Blood MMP-9 measured at 2 years after lung transplantation as a prognostic biomarker of chronic lung allograft dysfunction

Adrien Tissot, Eugénie Durand, Thomas Goronflot, Benjamin Coiffard, Benjamin Renaud-Picard, Antoine Roux, Xavier Demant, Jean-François Mornex, Loïc Falque, Mathilde Salpin, J. rôme le Pavec, Thomas Villeneuve, V. ronique Boussaud, Christiane Knoop, Antoine Magnan, David Lair, Laureline Berthelot, Richard Danger, Sophie Brouard, Elodie BlanchardXavier Demant, Virginie Hulo, the COLT consortium

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Background: Long-term outcomes of lung transplantation (LTx) remain hampered by chronic lung allograft dysfunction (CLAD). Matrix metalloproteinase 9 (MMP-9) is a secretory endopeptidase identified as a key mediator in fibrosis processes associated with CLAD. The objective of this study was to investigate whether plasma MMP9 levels may be prognostic of CLAD development. Methods: Participants were selected from the Cohort in Lung Transplantation (COLT) for which a biocollection was associated. We considered two time points, year 1 (Y1) and year 2 (Y2) post-transplantation, for plasma MMP-9 measurements. We analysed stable recipients at those time points, comparing those who would develop a CLAD within the 2 years following the measurement to those who would remain stable 2 years after. Results: MMP-9 levels at Y1 were not significantly different between the CLAD and stable groups (230 ng/ml vs. 160 ng/ml, p = 0.4). For the Y2 analysis, 129 recipients were included, of whom 50 developed CLAD within 2 years and 79 remained stable within 2 years. MMP-9 plasma median concentrations were higher in recipients who then developed CLAD than in the stable group (230 ng/ml vs. 118 ng/ml, p = 0.003). In the multivariate analysis, the Y2 MMP-9 level was independently associated with CLAD, with an average increase of 150 ng/ml (95% CI [0–253], p = 0.05) compared to that in the stable group. The Y2 ROC curve revealed a discriminating capacity of blood MMP-9 with an area under the curve of 66%. Conclusion: Plasmatic MMP-9 levels measured 2 years after lung transplantation have prognostic value for CLAD.
Original languageEnglish
Article number88
JournalRespiratory research
Issue number1
Publication statusPublished - 1 Dec 2024

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