The Experimental Study On The Relationship Of Blood Serum Matrix Metalloproteinase-9 And Tissue Inhibitors Of Metalloproteinase-1 Levels With The Disease Progresses Of IgA Nephropathy And Lupus Nephritis

Background: Mesangial cell proliferation and matrix expansion characterize many types of glomerulonephritis(GN). MMPs and TIMPs are expressed in both experimental and human GN in which extracellular matrix deposition occurs. suggest that these factors may have an important role in aggravating these changes. We Observated a certin effective on treatment of IgA nephropathy(IgAN) with Yangyinhuoxie Decoction combining with Western medicine.However, it is not known how the microenvironment in vivo changes under the treatment.Objectives: To determine the relationship of serum matrix metalloproteinase-9 (MMP-9)and tissue inhibitors of metalloproteinase-1 (TIMP-1) levels with the disease progress of IgAN and lupus nephritis(LN).To observe the changes of MMP-9 and TIMP-1 levels in blood serum of IgAN under the treatment of Yangyinhuoxie Decoction combining with Western medicine.Methods: Serum levels of MMP-9 and TIMP-1 were measured by ELISA in 33 patients with IgAN,27 with LN,20 healthy subjects as controls. Analyze the MMP-9 and TIMP-1 levels in different Lee fractionations of IgAN patients,and compare the levels in active phase of LN with inactive phase. Analyze the changes of 24hU-pro,RBC in urine and Ccr,Scr,MMP-9,TIMP-1 in serum of IgAN patients under the treatment of Yangyinhuoxie Decoction combining with Western medicine.Results: (1)Significantly increased serum levels of MMP-9 and TIMP-1,MMP-9/ TIMP-1 were found in the IgAN and the LN patients as compared with the healthy controls(P<0.01) ,obviously in IgAN. (2) Serum levels of MMP-9 were increased by degrees from II to IV class of IgAN,and the maximal level was in IV class。TIMP-1 levels also had a going up trend from II to V class,MMP-9/ TIMP-1in IV class is notably higher than II and III classes(P<0.05).(3) The levels MMP-9,TIMP-1 and MMP-9/ TIMP-1 in active phase of LN were much higher than those in inactive phase. (4)Ccr of the IgAN patients were Significantly improved after the treatment of Yangyinhuoxie Decoction combining with Western medicine(P<0.01),24hU-pro,RBC in urine and Ccr,Scr,MMP-9,MMP-9/TIMP-1 in serum were reducted after the treatment(P<0.05).CONCLUSIONS: MMP-9 and TIMP-1 were expressed in vivo in a variety of inflammatory conditions associated with increased deposition of extracellular matrix, aggravated the fibroproliferative responses that characterize these inflammatory disorders.This suggests that MMP-9 and TIMP-1 may have a central role in proliferative glomerular disease. treatment of IgA nephropathy ( IgAN ) with Yangyinhuoxie Decoction combining with Western medicine may prevente the increased deposition of extracellular matrix by reducing the MMP-9/TIMP-1 in serum.