Correlation Between Gene Polymorphisms and Levels of Serum Matrix Metalloproteinases with Cavitary Features and Pulmonary Fibrosis of the Patient Tuberculosis Multi-Drug Resistance Using High-Resolution Computerized Tomography of the Thorax

AbstractMatrix metalloproteinases (MMPs) are proteins that play a role in the inflammatory andremodeling processes caused by infections, including pulmonary tuberculosis (TB), especially multidrug resistance. This studyaims to correlate the relationship between serum levels and polymorphism of MMP-1 and MMP-9 with cavitycharacteristics, such as number, diameter, wall thickness as well as distribution of fibrosis in Multidrug-Resistant (MDR)- and Drug-Sensitive (DS)-TB patients. This study used a comparative cross-sectional study design. The subjects came from outpatients at Abdoel Moelok Hospital, Lampung Indonesia had passed the ethical test. Subjects were divided into two groups, 34 subjects in the MDR-TB group and 36 subjects in the DS-TB group. The levels of MMP-1 and MMP-9 were carriedout by ELISA test, genotype of MMP-1 and MMP-9 were determined using PCR-Sequencing method. In addition, cavities and fibrosis were measured using thoracic High-Resolution Computerized Tomography (HRCT) imaging. There was significant difference in the number of cavities more than 6, 6 mm in diameter, as well as cavity thickness in MDR-TB compared to DS-TB patients. Fibrosis distribution in lung segments was also different significantly in MDR-TB compared to DS-TB. Although MMP-9 levels in the MDR-TB group were highest than in the DS-TB group, there was no statistically significant. This study showed that there was a correlation between MDR-TB and DS-TB regarding the number of cavities, cavity diameter, cavity wall thickness, and distribution of fibrosis in the affected lung segments as measured by HRCT. There was no correlation between MMP-1 (-1607G) and MMP-9 (C1562T) genotypes and MMP-1 and MMP-9 serum levels, the MMP‑1 genotype in the two study groups differed significantly and was a risk factor for five times the incidence of MDR-TB. In addition, there was a substantial difference in cavity wall thickness between the G/G MMP-1 1607 genotype and the T/T MMP-9 genotype in the two study groups.