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Matrix Metalloproteinase-2 Protein in Lung Periphery Is Related to COPD Progression^*

^* From the Departments of Cardiac, Thoracic, and Vascular Sciences (Drs. Baraldo, Bazzan, Turato, Zuin, and Saetta, and Ms. Zanin), Experimental Biomedical Sciences (Dr. Garbisa), and Environmental Medicine and Public Health (Dr. Maestrelli), University of Padova, Padova, Italy; Department of Clinical and Experimental Medicine (Dr. Papi), University of Ferrara, Ferrara, Italy; National Institute of Research (Dr. Miniati), Institute of Physiology, Pisa, Italy; and Department of Oncology, Haematology and Respiratory Disease (Dr. Fabbri), University of Modena and Reggio Emilia, Modena, Italy.

Correspondence to: Marina Saetta, MD, FCCP, University of Padova, Department of Cardiac, Thoracic, and Vascular Sciences, Section of Respiratory Diseases, Via Giustiniani 3, Padova, Italy; e-mail: marina.saetta{at}unipd.it

Abstract

Background: There is increasing evidence that matrix metalloproteinases (MMPs) may contribute to the pathogenesis of COPD, but their role in humans is not completely understood. We performed this study to quantify the expression of MMP-2 in a population of COPD patients at different stages of severity.

Methods: We collected surgical specimens from 46 subjects, as follows: 10 smokers with severe COPD (Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage III-IV); 13 smokers with mild/moderate COPD (GOLD stage I-II); 12 control smokers; and 11 nonsmoking control subjects. We quantified MMP-2 expression in alveolar macrophages, alveolar walls, peripheral airways, and pulmonary arterioles by immunohistochemistry.

Results: In all compartments, MMP-2 expression was increased both in smokers with severe COPD and in smokers with mild/moderate COPD compared to control smokers and nonsmokers (p < 0.05 for all comparisons). Only in alveolar macrophages was MMP-2 expression increased in smokers with severe COPD compared to smokers with mild/moderate COPD (p = c0.002). Moreover, MMP-2 expression was inversely related to values of FEV₁/FVC ratio (p < 0.0001; r = –0.71) and PaO₂ (in millimeters of Hg) [p = 0.005; r = –0.49], and was positively related to emphysema score (p = 0.01; r = 0.65) and residual volume percent predicted (p = 0.04; r = 0.49). A stepwise increase in the total number of alveolar macrophages was observed in the four groups of subjects examined, with the highest value in those with severe COPD.

Conclusion: This study shows that MMP-2 expression in the lung periphery progressively increases as lung function worsens and the degree of emphysema increases. These results suggest that MMP-2 may be a key mediator of the mechanisms leading to lung tissue remodeling and inflammation in patients with severe COPD.

Key Words: airflow limitation • cigarette smoking • emphysema • extracellular matrix • inflammation

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