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Matrix metalloproteinase 9 (MMP-9) is a secretory endopeptidase identified as a key mediator in fibrosis processes associated with CLAD. The objective of this study was to investigate whether plasma MMP9 levels may be prognostic of CLAD development.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Participants were selected from the Cohort in Lung Transplantation (COLT) for which a biocollection was associated. We considered two time points, year 1 (Y1) and year 2 (Y2) post-transplantation, for plasma MMP-9 measurements. We analysed stable recipients at those time points, comparing those who would develop a CLAD within the 2\u00a0years following the measurement to those who would remain stable 2\u00a0years after.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>MMP-9 levels at Y1 were not significantly different between the CLAD and stable groups (230\u00a0ng\/ml vs. 160\u00a0ng\/ml, p\u2009=\u20090.4). For the Y2 analysis, 129 recipients were included, of whom 50 developed CLAD within 2\u00a0years and 79 remained stable within 2\u00a0years. MMP-9 plasma median concentrations were higher in recipients who then developed CLAD than in the stable group (230\u00a0ng\/ml vs. 118\u00a0ng\/ml, p\u2009=\u20090.003). In the multivariate analysis, the Y2 MMP-9 level was independently associated with CLAD, with an average increase of 150\u00a0ng\/ml (95% CI [0\u2013253], p\u2009=\u20090.05) compared to that in the stable group. The Y2 ROC curve revealed a discriminating capacity of blood MMP-9 with an area under the curve of 66%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Plasmatic MMP-9 levels measured 2\u00a0years after lung transplantation have prognostic value for CLAD.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12931-024-02707-3","type":"journal-article","created":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T18:02:27Z","timestamp":1707501747000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Blood MMP-9 measured at 2\u00a0years after lung transplantation as a prognostic biomarker of chronic lung allograft 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