Acta Medica Medianae
Klinika za oftalmologiju
Bul. dr Zorana Đinđića 48
GENDER-RELATED DIFFERENCE IN AQUEOUS HUMOR MATRIX METALLOPROTEINASES MMP-2 AND TISSUE INHIBITOR OF MATRIX METALLOPROTEINASES IN PATIENTS WITH PSEUDOEXFOLIATION SYNDROME/GLAUCOMA
Jasmina Djordjević-Jocić, Gordana Zlatanović, Dragan Veselinović, Gordana Stankovic-Babić and Sonja Cekić
Pseudoexfoliation syndrome (PEX Sy) is a common age–related disorder of the extracellular matrix that is frequently associated with severe secondary chronic open-angle glaucoma and cataract. Pseudoexfoliation glaucoma (PEX gl) is one of the most common causes of optic disc damage, low visual accuracy, damage of visual field and blidness. Deposits of white material on the anterior lens surface are the most consistent and important diagnostic feature of PEX syndrome/glaucoma. It is thought that PEX represents aberrant extracellular matrix synthesis.
The aim of this paper was to evaluate the gender-related difference in the level of matrix metalloproetinases MMP-2 and tissue inhibitor of matrix metalloproetinases (TIMP-1, TIMP-2, TIMP-3, TIMP-4) in aqueous humor in patients with pseudoexfoliation syndrome/glaucoma.
Aqueous humor was aspirated during surgery from 15 patients with PEX syndrome without glaucoma, 42 patients with PEX glaucoma, 36 patients with POAG and 14 age-matched control patients with cataract during cataract surgery or trabeculectomy. Data about medical history, medications, and demographic information were obtained from case notes. In all patients we determined Intra Ocular Pressure (IOP) by (measurement by Goldman aplanation tonometry), PEX appereance (determined with slet lamp examination). Fluorokine MultiAnalite Profiling kits (R&D Systems, Minneapolis, MN) and Luminex technology (Luminex Corporation, Austin, TX) were used to simultaneously measure MMP-2, and TIMP-1, TIMP-2, TIMP-3 and TIMP-4 in aqueous humor samples.
Patients with PEX glaucoma are older and of male sex compared to the patients with POAG. Male patients with PEX glaucoma and POAG were significantly older than female patients. Patients with PEX Sy have bilateral ocular changes more often compared to other groups. There were no significant gender differences in aqueous humour MMP-2, TIMP-2, TIMP-3, TIMP-4 levels among examined groups. In the group with PEX syndrome a significantly higher level of TIMP-1 was registred in male patients.
Despite significant variation in humour protease and protease inhibitors level among patients with different clinical forms of glaucoma and cataract, there are not important gender-related differences. Only the level of TIMP-1 is significantly higher in male patients with PEX syndrome, The level of TIMP-4 is significanty higer in the elderly male patients with PEX glaucoma. Acta Medica Medianae 2010;49(1):5-12.
Key words: gender, matrix metalloproteinases, MMP-2, inhibitor, pseudoexfoliation, syndrome, glaucoma, TIMP