OBJECTIVE
To assess the serum levels of matrix metalloproteinases (MMP) MMP-2, MMP-9, and vascular endothelial growth factor (VEGF) during the acute period of ischemic stroke (IS) in the context of clinical and functional recovery of patients.
MATERIAL AND METHODS
The study sample consisted of 114 patients with IS. Patient groups: Group 1 — mild stroke (n=57 patients), Group 2 — moderate stroke (n=25 patients), Group 3 — severe stroke (n=32 patients). Observation period: 14 days. Assessment timepoints: I — 48—72 hours from the onset of the disease; II — Day 14. Scores: Glasgow Coma Scale (GCS), National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS). Serum MMP-2 and MMP-9 were measured using enzyme-linked immunosorbent assay (ELISA), and VEGF was measured on a multiplex analyzer. Statistical data processing was performed using the Statistica 13.0 software bundle.
RESULTS
Patients of Groups 1 and 2 showed significant improvement in the NIHSS and mRS scores (p<0.001), and patients of Group 3 demonstrated no change (p=0.157 and p=0.315, respectively). MMP-2 levels were significantly lower in Group 3 when compared with patients of Groups 1 and 2 at timepoints I and II (p1—3=0.03 and p1—3=0.014). A strong positive correlation was found between ΔGCS=0 [–3; 1] and MMP-2_II (r=0.927; p=0.024). ΔMMP-9 in Group 1 was 75 [–38; 302] ng/mL and positively correlated with mRs_II (r=0.613; p=0.034). Group 3 patients showed a significant increase in VEGF at timepoint II (pI—II=0.021); ΔVEGF=68 [38; 105] pg/mL positively correlated with NIHSS_I (r=0.691; p=0.027). In patients of Group 2, the inverse relationship was observed, a negative correlation between ΔVEGF and ΔNIHSS (r=–0.653; p=0.041). Significant interbiomarker associations were found: positive between MMP-2_I and MMP-9_II in Group 2 (r=0.566, p=0.044), and negative between MMP-2_I and VEGF_II in Group 3 (r=–0.721, p=0.019).
CONCLUSION
The study demonstrated the association of biomarker profiles (VEGF, MMP-2, and MMP-9) with stroke severity. In mild to moderate disease, their modulation contributes to recovery, while in severe disease, it requires control. The obtained data support the development of personalized therapeutic strategies aimed at optimizing neuroplasticity by regulating the activity of the studied molecules.
