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. 2023 May 23;14(1):35.
doi: 10.1186/s13293-023-00514-x.

Sex-specific associations of matrix metalloproteinases in Alzheimer's disease

Mari Aksnes  1 , Trine H Edwin  2 , Ingvild Saltvedt  3   4 , Rannveig S Eldholm  3   4 , Farrukh A Chaudhry  5 , Nathalie B Halaas  6   2 , Marius Myrstad  7   8 , Leiv O Watne  9   10 , Anne-Brita Knapskog  2
Affiliations

Sex-specific associations of matrix metalloproteinases in Alzheimer's disease

Mari Aksnes et al. Biol Sex Differ. .

Abstract

Introduction: Alzheimer's disease (AD) can be characterised in vivo by biomarkers reflecting amyloid-β (Aβ) and tau pathology. However, there is a need for biomarkers reflecting additional pathological pathways. Matrix metalloproteinases (MMPs) have recently been highlighted as candidate biomarkers for sex-specific mechanisms and progression in AD.

Methods: In this cross-sectional study, we investigated nine MMPs and four tissue inhibitors of metalloproteinases (TIMPs) in the cerebrospinal fluid of 256 memory clinic patients with mild cognitive impairment or dementia due to AD and 100 cognitively unimpaired age-matched controls. We studied group differences in MMP/TIMP levels and examined the associations with established markers of Aβ and tau pathology as well as disease progression. Further, we studied sex-specific interactions.

Results: MMP-10 and TIMP-2 levels differed significantly between the memory clinic patients and the cognitively unimpaired controls. Furthermore, MMP- and TIMP-levels were generally strongly associated with tau biomarkers, whereas only MMP-3 and TIMP-4 were associated with Aβ biomarkers; these associations were sex-specific. In terms of progression, we found a trend towards higher MMP-10 at baseline predicting more cognitive and functional decline over time exclusively in women.

Conclusion: Our results support the use of MMPs/TIMPs as markers of sex differences and progression in AD. Our findings show sex-specific effects of MMP-3 and TIMP-4 on amyloid pathology. Further, this study highlights that the sex-specific effects of MMP-10 on cognitive and functional decline should be studied further if MMP-10 is to be used as a prognostic biomarker for AD.

Keywords: Alzheimer disease; Biomarkers; Cerebrospinal fluid; Cognitive decline; Matrix metalloproteinases; Neurodegenerative diseases; Prognosis; Sex differences; Tissue inhibitor of metalloproteinases.

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Conflict of interest statement

ABK and THE have been investigators on the clinical trial Roche BN29553; ABK, THE and IS have worked on the Boehringer-Ingelheim clinical trial 1346.0023; and ABK has worked on the Novo Nordisk drug trial NN6535-4730. The remaining authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Violin plots showing the distribution of MMP- and TIMP-levels across the A− CU, A+ CU, MCI-AD and AD dementia groups. Boxes show the median (middle line), first quartile (bottom edge) and third quartile (top edge). P-values are given for Holm post hoc comparisons after ANOVA. AD Alzheimer’s disease, CU cognitively unimpaired, MCI mild cognitive impairment, MMP matrix metalloproteinase, TIMP tissue inhibitor of matrix metalloproteinase
See this image and copyright information in PMC

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