TY - JOUR T1 - High MMP-9 activity characterises pleural tuberculosis correlating with granuloma formation JF - European Respiratory Journal JO - Eur Respir J SP - 134 LP - 141 DO - 10.1183/09031936.00127807 VL - 33 IS - 1 AU - P. Sheen AU - C. M. O’Kane AU - K. Chaudhary AU - M. Tovar AU - C. Santillan AU - J. Sosa AU - L. Caviedes AU - R. H. Gilman AU - G. Stamp AU - J. S. Friedland Y1 - 2009/01/01 UR - http://erj.ersjournals.com/content/33/1/134.abstract N2 - Tuberculosis (TB) pleural disease is complicated by extensive tissue destruction. Matrix metalloproteinase (MMP)-1 and -9 are implicated in immunopathology of pulmonary and central nervous system TB. There are few data on MMP activity in TB pleurisy. The present study investigated MMP-1, -2 and -9 and their specific inhibitors (tissue inhibitor of metalloproteinase (TIMP)-1 and -2) in tuberculous effusions, and correlated these with clinical and histopathological features. Clinical data, routine blood tests, and pleural fluid/biopsy material were obtained from 89 patients presenting with pleural effusions in a TB-endemic area. MMP-1, -2 and -9 were measured by zymography or western blot, and TIMP-1 and -2 by ELISA. Pleural biopsies were examined microscopically, cultured for acid–alcohol fast bacilli and immunostained for MMP-9. Tuberculous pleural effusions contained the highest concentrations of MMP-9 compared with malignant effusions or heart failure transudates. MMP-9 concentrations were highest in effusions from patients with granulomatous biopsies: median (interquartile range) 108 (61–218) pg·mL−1 versus 43 (12–83) pg·mL−1 in those with nongranulomatous pleural biopsies. MMP-1 and -2 were not upregulated in tuberculous pleural fluid. The ratio of MMP-9:TIMP-1 was significantly higher in TB effusions. Tuberculous pleurisy is characterised by a specific pattern of matrix metalloproteinase-9 upregulation, correlating with the presence of granulomas and suggesting a specific role for matrix metalloproteinase-9 in inflammatory responses in tuberculous pleural disease. ER -