Relationship between serum levels of vascular endothelial growth factor and matrix metalloproteinase-9 and Suzuki' s grading in adult moyamoya disease

Abstract

Objective To investigate the relationship between serum levels of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) and Suzuki’s grading system in adult moyamoya disease (MMD). Methods Fifty-two adult patients with MMD, who were diagnosed in Jinling hospital between April 2009 and January 2010, were retrieved from the Nanjing Stroke Registry Program (NSRP). Sixteen sex- and age-matched healthy individuals with MMD patients consisted of the control group. Using enzyme-linked immunosorbent assay, serum concentrations of VEGF and MMP-9 were compared between adult MMD patients and healthy individuals. By Suzuki’s six-grading system, patients were divided into different subgroups, and the correlation of serum levels of VEGF and MMP-9 corresponding to different subgroup and Suzuki’s grading was respectively analyzed. In addition, the correlation of serum levels of VEGF and MMP-9 was also evaluated. Results Serum VEGF concentrations in ischemic and hemorrhagic MMD patients was respectively (289.4±69.2) pg/ml and (324.3±95.6) pg/ml and were significantly higher compared to those in healthy controls ((63.5±7.6) pg/ml; F=69.43，P<0.01). Similar findings were observed for MMP-9 ((499.4±76.2) ng/ml and (531.2±100.2) ng/ml versus (257.1±30.7) ng/ml; F=66.023，P<0.01). With the increase of Suzuki’s grading, serum levels of VEGF and MMP-9 respectively showed a high trend (r=0.879, P<0.01; r=0.838, P<0.01). In addition, a positive correlation between serum levels of VEGF and MMP-9 was found in the MMD group（r=0.590, P<0.01）. Conclusion The results show that serum levels of VEGF and MMP-9 in adult MMD are higher than those in healthy controls, which may play a role in neovascularization in MMD, and moreover, serum levels of VEGF and MMP-9 show a high trend with the progression of MMD, which suggest that serum levels of VEGF and MMP-9 can reflect the severity of MMD. Key words: Moyamoya disease; Stroke; Vascular endothelial growth factor; Matrix metalloproteinase 9; Severity of illness index