科研之友
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摘要
objective: lymphangioleiomyomatosis (lam) is characterized by lung cysts, whose development is associated with matrix metalloproteinase (mmp) hyperactivity, principally that of mmp-2 and mmp-9. our objective was to compare lam patients and controls in terms of the levels of these mmps, as well as to determine the safety and efficacy of treatment with doxycycline, a potent mmp inhibitor. methods: prospective clinical study involving female lam patients who received doxycycline (100 mg/day) for six months. urine and blood samples were collected for the quantification of mmp-2 and mmp-9 before and after the treatment period. samples from 10 healthy women were also collected. results:of the 41 lam patients who started the treatment, 34 completed the protocol. serum and urinary mmp-9 levels were significantly lower in the controls than in the lam patients (p %26lt; 0.0001). comparing pre- and post-treatment values, we found that the median level of mmp-9 in serum decreased from 919 ng/ml to 871 ng/ml (p = 0.05), whereas that of mmp-9 in urine decreased from 11,558 pg/ml to 7,315 pg/ml (p = 0.10). after treatment, the median level of mmp-2 in serum was significantly lower (p = 0.04) and urinary mmp-2 levels were undetectable. nausea, diarrhea, and epigastric pain were the most prevalent adverse affects and were often self-limiting. there was only one case in which the patient discontinued the treatment because of side effects. conclusions: we have demonstrated, for the first time, a decrease in serum and urine levels of mmps in lam patients treated with doxycycline, which proved to be a safe medication, with mild and well-tolerated side effects.
