treatment with pegvisomant in subjects with acromegaly. J. Clin. Endocrinol. Metab. 91, 4635–4640 (2006)CrossRefGoogle Scholar
- 21.G.A. Kanakis, A. Chrisoulidou, A. Bargiota, L. Efstathiadou, A. Papanastasiou, A. Theodoropoulou, S.K. Tigas, D.A. Vassiliadi, S. Tsagarakis, M. Alevizaki, The ongoing challenge of discrepant growth hormone and insulin-like growth factor I results in the evaluation of treated acromegalic patients: a systematic review and meta analysis. Clin. Endocrinol. (Oxf). 85, 681–688 (2016)CrossRefGoogle Scholar