Brief Article
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World J Gastroenterol. Jul 28, 2013; 19(28): 4590-4595
Published online Jul 28, 2013. doi: 10.3748/wjg.v19.i28.4590
Increased expression of matrix metalloproteinase-9 associated with gastric ulcer recurrence
Sen-Lin Li, Jing-Run Zhao, Xiao-Yan Ren, Jia-Ping Xie, Qing-Zhu Ma, Qiu-Hua Rong
Sen-Lin Li, Jing-Run Zhao, Jia-Ping Xie, Qing-Zhu Ma, Qiu-Hua Rong, Department of Gastroenterology, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
Xiao-Yan Ren, Central Laboratory, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
Author contributions: Li SL and Zhao JR contributed equally to this study; Li SL and Zhao JR designed this study; Ren XY, Xie JP, Ma QZ and Rong QH contributed to performance of this study; all the authors contributed to the writing and revision of the manuscript.
Correspondence to: Dr. Jing-Run Zhao, Department of Gastroenterology, Liaocheng People’s Hospital, Dongchang West Road 67, Liaocheng 252000, Shandong Province, China. zhjrun77@163.com
Telephone: +86-635-8272030 Fax: +86-635-8276110
Received: April 2, 2013
Revised: May 20, 2013
Accepted: June 1, 2013
Published online: July 28, 2013
Abstract

AIM: To compare matrix metalloproteinase (MMP)-9 and tissue inhibitor of metalloproteinase (TIMP)-1 in gastric ulcer (GU) and chronic superficial gastritis (CSG).

METHODS: This study enrolled 63 patients with GU and 25 patients with CSG. During upper gastroduodenal endoscopy, we took samples of gastric mucosa from the antrum and ulcer site from patients with GU, and samples of antral mucosa from patients with CSG. Mucosal biopsy tissues were cultured for 24 h, and the culture supernatant was measured for levels of MMP-9 and TIMP-1. After receiving eradication therapy for Helicobacter pylori (H. pylori) and 8 wk proton-pump inhibitor therapy for GU, follow-up endoscopy examination was performed after 6 mo and whenever severe symptoms occurred.

RESULTS: Levels of MMP-9 and TIMP-1 at the ulcer site or in the antrum were significantly higher in GU than CSG patients. MMP-9 levels at the ulcer site were significantly higher than in the antrum in GU patients, and had a significantly positive correlation with TIMP-1. MMP-9 levels were significantly higher in H. pylori-positive than H. pylori-negative GU and CSG patients. Levels of MMP-9 or TIMP-1 at the ulcer site were associated with the histological severity of activity and inflammation. About 57 GU patients were followed up, and seven had GU recurrence. H. pyloriinfection and MMP-9 levels were risk factors for the recurrence of GU adjusted for age and sex by multiple logistic regression analysis.

CONCLUSION: MMP-9 may perform an important function in gastric ulcer formation and recurrence.

Keywords: Gastric ulcer, Matrix metalloproteinase-9, Tissue inhibitor of metalloproteinase-1, Helicobacter pylori

Core tip: Gastric ulcer is a multifaceted process including acid secretion, reactive oxygen species generation, prostaglandin inhibition, and extracellular matrix degradation. Gastric mucosal damage is directly associated with extracellular matrix degradation in which matrix metalloproteinases (MMPs) play a crucial role. In this study, the authors compared MMP-9 and tissue inhibitor of metalloproteinase-1 levels in patients with gastric ulcer or chronic superficial gastritis.