Matrix metalloproteinases as potential fecal biomarkers for ulcerative colitis – a function beyond their proteolytic activity

Abstract:

Specific, sensitive, and noninvasive biomarkers are the most relevant tools to monitor activity, early stage detection, and the treatment management of ulcerative colitis (UC). Although, there is no single “Gold Standard” test for the diagnosis of UC, clinicians utilize a combination of clinical score, histological score, and colonoscopy index to assess disease activity and to predict the outcome of the disease. Over a decade, different biomarkers from body fluids have been considered to assess UC. The disadvantage of these biomarkers (as for example, serum or blood) is that they can be influenced by other inflammatory diseases. Feces formation mainly occurs in colon; therefore, fecal biomarkers could be the most sensitive and specific ones for UC assessment compared to any other body-fluid biomarkers. Fecal biomarkers are the proteins that either secreted out or are generated by the inflamed intestinal mucosa. The main advantage of them is their use in diagnosing and assessing disease activity in difficult cases, especially when invasive strategies can be very stressful for the patients. In this review, we validate a panel of matrix metalloproteinases (MMPs) as fecal biomarkers demonstrating not only their capacity as inflammatory markers but also their specificity to colonic inflammation. Based on our literature search, we also identify MMP9 as the most promising fecal biomarker for UC activity.

Keywords::

• Cytokines
• calprotectin
• lipocalin
• inflammatory bowel disease
• UC therapy
• MMP1
• MMP3
• MMP7
• MMP10
• MMP14