@article{3137874,
    title = "Circulating Tissue Inhibitor of Matrix Metalloproteinase-4 (TIMP-4) in
Systemic Sclerosis Patients with Elevated Pulmonary Arterial Pressure",
    author = "Elias, Gialafos J. and Ioannis, Moyssakis and Theodora, Psaltopoulou and and Dimitrios, Papadopoulos P. and Despoina, Perea and Kostantinos, Vlasis and and Charalampos, Kostopoulos and Vassilios, Votteas and Petros, Sfikakis and P.",
    journal = "Mediators of Inflammation",
    year = "2008",
    volume = "2008",
    publisher = "HINDAWI LTD",
    issn = "0962-9351, 1466-1861",
    doi = "10.1155/2008/164134",
    abstract = "Decreased levels of matrix metalloproteinases (MMPs) or excess levels of
their tissue inhibitors (TIMPs) may contribute to dysregulation of
extracellular matrix turnover in systemic sclerosis (SSc). In a
cross-sectional study of 106 SSc patients, we measured serum levels of
TIMP-4 which is preferentially expressed in cardiovascular structures
and searched for correlations with simultaneously performed
echocardiography measurements of pulmonary artery systolic pressure
(PASP), myocardial performance, and pulmonary function tests. TIMP-4,
but not MMP-9, levels were significantly raised in patients with SSc
than controls. However, in the subgroup of patients with PASP
measurements lower to 40 mmHg (n = 69), TIMP-4 levels were comparable to
controls irrespective of the presence of diffuse or limited skin
involvement, or lung fibrosis. Individual PASP measurements suggestive
of pulmonary hypertension were associated with increased TIMP-4 serum
levels (P = .03), independently of age, extent of skin sclerosis, or
lung fibrosis, suggesting a cardiopulmonary vasculature-specific role of
TIMP-4 activation in SSc. Copyright (c) 2008 Gialafos J. Elias et al."
}