Matrix metalloproteinases and their inhibitors in different acute stroke subtypes

The aim of the study was to determine serum levels of selected matrix metalloproteinases ( MMPs) and their natural inhibitors ( TIMPs) in the acute phase of different stroke types subdivided according to the Oxfordshire Community Stroke Project ( OCSP) classification and the possibility of discriminating stroke types according to their levels. The study included 126 patients with acute stroke within the first 24 h of symptom onset, and 124 healthy volunteers. The stroke group had lower MMP-2 concentrations and MMP-2/TIMP-2 ratios ( p<0.001) but higher TIMP-2 ( p<0.001) than controls. The level of MMP-9 and the MMP-9/TIMP-1 ratio were higher in patients with total anterior circulation infarct ( TACI) than in patients with other stroke subtypes according to OCSP classification ( p=0.0019, p=0.0065, respectively) or in controls ( p<0.0001, p=0.0024, respectively). A negative correlation of MMP-2 levels with MMP-9 and MMP-9/TIMP-1 ratio was recorded in all stroke subtypes except for TACI. Receiver operating characteristic analysis showed similar discriminating power for MMP-9 levels and Barthel index in the differential diagnosis of TACI. High MMP-9/TIMP-1 ratio ( odds ratio 3.263) was associated with TACI. Our results demonstrate that the MMP-9/TIMP-1 ratio may provide information to help in assessing stroke patients in the future as a baseline biomarker of infarct extent.