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July2014 Vol.51 Issue:        3       (Supp.) Table of Contents
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Role of MMP9 and MMP9/TIMP1 Ratio in Assessment of Relapse in Multiple Sclerosis Patients

Samia Ashour1, Magd Zakaria1, Mahmoud Hemeda1, Nermin Helmy2,

Dina Abdelgawad1, Ahmed Elbassiony1, Ayman Abdelhady1

Departments of Neurology1, Clinical Pathology2; Ain Shams University; Egypt


Background: Multiple sclerosis (MS) is a progressive inflammatory disease of the central nervous system affecting young adults. The development of process-specific therapies is impossible without use of biological markers that can objectively reflect the targeted immunopathological process, and indicate patients’ responses to therapeutic interventions. One of these biomarkers are indicators of blood brain barrier (BBB) disruption as matrix metalloproteinases (MMPs) and their inhibitors; tissue inhibitor matrix metalloproteinase1 (TIMP). Objective: To determine the relation between the MMP9, MMP9/TIMP1 ratio, and disease activity (relapse) in relapsing remitting Multiple sclerosis. Methods: Thirty-five relapsing remitting multiple sclerosis patients and fifteen healthy volunteers were recruited. Patients submitted to clinical evaluation including Expanded Disability Status Scale (EDSS), laboratory investigations including serum measurement of MMP9, TIMP1 levels and MMP9/TIMP1 ratio, magnetic resonance imaging (MRI), while the healthy volunteers were subjected to measurement of MMP-9 level, TIMP1 level and MMP-9/TIMP1 Ratio. Results: MMP9 level in serum could be used for diagnosis of MS patients in relapse at a level of ≥850 µg/dl, while MMP9/TIMP1 ratio could be used for diagnosis of MS patient in relapse at a ratio of ≥0.102. The mean level of MMP9 was 1529.290µg/dl during relapse, 456.25µg/dl after 3 months, while change in MMP9 was 1093.750µg/dl. The mean level of MMP9/TIMP1 ratio was (0.15) during relapse, significantly elevated than level (0.08) after 3 months, this is consistent with MRI activity. Conclusion: MMP9 and MMP9/TIMP1 ratio may be considered a marker of multiple sclerosis disease activity. [Egypt J Neurol Psychiat Neurosurg.  2014; 51(3): 303-310]


Key Words: Matrix Metalloproteinase 9, Tissue inhibitor matrix metalloproteinase1, Multiple sclerosis

Correspondence to Dina Abdelgawad Zamzam, Department of Neurology, Ain Shams University, Egypt. Email:


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