The Effect of Thiamine, Ascorbic Acid, and the Combination of Them on the Levels of Matrix Metalloproteinase-9 (MMP-9) and Tissue Inhibitor of Matrix Metalloproteinase-1 (TIMP-1) in Sepsis Patients

Bastian Lubis, Aznan Lelo, Putri Amelia, Agus Prima, Bastian Lubis, Aznan Lelo, Putri Amelia, Agus Prima

Abstract

Background: Sepsis is a global health problem. Therapeutic agents continue to develop for the management of sepsis. Ascorbic acid and thiamine are currently potential agents intensively studied for their benefits in sepsis.

Methods: This study was a randomized controlled trial (RCT) with a pretest-posttest control group design. Randomization was using a computer. The research was conducted at Haji Adam Malik General Hospital Medan and Grand Medistra Hospital. Blood tests were at the Integrated Laboratory of the Faculty of Medicine, University of North Sumatra. The research was for 14 months. The number of patients in this study was 86 septic patients divided into four groups (NaCl, thiamine, ascorbic acid, and combination). The parameters measured were the enzyme MMP-9 and the enzyme TIMP-1.

Results: The number of subjects who met the inclusion criteria was 147 patients. Fifty-three patients passed away during the monitoring period, and eight blood samples were damaged. The final data analyzed consisted of 86 subjects. Of the 86 septic patients obtained Based on initial MMP-9 values, MMP-9 levels increased in the 0.9% NaCl group (25.6%), while MMP-9 levels decreased after intervention in the thiamine, ascorbic acid, and combination groups but a significant decrease in MMP-9 was found in the ascorbic acid group (17.2%; p = 0.04) and the combination group (17.9%; p = 0.026). For TIMP-1 levels, a decreasing trend was only in the ascorbic acid (5.1%) and combination (5.9%) but not significant (p > 0.05). The highest MMP-9/TIMP-1 ratio was in septic patients receiving thiamine with a significant linear correlation (p < 0.05) between levels of MMP-9 and the MMP-9/TIMP-1 ratio with a moderate correlation level and significant negative correlation (p < 0.05) between TIMP-1 and the MMP-9/TIMP-1 with a moderate level of correlation.

Conclusion: Administration of thiamine alone gives better advantages than ascorbic acid alone and their combination.

Keywords: MMP-9; MMP-9/TIMP-1 ratio; TIMP-1; ascorbic acid; sepsis; thiamine.

Conflict of interest statement

The authors report no conflicts of interest in this work.

© 2022 Lubis et al.

Figures

Figure 1
Figure 1
Flow of Patients Through the Ascorbic Acid, Thiamine and Combination of Them in Septic Patients.
Figure 2
Figure 2
Kaplan Meier survival curve in non-survival subjects within 72 hours of observation.
Figure 3
Figure 3
Scatterplot graph of MMP-9 and TIMP-1 levels in sepsis patients who did not survive during observation.
Figure 4
Figure 4
Scatterplot graph of MMP-9, TIMP-1 levels, and MMP-9/TIMP-1 ratio in sepsis patients who did not survive during observation.
Figure 5
Figure 5
Scatterplot graph of changes in MMP-9, TIMP-1 level, and MMP-9/TIMP-1 ratio in sepsis patients who survived during observation.

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