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Relationship between pulmonary matrix metalloproteinases and quantitative CT markers of small airways disease and emphysema in COPD
  1. Kristoffer Ostridge1,2,
  2. Nicholas Williams1,2,
  3. Viktoriya Kim1,2,
  4. Michael Bennett1,
  5. Stephen Harden3,
  6. Lindsay Welch1,
  7. Simon Bourne2,
  8. Ngaire A Coombs4,
  9. Paul T Elkington1,2,
  10. Karl J Staples2,5,
  11. Tom MA Wilkinson1,2,5
  1. 1Southampton NIHR Respiratory Biomedical Research Unit, Southampton General Hospital, Southampton, UK
  2. 2Department of Clinical & Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK
  3. 3Department of Radiology, University Hospital Southampton, Southampton General Hospital, Southampton, UK
  4. 4Department of Primary Care & Population Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK
  5. 5Wessex Investigational Sciences Hub, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK
  1. Correspondence to Dr Tom Wilkinson, Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Sir Henry Wellcome Laboratories, Southampton General Hospital, Mailpoint 810, Tremona Road, Southampton SO16 6YD, UK; t.wilkinson{at}soton.ac.uk

Abstract

Background Matrix metalloproteinases (MMPs) are proteolytic enzymes that can degrade the extracellular matrix and drive tissue remodelling, key processes in the pathogenesis of COPD. The development of small airway disease has been identified as a critical mechanism in the early development of airflow obstruction but the contribution of MMPs in human disease is poorly characterised.

Objectives We investigated the role of MMPs and inflammatory cytokines in the lung by quantifying levels and determining relationships with the key pathological components of COPD in patients and healthy controls.

Methods We analysed levels of MMPs and inflammatory cytokines in bronchoalveolar lavage from 24 COPD and 8 control subjects. Each subject underwent spirometry and high-resolution CT. Image analysis quantitatively assessed emphysema, bronchial wall thickening and small airways disease.

Results Multiple MMPs (MMP-1, -2, -3, -8, -9 and -10) and cytokines (interleukin (IL) 6 and IL-8) were elevated in lungs of subjects with COPD. MMP-3, -7, -8, -9, -10 and -12 concentrations closely associated with CT markers of small airways disease. Emphysema severity was also associated with MMP-3, -7 and -10. However, there were no strong relationships between MMPs and bronchial wall thickness of the larger airways.

Conclusions Pulmonary MMP concentrations are directly associated with the extent of gas trapping and small airways disease identified on CT scan. This study suggests that MMPs play a significant role in small airways remodelling, a key feature in the pathogenesis of COPD.

Trial registration number NCT01701869

  • COPD ÀÜ Mechanisms
  • Lung Proteases
  • Imaging/CT MRI etc
  • Emphysema

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