Gender Related Differences in Humor Matrix Metalloproteinases Mmp-2 Activity and Tissue Inhibitor of Matrix Metalloproteinases in Patients with Pseudoexfoliation Syndrome/glaucoma

Pseudoexfoliation syndrome (PEX Sy) is a common age–related disorder of the extracellular matrix that is frequently associated with severe secondary chronic open-angle glaucoma and cataract. Pseudoexfoliation glaucoma (PEX gl) is one of the most common causes of optic disc damage, low visual accuracy, damage of visual field and blidness. Deposits of white material on the anterior lens surface are the most consistent and important diagnostic feature of PEX syndrome/glaucoma. It is thought that PEX represents aberrant extracellular matrix synthesis. The aim of this paper was to evaluate gender related difference in level of matrix metalloproetinases MMP-2 and tissue inhibitor of matrix metalloproetinases (TIMP-1, TIMP2, TIMP-3, TIMP-4) in aqueous humor in patients with pseudoexfoliation syndrome/glaucoma. Aqueous humor was aspirated during surgery from 15 patients with PEX syndrome without glaucoma, 42 patients with PEX glaucoma, 36 patients with POAG and 14 agematched control patients with cataract during cataract surgery or trabeculectomy. Data about medical history, medications, and demographic information were obtained from case notes. In all patients we determined Intra Ocular Pressure (IOP) by (measurement by Goldman aplanation tonometry), PEX appereance (determined with slet lamp examination). Fluorokine MultiAnalite Profiling kits (R&D Systems, Minneapolis, MN) and Luminex technology (Luminex Corporation, Austin, TX) were used to simultaneously measure MMP-2, and TIMP-1, TIMP-2, TIMP-3 and TIMP-4 in aqueous humor samples. Patients with PEX glaucoma are older and of male sex than patients with POAG. Male patients with PEX glaucoma and POAG were significantly older than female patients. Patients with PEX Sy have bilateral ocular changes more often compared to other groups. There were no significant gender differences in aqueous humour MMP-2, TIMP-2, TIMP-3, TIMP-4 levels among examined groups. In the group with PEX syndrome significantly higher level of TIMP-1 was registred in male patients. Despite significant variation in humour protease and protease inhibitors level among patients with different clinical forms of glaucoma and cataract there are not important gender related difference. Only level of TIMP-1 is significantly higher in male patients with PEX Syndroma, The level of TIMP-4 is significanty higer in male older patients with PEX glaucoma. Acta Medica Medianae 2010;49(1):5-12.