Association of Serum MMP-9 Level and Lung Function in New Pulmonary Tuberculosis Case

Background: Histopathological abnormalities of pulmonary tuberculosis (TB) include caseous granuloma formation, tissue damage, and cavity formation, all of which could lead to permanent changes in the pulmonary anatomy. In pulmonary TB, an increase in serum Matrix Metalloproteinase (MMP)-9 correlates with disease severity and worse prognosis. This study aims to analyze the association between serum MMP-9 levels and the values of FVC, FEV1, and FEV1/FVC. Methods: A cross-sectional study involving patients with pulmonary tuberculosis was conducted at the Tuberculosis Outpatient Clinic, Dr. Soetomo Academic Hospital, Surabaya, Indonesia. Spirometry and serum MMP-9 levels were examined in new pulmonary TB patients prior to antituberculosis therapy. The relationship between serum MMP-9 levels and results of spirometry examination was then analyzed. Results: There were 44 new pulmonary TB cases with a mean age of 37.90 ± 15.15 years. The patients who experienced symptoms in <1 month were 20.5%, ≥ 1 month were 59.1%, and ≥ 2 months were 20.4%. The mean MMP-9 serum level was 11.27 ± 5.47 ng/ml. Spirometry results were: FVC 1.83 ± 0.69 L, FVC predicted 56.24 ± 18.74%, FEV1 1.71 ± 0.72 L/sec, FEV1 predicted 60.85 ± 21.30%, and FEV1/FVC 104.16 ± 17.45%. In pulmonary TB patients with symptoms experienced in <1 month, a significant relationship between MMP-9 and FVC levels was found with r = -0.839 (p = 0.005). Conclusion: There is a correlation between serum MMP-9 level and restrictive pulmonary impairment in new pulmonary TB cases with symptoms experienced in <1 month.