Matrix metalloproteinase 2 may be associated with CKD progression
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Key takeaways:
- Persistently elevated matrix metalloproteinase 2 of increased risk of CKD progression.
- wmodified by inflammation and proteinuria.
Matrix metalloproteinase 2 may be associated with the progression of chronic kidney disease, especially in patients with low inflammation or with proteinuria, data show.
“Matrix metalloproteinase 2 (MMP-2), or gelatinase A, is a zinc-containing, matrix-degrading protease that regulates key cellular events relating to fibrosis. MMP-2 has been identified as a biomarker that is prognostic of fibrosis on biopsy, and higher levels of MMP-2 have been found in those with CKD,” Robin L. Baudier, MSPH, of Tulane University School of Public Health and Tropical Medicine in New Orleans, wrote with colleagues.
“MMP-2 has also been found to be associated with longitudinal decline in kidney function as measured by eGFR in nondiabetic, nonproteinuric patients with coronary artery disease and CKD and in prospective kidney disease interventional studies of patients with type 2 diabetes.”
In a prospective cohort of Chronic Renal Insufficiency Cohort participants with CKD, Baudier and colleagues measured MMP-2 at baseline and at 2 years to assess the relationship between repeated measures of MMP-2 and CKD progression. Overall, 3,827 patients were followed in the multicenter study for a median of 4.6 years from year 2 and 6.9 years from baseline.
According to the results, persistently elevated MMP-2 of at least 300 ng/mL at baseline and at year 2 was linked with an increased risk of CKD progression after adjusting for covariates.
Baudier and colleagues found the relationship between elevated MMP-2 and CKD progression was modified by levels of inflammation and proteinuria with a 2.6 times higher rate of the composite kidney endpoint in patients with high-sensitivity C-reactive protein of less than 2.5 g/dL at the start of the study.
Heterogeneity of effect was found with proteinuria, with a baseline MMP-2 level of at least 300 ng/mL being linked to an increased risk of the CKD progression.
“Future investigations should confirm if elevation of the fibrosis marker MMP-2 relates to an increased risk of CKD progression among these subgroups of patients with CKD, according to the researchers. “Further mechanistic studies identifying MMP-2’s role in specific proteinuric CKD pathways are warranted.”
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