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Abstract: Slide Presentations |

MATRIX METALLOPROTEASES IN BRONCHOALVEOLAR LAVAGE FLUID OF PATIENTS WITH TYPE III PSEUDOMONAS AERUGINOSA PNEUMONIA FREE TO VIEW

Ali A. El Solh, MD*; Daniel Amsterdam, PhD; Ahmad Alhajhusain, MD; Susan Lynch, PhD; Jeanine Wiener-Kronish, MD
Author and Funding Information

State University of New York at Buffalo, Buffalo, NY


Chest


Chest. 2009;136(4_MeetingAbstracts):37S. doi:10.1378/chest.136.4_MeetingAbstracts.37S-f
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Abstract

PURPOSE:  In patients with ventilator associated pneumonia (VAP), Pseudomonas aeruginosa type III (TTSS) secreting isolates have been linked to poor clinical outcomes. Differential expression of matrix metalloproteinases (MMPs) induced by type III effector proteins may herald an irreversible lung injury.

METHODS:  Serial bronchoalveolar lavage fluids collected from 41 patients with P. aeruginosa VAP at onset of VAP, day 4, and day 8 after antibiotic therapy were assayed for MMP-8, MMP-9, TIMP-1, and α-2 macroglobulin levels.

RESULTS:  At the onset of VAP, isolates secreting ExoU had the highest MMP-9 levels. The response to antimicrobial therapy showed a differential drop in MMPs with significant decrease in MMP-8 and MMP-9 levels on days 4 and 8 in patients with TTSS- compared to TTSS+ phenotype. The ratio of MMP-9/TIMP-1 was significantly associated with α-2 macroglobulin at end of therapy (r=0.4, p=0.02). Patients who survived had a lower MMP-9/TIMP-1ratio than those who died (p=0.003).

CONCLUSION:  VAP linked to P. aeruginosa Type III phenotype portrays a divergent antibiotic treatment response in regards to the concentrations of metalloproteinases in the alveolar space.

CLINICAL IMPLICATIONS:  The imbalance between MMP-9 and TIMP-1 may determine the intensity of alveolocapillary damage and ultimate outcome of P. aeruginosa VAP.

DISCLOSURE:  Ali El Solh, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, November 3, 2009

10:30 AM - 12:00 PM


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