Matrix metalloproteinase-9 in the ventricular cerebrospinal fluid correlated with the prognosis of traumatic brain injury

Abstract

AIM: Matrix metalloproteinase 9 (MMP-9) has been shown to be a potential biomarker for outcome prediction after neuron damage. This study investigated whether MMP-9 could be used for outcome prediction after traumatic brain injury (TBI). MATERIAL and METHODS: For the TBI group, cerebrospinal fluid (CSF) was collected at different days after surgery from 6 head injury patients who had received surgical intervention with external ventricular drainage insertion. CSF collected from non-TBI patients (N=85) diagnosed with isolated hydrocephalus by a ventricular puncture during a ventriculo-peritoneal shunt surgery was used as control. RESULTS: The mean concentration of MMP-9 in the CSF of 85 non-TBI patients was determined to be 1.172±0.859 ng/mL. We found that the CSF MMP-9 concentration from TBI patients was elevated immediately after head injury with a median of 1.926 ng/mL (range, 0.673 to 24.990). Despite an early increase in the concentration of MMP-9, levels decreased within 72 hrs and nearly reached the normal range. Nevertheless, the concentration of MMP-9 was negatively correlated with the Glasgow Coma Scale (γ = - 0.337, p = 0.013). CONCLUSION: MMP-9 concentration in the CSF of TBI patients correlated with neurological outcome and may represent an early indicator for the prognosis of this condition.