The prognostic importance of the protease-antiprotease imbalance in development of chronic obstructive pulmonary disease comorbid with chronic pancreatitis

Background: chronic obstructive pulmonary disease (COPD) is frequently comorbid with chronic pancreatitis (CP). One of the genes that could play a role in occurrence of that comorbidity by controlling protease-antiprotease balance, is a gene encoding alpha-1-antitrypsin (AAT). Aim: to find markers of susceptibility to CP in COPD patients. Methods: the serum levels of AAT, its genotype, tissue inhibitor of metalloproteinase-1 (TIMP-1), matrix metalloproteinase-9 (MMP-9) and MMP-3 in serum were measured in COPD patients with/without CP in equal groups of 60 subjects each. Results: heterozygous carriers of deficient alleles were found in 5% of patients with comorbidity COPD and CP (group 1), while in the group without CP (group 2) - only 1.67%. Moreover, in group 1 there were a large number of people - 18.3% (11 of 60 patients) compared with data of group 2 - 8.3% (5 of 60) in whom the pathology of the respiratory and digestive systems was associated with a lack production of AAT. A significantly higher serum MMP-9 level was observed in patients from group 1 (median - 242.92 ng/ml vs. 131.15 ng/ml). Changes of TIMP 1 had multidirectional character - among 30.56% of patients from group 1 there were increased serum level of TIMP 1, whereas in 16.67% of patients from group 2 this indicator was marked decreased. There were no statistically significant differences in MMP-3 serum levels between the studied groups. Conclusions. Heterozygosity for PiM- polymorphisms and especially both serum AAT and MMP-9 levels are valuable biomarkers for verification predisposition to the occurrence CP among COPD patients.