| ObjectiveThis study aimed to evaluate the distribution and expression of matrix metalloproteinase (MMP)-9in the lung tissues of COPD patients and its correlation with the level of airflow obstruction, respiratory failure,quality of life and dyspnoea. The purpose is to provide the new idea about its prevention and the therapy of COPD for clinic.MethodsTotally sixty-three edge lung tissue samples (the distance of tumor tissue>5cm) were selected from the chest surgical excision of lung tumor patientes in Thoracic Surgery,Pneumosurgery at the General Hospital,TianJin Medical University. These tissue samples were assigned into10non-smokers without COPD group (A group),15COPD patients without smoking(B group),14mild COPD patients with smoking (C group),16moderate COPD patients with smoking (D group), and8severe COPD patients with smoking (E group). FEV1, FEV1(%pred), FEV1/FVC, MEF50(%Predicted), MEF25(%Predicted), PaO2, PaCO2of those were also tested respectively by pulmonary function instrument and blood gas analyzer, quality of life and the level of dyspnoea of those were also evaluated respectively by grading the scale of CAT, MMRC. The lung tissue pathology was observed with HE staining.Immunohistochemical staining was used to investigate the distribution and expression of matrix metalloproteinase-9(MMP-9) in the lung tissues, and the correlative analysis was conducted.Results1.1.The indicators of pulmonary function:FEV1(L):There was statistical significant differences between each two different D,E and each two different A,B,C group in FEV1(P<0.05). There was statistical significant differences between D and E group(P<0.05), except among each two different A,B,C group(P>0.05).FEV1/FVC(%):There was statistical significant differences between each two different A, B, C, D and E group in FEV1/FVC percentage(P<0.05), except between A and B group(P>0.05).MEF50(%Predicted):There was statistical significant differences between each two different A, B, C, D and E group in MEF50(%Predicted)(P<0.05). The level in COPD group has the trend to descend. 1.2.The indicators of analysis of arterial blood gas: PaO2:There was statistical significant differences between each two different A, B, C, D and E group in PaO2(P<0.05), except between A,B group, and B,C group(P>0.05).1.3.The quality of life and the level of dyspnoea: The scale of CAT and MMRC:There was statistical significant differences between each two different A, B, C, D and E group in the scale of CAT and MMRC(P<0.05), except between A, B group, and B, C group(P>0.05).2.HE staining of lung tissue: Compared with mild COPD patients and patients without COPD, the alveoli of moderate and severe COPD patients have been significantly destroyed, the airway have remodeled, inflammation appeared in airway, the bronchus wall and the pulmonary alveoli have been filled with inflammatory cell, extracellular matrix have been apparently degradated.3.Immunohistochemical staining of lung tissue: Distribution and Expression of matrix metalloproteinase-9:The number of MMP-9positive cells of moderate and severe COPD patients was significantly higher than that of mild COPD patients and patients without COPD. Cells have brown granules in their cytoplasm are taken as positive stained,which mainly were alveolar epithelial cells, bronchial epithelial cell, vascular smooth miscle cell, alveolar macrophages, interstitial cells.The positive expression of matrix metalloproteinase-9:There was statistical significant differences between each two different A, B, C, D and E group in the positive expression of matrix metalloproteinase-9(P<0.05). The positive expression of matrix metalloproteinase-9in COPD group has the trend to ascend.4.The correlation analysis:The expressions of MMP-9in the five group was negative correlation with the FEV1, FVC(%Predicted), FEV1/FVC(%), MEF50(%Predicted), MEF25(%Predicted)(r=-0.504, P=0.009; r=-0.512, P=0.009; r=-0.534, P=0.008; r=-0.463, P=0.01;r=-0.461,P=0.015).The expressions of MMP-9in the five group was negative correlation with the level of PaO2(r=-0.450, P=0.032).The expressions of MMP-9in the five group was positive correlation with the Scale of CAT,classification of MMRC(r=0.455, P=0.016; r=0.452, P=0.018). Conclusion1.Compared with mild COPD patients and patients without COPD, the alveoli of moderate and severe COPD patients have been significantly destroyed,the airway have remodeled, inflammation appeared in airway,the bronchus wall and the pulmonary alveoli have been filled with inflammatory cell, extracellular matrix have been apparently degradated.2.The expression of matrix metalloproteinase-9of COPD patients with smoking was significantly higher than that of non-smokers. It was suggested that smoking can promot the expression of matrix metalloproteinase-9.conditon3.The expression of matrix metalloproteinase-9of COPD patients was significantly higher than that of patients without COPD. The expression of matrix metalloproteinase-9of severe COPD patients was significantly higher than that of mild and moderate COPD patients. The expression of matrix metalloproteinase-9of moderate COPD patients was significantly higher than that of mild COPD patients. It was suggested that the expression of matrix metalloproteinase-9increased as the COPD got worse.4. The expressions of MMP-9in COPD patients was negative correlation with the FEV1,FVC(%Predicted), FEV1/FVC(%), MEF50(%Predicted), MEF25(%Predicted)(r=-0.504, P=0.009; r=-0.512, P=0.009; r=-0.534, P=0.008; r=-0.463, P=0.01; r=-0.461, P=0.015). The expressions of MMP-9in the five group was negative correlation with the level of PaO2(r=-0.450, P=0.032). The expressions of MMP-9in the five group was positive correlation with the Scale of CAT,classification of MMRC(r=0.455, P=0.016; r=0.452, P=0.018). It was suggested that the expression of matrix metalloproteinase-9was correlation with declining lung function decline, quality of life,COPD patients’ conditon. |
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