Comparative analysis of tissue levels of MMP-2 and MMP-9 with blood level of VEGF in chronic wounds.

INTRODUCTION

Chronic wounds are difficult to manage because of their unpredictable outcome in terms of healing. Comparative analysis of tissue levels of matrix metalloproteinases MMP-2 and MMP-9 with blood levels of vascular endothelial growth factor (VEGF) in chronic wounds was carried out and followed up.

METHODS

A total of 52 patients were recruited to compare analysis of tissue levels of MMP-2 and MMP-9 with blood levels of VEGF in chronic wounds. Of these, 34 (65.4%) had diabetes. These patients had pressure ulcers grade 2-4 or wounds which had been present for >6 weeks.

RESULTS

Expression of VEGF was significantly increased in patients with chronic wounds (p<0.001). The mean level of VEGF was 648.55±497.03pg/ml at first visit and 965.69±461.51pg/ml after 6 weeks, whereas the normal level is considered to be 31-86 pg/ml. Levels of MMP-2 and MMP-9 were measured and assessed using immunohistochemistry at the time of first visit and after 6 weeks. Both were seen on keratinocytes, fibroblasts, inflammatory cells and endothelial cells at both time points. There was a significant increase in levels of both MMP-2 (p<0.001) and MMP-9 (p<0.001) in all of these cells after 6 weeks.

CONCLUSION

Blood levels of VEGF and level of expression of MMP-2 and MMP-9 in tissues increased significantly with healing of chronic wounds.