Relationship between the Matrix Metalloproteinases and the Occurrence of Central Nervous System Bleeding in Factor XIII Deficiency

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Pediatrics Hematology and Oncology, Ali Ebn-e Abi Taleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran

2 Department of Hematology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Hematology, School of Allied Medical Sciences, Tehran University of Medical Sciences AND PhD Student, Department of Hematology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran

4 Assistant Professor, Department of Hematology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran

5 Department of Hematology, School of Medicine, Tarbiat Modares University, Tehran, Iran

Abstract

Background: Matrix metalloproteinase (MMP) has a crucial role in degradation of basal membrane and tissue remodeling and has a possible role in occurrence of central nervous system (CNS) bleeding. Factor XIII deficiency is an extremely rare bleeding disorder with estimated incidence of 1 per 2 million. Since central nervous system bleeding is the main cause of death among these patients, this study aimed to assess to role of MMP-9 and MMP-2 in occurrence of this bleeding in factor XIII deficiency.Methods: In this case-control study, gene expression of MMP-9 and MMP-2 was determined via quantitative real-time reverse transcription polymerase chain reaction (Q-RT-PCR) assays in 42 patients with factor XIII deficiency that were divided in two groups of with (case) and without central nervous system bleeding (control). Gene expression was compared with comparison method (2–ΔΔcCt) and glyceraldehyde 3-phosphate dehydrogenase (GAPDH) was used for standardization of gene expression.Findings: Cord bleeding was the most common bleeding episode among all the patients. Overexpression of MMP-9 was observed among 13 patients in case (72.2%) and 3 patients in control group (12.5%) that showed a statistically significant difference (P = 0.001, CI95%: 2.8-95.3).Conclusion: Patients with factor XIII deficiency have a wide spectrum of clinical presentations that has a crucial role in screening and diagnosis of the disease. According to results of this study, overexpression of MMP-9, due to polymorphism or inflammation, had a role in pathogenesis of central nervous system bleeding. Inhibition of MMP-9 may have a role in decreasing the rate of morbidity and mortality among patients with factor XIII deficiency.

Keywords


  1. Dorgalaleh A, Naderi M, Hosseini MS, Alizadeh S, Hosseini S, Tabibian S, Eshghi P. Factor XIII Deficiency in Iran: A Comprehensive Review of the Literature. Semin Thromb Hemost 2015. [Epub ahead of print]
  2. Naderi M, Imani M, Eshghi P, Dorgalaleh A, Tabibian Sh, Alizadeh Sh, et al. Factor XIII deficiency in Sistan and Baluchistan province. Sci J Iran Blood Transfus Organ 2013; 10(3): 282-8. [In Persian].
  3. Muszbek L, Bereczky Z, Bagoly Z, Komaromi I, Katona E. Factor XIII: a coagulation factor with multiple plasmatic and cellular functions. Physiol Rev 2011; 91(3): 931-72.
  4. Hsieh L, Nugent D. Factor XIII deficiency. Haemophilia 2008; 14(6): 1190-200.
  5. Schroeder V, Kohler HP. Factor XIII deficiency: an update. Semin Thromb Hemost 2013; 39(6): 632-41.
  6. Lak M, Peyvandi F, Ali SA, Karimi K, Mannucci PM. Pattern of symptoms in 93 Iranian patients with severe factor XIII deficiency. J Thromb Haemost 2003; 1(8): 1852-3.
  7. Bosche B, Molcanyi M, Noll T, Kochanek M, Kraus B, Rieger B, et al. Occurrence and recurrence of spontaneous chronic subdural haematoma is associated with a factor XIII deficiency. Clin Neurol Neurosurg 2013; 115(1): 13-8.
  8. Zhu XL, Chan MS, Poon WS. Spontaneous intracranial hemorrhage: which patients need diagnostic cerebral angiography? A prospective study of 206 cases and review of the literature. Stroke 1997; 28(7): 1406-9.
  9. Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Engl J Med 2001; 344(19): 1450-60.
  10. Ferro JM. Update on intracerebral haemorrhage. J Neurol 2006; 253(8): 985-99.
  11. Manno EM. Update on intracerebral hemorrhage. Continuum (Minneap Minn ) 2012; 18(3): 598-610.
  12. Perez DL, Diamond EL, Castro CM, Diaz A, Buonanno F, Nogueira RG, et al. Factor XIII deficiency related recurrent spontaneous intracerebral hemorrhage: a case and literature review. Clin Neurol Neurosurg 2011; 113(2): 142-5.
  13. Todd T, Perry DJ. A review of long-term prophylaxis in the rare inherited coagulation factor deficiencies. Haemophilia 2010; 16(4): 569-83.
  14. Trinh CH, Sh EW, Eshghi P, Miri-Moghaddam E, Zadeh-Vakili A, Markham AF, et al. Molecular analysis of sixteen unrelated factor XIIIA deficient families from south-east of Iran. Br J Haematol 2008; 140(5): 581-4.
  15. Tamaddon GhH, Kazemi A, Rastegar Gh, Alla F, Hejazi Sh. Molecular basis of inherited factor XIII- A deficiency among patients from Sistan - Baluchestan. Zahedan J Res Med Sci 2010; 11(4): 19-24. [In Persian].
  16. Naderi M, Dorgalaleh A, Alizadeh S, Kashani Khatib Z, Tabibian S, Kazemi A, et al. Polymorphism of thrombin-activatable fibrinolysis inhibitor and risk of intracranial haemorrhage in factor XIII deficiency. Haemophilia 2014; 20(1): e89-e92.
  17. Naderi M, Eshghi P, Cohan N, Haghpanah S, Karimi M. Evaluation of the FXIII deficiency prophylaxis intervals in large number of FXIII deficiency patients from Iran. Haemophilia 2013; 19(3): e175-e176.
  18. Abilleira S, Montaner J, Molina CA, Monasterio J, Castillo J, Alvarez-Sabin J. Matrix metalloproteinase-9 concentration after spontaneous intracerebral hemorrhage. J Neurosurg 2003; 99(1): 65-70.
  19. Hernandez-Guillamon M, Martinez-Saez E, Delgado P, Domingues-Montanari S, Boada C, Penalba A, et al. MMP-2/MMP-9 plasma level and brain expression in cerebral amyloid angiopathy-associated hemorrhagic stroke. Brain Pathol 2012; 22(2): 133-41.
  20. Naderi M, Eshghi P, Cohan N, Miri-Moghaddam E, Yaghmaee M, Karimi M. Successful delivery in patients with FXIII deficiency receiving prophylaxis: report of 17 cases in Iran. Haemophilia 2012; 18(5): 773-6.
  21. Wang L, Deng S, Lu Y, Zhang Y, Yang L, Guan Y, et al. Increased inflammation and brain injury after transient focal cerebral ischemia in activating transcription factor 3 knockout mice. Neuroscience 2012; 220: 100-8.
  22. Nagase H, Woessner JF, Jr. Matrix metalloproteinases. J Biol Chem 1999; 274(31): 21491-4.