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Published ahead of print on August 26, 2005, doi:10.1164/rccm.200506-953OC

Am. J. Respir. Crit. Care Med., Volume 172, Number 11, December 2005, 1378-1382

A more recent version of this article appeared on December 1, 2005
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Submitted on June 20, 2005
Accepted on August 26, 2005

Matrix Metalloproteinase-9 Promoter Polymorphism Associated with Upper Lung Dominant Emphysema

Isao Ito1, Sonoko Nagai1*, Tomohiro Handa1, Shigeo Muro1, Toyohiro Hirai1, Mitsuhiro Tsukino1, and Michiaki Mishima1

1 Department of Respiratory Medicine, Kyoto University, Graduate School of Medicine, Kyoto, Japan

* To whom correspondence should be addressed. E-mail: nagai{at}kuhp.kyoto-u.ac.jp.

Rationale: Matrix metalloproteinase 9 (MMP-9) has proteolytic activity against connective tissue proteins and appears to play an important role in the development of chronic obstructive pulmonary disease (COPD). The functional polymorphism of MMP-9 (C-1562T) is considered as one of the candidate genes in the susceptibility to COPD. Objectives: To determine if MMP-9 (C-1562T) is related to the development of COPD in the Japanese population and whether it is associated with development of pulmonary emphysema; assessed by high-resolution computed tomographic (HRCT) parameters. Methods: 84 COPD patients and 85 healthy smoker controls were genotyped for MMP-9 (C-1562T) by the restriction fragment length polymorphism method. We further investigated the relationship between the genotype using automatically analyzed HRCT parameters such as low attenuation area % (LAA%) and average CT value density (Hounsfield unit) (mean-CTv) in upper, middle and lower lung fields in all COPD patients. Measurements and Main Results: There was no difference in polymorphism of MMP-9 (C-1562T) between COPD patients and smoker controls. In the HRCT study, COPD patients with a T-allele (C/T or T/T) showed larger LAA% (95%CI of difference: 0.5 to 18.7, p=0.04), and smaller mean-CTv (-34.3 to -1.0, p=0.04) in the upper lung compared to patients without T-alleles (C/C). However, pulmonary function tests showed no difference between the two patient groups. Patients with a T-allele showed a decrease in LAA% and an increase in mean-CTv from upper to lower lung fields (p=0.006 and p=0.002). Conclusions: Polymorphism of MMP-9 (C-1562T) was associated with upper lung dominant emphysema in patients with COPD.


Key words: High-resolution computed tomography, Low attenuation area %, Mean-CT value, Chronic obstructive pulmonary disease




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