Association of Matrix Metalloproteinase 9 and Cellular Fibronectin and Outcome in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis
Introduction: The role of matrix metalloproteinase 9 (MMP-9) and cellular fibronectin (c-Fn) in acute ischemic stroke is controversial. We systematically reviewed the literature to investigate the association of circulating MMP-9 and c-Fn levels and MMP-9 rs3918242 polymorphism with the risk of thre...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2020-11-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2020.523506/full |
| _version_ | 1818240066791669760 |
|---|---|
| author | Lu Wang Lu Wang Linghui Deng Ruozhen Yuan Junfeng Liu Yuxiao Li Ming Liu |
| author_facet | Lu Wang Lu Wang Linghui Deng Ruozhen Yuan Junfeng Liu Yuxiao Li Ming Liu |
| author_sort | Lu Wang |
| collection | DOAJ |
| description | Introduction: The role of matrix metalloproteinase 9 (MMP-9) and cellular fibronectin (c-Fn) in acute ischemic stroke is controversial. We systematically reviewed the literature to investigate the association of circulating MMP-9 and c-Fn levels and MMP-9 rs3918242 polymorphism with the risk of three outcome measures after stroke.Methods: We searched English and Chinese databases to identify eligible studies. Outcomes included severe brain edema, hemorrhagic transformation, and poor outcome (modified Rankin scale score ≥3). We estimated standardized mean differences (SMDs) and pooled odds ratios (ORs) with 95% confidence intervals (CIs).Results: Totally, 28 studies involving 7,239 patients were included in the analysis of circulating MMP-9 and c-Fn levels. Meta-analysis indicated higher levels of MMP-9 in patients with severe brain edema (SMD, 0.76; 95% CI, 0.18–1.35; four studies, 419 patients) and hemorrhagic transformation (SMD, 1.00; 95% CI, 0.41–1.59; 11 studies, 1,709 patients) but not poor outcome (SMD, 0.30; 95% CI, −0.12 to 0.72; four studies, 759 patients). Circulating c-Fn levels were also significantly higher in patients with severe brain edema (SMD, 1.55; 95% CI, 1.18–1.93; four studies, 419 patients), hemorrhagic transformation (SMD, 1.75; 95% CI, 0.72–2.78; four studies, 458 patients), and poor outcome (SMD, 0.46; 95% CI, 0.16–0.76; two studies, 210 patients). Meta-analysis of three studies indicated that the MMP-9 rs3918242 polymorphism may be associated with hemorrhagic transformation susceptibility under the dominant model (TT + CT vs. CC: OR, 0.621; 95% CI, 0.424–0.908; P = 0.014). No studies reported the association between MMP-9 rs3918242 polymorphism and brain edema or functional outcome after acute stroke.Conclusion: Our meta-analysis showed that higher MMP-9 levels were seen in stroke patients with severe brain edema and hemorrhagic transformation but not poor outcome. Circulating c-Fn levels appear to be associated with all three outcomes including severe brain edema, hemorrhagic transformation, and poor functional outcome. The C-to-T transition at the MMP-9 rs3918242 gene appears to reduce the risk of hemorrhagic transformation. |
| first_indexed | 2024-12-12T13:07:32Z |
| format | Article |
| id | doaj.art-775be83bc0aa40f88ab0bbb2fc213fae |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-12T13:07:32Z |
| publishDate | 2020-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-775be83bc0aa40f88ab0bbb2fc213fae2022-12-22T00:23:37ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-11-011110.3389/fneur.2020.523506523506Association of Matrix Metalloproteinase 9 and Cellular Fibronectin and Outcome in Acute Ischemic Stroke: A Systematic Review and Meta-AnalysisLu Wang0Lu Wang1Linghui Deng2Ruozhen Yuan3Junfeng Liu4Yuxiao Li5Ming Liu6Department of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaCenter of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, ChinaNational Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaIntroduction: The role of matrix metalloproteinase 9 (MMP-9) and cellular fibronectin (c-Fn) in acute ischemic stroke is controversial. We systematically reviewed the literature to investigate the association of circulating MMP-9 and c-Fn levels and MMP-9 rs3918242 polymorphism with the risk of three outcome measures after stroke.Methods: We searched English and Chinese databases to identify eligible studies. Outcomes included severe brain edema, hemorrhagic transformation, and poor outcome (modified Rankin scale score ≥3). We estimated standardized mean differences (SMDs) and pooled odds ratios (ORs) with 95% confidence intervals (CIs).Results: Totally, 28 studies involving 7,239 patients were included in the analysis of circulating MMP-9 and c-Fn levels. Meta-analysis indicated higher levels of MMP-9 in patients with severe brain edema (SMD, 0.76; 95% CI, 0.18–1.35; four studies, 419 patients) and hemorrhagic transformation (SMD, 1.00; 95% CI, 0.41–1.59; 11 studies, 1,709 patients) but not poor outcome (SMD, 0.30; 95% CI, −0.12 to 0.72; four studies, 759 patients). Circulating c-Fn levels were also significantly higher in patients with severe brain edema (SMD, 1.55; 95% CI, 1.18–1.93; four studies, 419 patients), hemorrhagic transformation (SMD, 1.75; 95% CI, 0.72–2.78; four studies, 458 patients), and poor outcome (SMD, 0.46; 95% CI, 0.16–0.76; two studies, 210 patients). Meta-analysis of three studies indicated that the MMP-9 rs3918242 polymorphism may be associated with hemorrhagic transformation susceptibility under the dominant model (TT + CT vs. CC: OR, 0.621; 95% CI, 0.424–0.908; P = 0.014). No studies reported the association between MMP-9 rs3918242 polymorphism and brain edema or functional outcome after acute stroke.Conclusion: Our meta-analysis showed that higher MMP-9 levels were seen in stroke patients with severe brain edema and hemorrhagic transformation but not poor outcome. Circulating c-Fn levels appear to be associated with all three outcomes including severe brain edema, hemorrhagic transformation, and poor functional outcome. The C-to-T transition at the MMP-9 rs3918242 gene appears to reduce the risk of hemorrhagic transformation.https://www.frontiersin.org/articles/10.3389/fneur.2020.523506/fullmatrix metalloproteinase 9cellular fibronectinsevere brain edemahemorrhagic transformationpoor outcome |
| spellingShingle | Lu Wang Lu Wang Linghui Deng Ruozhen Yuan Junfeng Liu Yuxiao Li Ming Liu Association of Matrix Metalloproteinase 9 and Cellular Fibronectin and Outcome in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis Frontiers in Neurology matrix metalloproteinase 9 cellular fibronectin severe brain edema hemorrhagic transformation poor outcome |
| title | Association of Matrix Metalloproteinase 9 and Cellular Fibronectin and Outcome in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis |
| title_full | Association of Matrix Metalloproteinase 9 and Cellular Fibronectin and Outcome in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis |
| title_fullStr | Association of Matrix Metalloproteinase 9 and Cellular Fibronectin and Outcome in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Association of Matrix Metalloproteinase 9 and Cellular Fibronectin and Outcome in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis |
| title_short | Association of Matrix Metalloproteinase 9 and Cellular Fibronectin and Outcome in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis |
| title_sort | association of matrix metalloproteinase 9 and cellular fibronectin and outcome in acute ischemic stroke a systematic review and meta analysis |
| topic | matrix metalloproteinase 9 cellular fibronectin severe brain edema hemorrhagic transformation poor outcome |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2020.523506/full |
| work_keys_str_mv | AT luwang associationofmatrixmetalloproteinase9andcellularfibronectinandoutcomeinacuteischemicstrokeasystematicreviewandmetaanalysis AT luwang associationofmatrixmetalloproteinase9andcellularfibronectinandoutcomeinacuteischemicstrokeasystematicreviewandmetaanalysis AT linghuideng associationofmatrixmetalloproteinase9andcellularfibronectinandoutcomeinacuteischemicstrokeasystematicreviewandmetaanalysis AT ruozhenyuan associationofmatrixmetalloproteinase9andcellularfibronectinandoutcomeinacuteischemicstrokeasystematicreviewandmetaanalysis AT junfengliu associationofmatrixmetalloproteinase9andcellularfibronectinandoutcomeinacuteischemicstrokeasystematicreviewandmetaanalysis AT yuxiaoli associationofmatrixmetalloproteinase9andcellularfibronectinandoutcomeinacuteischemicstrokeasystematicreviewandmetaanalysis AT mingliu associationofmatrixmetalloproteinase9andcellularfibronectinandoutcomeinacuteischemicstrokeasystematicreviewandmetaanalysis |