Donor spontaneous intracerebral hemorrhage is associated with systemic activation of matrix metalloproteinase-2 and matrix metalloproteinase-9 and subsequent development of coronary vasculopathy in the heart transplant recipient.

Abstract

BACKGROUND:

Matrix metalloproteinase (MMP)-2 and MMP-9 have been shown to play a role in the progression of hemorrhagic stroke. We hypothesized that donor intracerebral hemorrhage (ICH) is associated with activation of the metalloproteinases before transplantation that play a key role in the subsequent development of transplant vasculopathy.

METHODS AND RESULTS:

We evaluated mRNA expressions of MMP-2 and MMP-9 in donor spleen lymphocytes (before transplantation) and in heart biopsies at 1 week after transplantation in 20 recipients from ICH donors and 20 recipients from trauma donors. Patients underwent serial coronary intravascular ultrasound, and interstitial myocardial fibrosis was quantified at 1 year. The baseline characteristics were similar except for increased donor age in the ICH group. Heart biopsies from the ICH group showed significant increased expression of MMP-2 (17-fold, P<0.0001) and MMP-9 (20-fold, P<0.0001) compared with the trauma group. Furthermore, the ICH group showed 1.8-fold (P=0.016) increased mRNA expression of MMP-2 and 1.7-fold (P=0.015) increased mRNA expression of MMP-9 in the donor spleen lymphocytes, suggesting the presence of systemic activation of metalloproteinases before transplantation. At 1 year, the ICH group showed increased myocardial fibrosis and accelerated coronary vasculopathy. Using multivariate regression analysis, MMP-9 was found to be associated with increased risk for vasculopathy independent of donor age (OR, 2.41; P=0.01; 95% CI, 1.24 to 4.69).

CONCLUSIONS:

This is the first report to describe systemic activation of MMP-2 and MMP-9 in donors with intracerebral hemorrhage and subsequent development of allograft vasculopathy.

• Authors: Mohamad H Yamani, Randall C Starling, Daniel J Cook, E Murat Tuzcu, Ashraf Abdo, Philip Paul, Kimerly Powell, Norman B Ratliff, Yang Yu, Patrick M McCarthy, James B Young
• Journal: Circulation (Circulation) Vol. 108 Issue 14 Pg. 1724-8 (Oct 07 2003) ISSN: 1524-4539 [Electronic] United States
• PMID: 12975253 (Publication Type: Journal Article)

Chemical References

• RNA, Messenger
• Matrix Metalloproteinase 2
• Matrix Metalloproteinase 9

Topics

• Adult
• Cerebral Hemorrhage (complications, enzymology, genetics)
• Coronary Disease (enzymology, etiology, pathology)
• Coronary Vessels (diagnostic imaging, pathology)
• Enzyme Activation
• Female
• Heart Transplantation
• Humans
• Male
• Matrix Metalloproteinase 2 (genetics, metabolism)
• Matrix Metalloproteinase 9 (genetics, metabolism)
• Middle Aged
• RNA, Messenger (metabolism)
• Tissue Donors
• Ultrasonography