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From the authors

Dept of Internal Medicine, Wakayama Medical University Kihoku Hospital, Ito-gun, Japan.

We would like to thank M. John and K. Jung for their interest in our study 1 and their comments upon the important issue of the analytical conditions for blood sampling. As M. John and K. Jung mentioned, we did not evaluate the influence of blood sampling and separation of serum from blood cells. We agree with M. John and K. Jung that we must be aware of pre-analytical problems when analysing the circulating matrix metalloproteinase (MMP)-9 and tissue inhibitor of metalloproteinase (TIMP)-1 levels. However, we used only serum samples in our study because we usually use serum samples for clinical examinations in our hospital. Therefore, we think that the comparison of the serum TIMP-1 and MMP-9 concentrations in each patient group is valid. Our results are consistent with serum TIMP-1 and MMP-9 concentrations reported elsewhere 2, 3.

We also agree with M. John and K. Jung that the changes of white blood cell count during chronic obstructive pulmonary disease (COPD) exacerbations could have influenced TIMP-1 concentrations, because the white blood cell count increased during most exacerbations. We are now planning to identify specific cell types that are involved in the production and secretion of circulating TIMP-1 and MMP-9 in COPD patients.

We thank M. John and K. Jung for their suggestions for our future studies.

REFERENCES

1. Higashimoto Y, Yamagata Y, Iwata T, et al. Increased serum concentrations of tissue inhibitor of metalloproteinase-1 in COPD patients. Eur Respir J 2005;25:885–890.[Abstract/Free Full Text]
2. Bosse M, Chakir J, Rouabhia M, Boulet LP, Audette M, Laviolette M. Serum matrix metalloproteinase-9: tissue inhibitor of metalloproteinase-1 ratio correlates with steroid responsiveness in moderate to severe asthma. Am J Respir Crit Care Med 1999;159:596–602.[Abstract/Free Full Text]
3. Oshita Y, Koga T, Kamimura T, Matsuo K, Rikimaru T, Aizawa H. Increased circulating 92 kDa matrix metalloproteinase (MMP-9) activity in exacerbations of asthma. Thorax 2003;58:757–760.[Abstract/Free Full Text]

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