The Correlation Between MMP-9 And Mac-2bp Of Single Small Subcortical Infarction In The Middle Cerebral Artery

BackgroundSingle small subcortical infarction(SSSI)is an etiologically heterogeneous disease.Single subcortical infarctions have been considered to be caused by small vessel disease and branch atheromatous disease.In acute SSSI diagnostics,DWI-MRI is still the procedure with the highest diagnostic quality.Matrix metalloproteinase-9(MMP-9)is the most widely studied enzyme in ischemic cerebral infarction,and its expression is rapidly upregulated after cerebral ischemia.As an emerging biomarker of cardiovascular disease,MAC-2binding protein(Mac-2bp)has been shown to be associated with ischemic cerebral infarction.MMP-9 and Mac-2bp are important biomarkers related to ischemic stroke.However,the investigation of the combination of them in SSSI has not been examined in previous studies,especially in the differentiation of etiological subgroups.ObjectiveSingle subcortical small infarction was classified by neuroimaging,and the changes of serum MMP-9and Mac-2bp in patients with acute stage under different SSSI classifications were investigated.We aimed to observe and describe the potential association between MMP-9 and Mac-2bp levels and the etiologic subtype of SSSI.And the clinical significance of the combined detection of MMP-9 and Mac-2bp as biological markers to judge SSSI classifications was also discussed.To provide a new basis and reference for the clinical classification of SSSI patients.MethodAccording to the inclusion and exclusion criteria,180 patient with acute SSSI admitted to the Department of Neurology Affiliated Zhengzhou People’s Hospital were prospectively recruited for nearly 2 years(between March 2019 and January 2021).SSSI patients were divided into three groups based on whether or not they were accompanied by carrier artery disease and infarct location on neuroimaging.Patients were divided into three groups,(1)SSSI associated with parent artery disease(SSSIPAD).(2)Proximal perforator disease without PAD(pSSSI-pad).(3)Distal perforator disease without PAD(dSSSIpad).Serum MMP-9 level and serum Mac-2bp level after 24 hours,72 hours,14 days were measured by enzyme linked immunosorbent assay(ELISA).At the same time,the detection of peripheral blood in 30 cases of healthy people,MMP-9 and Mac-2bp content as the control reference contrast,analysis of serum MMMP-9 and Mac-2bp content and its relation to the SSSI three groups,and their correlation was discussed.Results1.The results of this study reinforce the existence of distinct pathophysiological mechanisms in patients with SSSI,The characteristics of atherosclerosis in SSSIPAD group were obvious,the characteristics of small vessel disease in dSSSIPAD group were obvious,Patients with pSSSI-PAD showed intergroup characteristics,in which atherosclerosis characteristics may be greater.2.Relationship between MMP-9 andSSSI typing,Serum MMP-9 levels of all SSSI subtypes were significantly higher than those of the control group(P<0.05)within 24 h after onset.Serum MMP-9 level in SSSIPAD group and pSSSI-PAD group was significantly higher than that in dSSSI-PAD group.Serum MMP-9 level began to decline72 hours after admission,and reached the level of control group by 14 days after admission.Serological MMP-9 was higher in the dSSSI-PAD group at 24 hours of admission than in the control group and began to return to normal at 72 hours of admission.3.Relationship between Mac-2bp andSSSI typing Within 24 h after onset,serum Mac-2bp content of all SSSI subtypes was significantly higher than that of control group(P<0.05).The level of serum Mac-2bp in SSSIPAD group and pSSSI-PAD group was significantly higher than that in dSSSI-PAD group,and the level of serum Mac-2bp began to decline 72 hours after admission,and approached to the level of control group by 14 days after admission.Serological Mac-2bpwas higher in the dSSSI-PAD group than in the control group 24 hours after admission,and began to return to normal 72 hours after admission.4.Relationship between MMMP-9 and Mac-2bp,Serological level of MMP-9 was positively correlated with that of Mac-2bp within 24 hours,and the change trend was the same.ConclusionSSSI have different etiology and pathogenesis.SSSIPAD was associated with atherosclerosis.Patients in the dSSSI-PAD group had obvious characteristics of small vessel diseases.pSSSI-PAD patients had common features between the two groups,among which atherosclerosis was more characteristic.Serum MMP-9 and Mac-2bp increased in patients with SSSI,and the amplitude and change pattern were different among SSSI subtypes.Serum MMP-9 and Mac-2bp were positively related in 24 h in patients with acute SSSI,and the trend of change was similar.