{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T12:29:29Z","timestamp":1787574569428,"version":"build-2736575974"},"reference-count":20,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T00:00:00Z","timestamp":1787356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Acute subdural hematoma (ASDH) and chronic subdural hematoma (ChSDH) differ substantially in their pathophysiology, clinical course, and outcomes. Matrix metalloproteinases (MMPs), particularly MMP-2 and MMP-9, have been implicated in blood\u2013brain barrier disruption, extracellular matrix remodeling, and inflammatory processes involved in both traumatic brain injury and ChSDH. However, direct comparisons of perioperative MMP profiles between ASDH and ChSDH and their relationships with clinical characteristics remain limited. The aim of this study was to compare perioperative MMP-2 and MMP-9 concentrations in patients with ASDH and ChSDH and explore their associations with selected clinically relevant parameters. Methods: Thirty patients undergoing surgical treatment for subdural hematoma were prospectively enrolled, including 10 patients with ASDH and 20 with ChSDH. Serum samples were collected before surgery and on postoperative day 3, and hematoma content was obtained intraoperatively. MMP-2 and MMP-9 concentrations were measured using enzyme-linked immunosorbent assay. Results: Patients with ASDH had significantly higher MMP-9 concentrations in hematoma content (p = 0.002) and postoperative serum (p = 0.029) than patients with ChSDH, whereas MMP-2 concentrations did not differ significantly between the groups. In the ChSDH group, both MMP-2 and MMP-9 concentrations were significantly lower in hematoma content than in preoperative and postoperative serum, while no significant perioperative changes were observed in patients with ASDH. Higher MMP-2 concentrations in hematoma content were associated with lower leukocyte counts and smaller midline shift, whereas higher hematoma MMP-9 concentrations were associated with lower APTT and CRP concentrations after FDR correction. These findings suggest distinct perioperative MMP-2 and MMP-9 profiles in acute and chronic subdural hematomas. Conclusions: This study provides a direct comparison of perioperative MMP-2 and MMP-9 profiles in serum and hematoma content between patients with ASDH and ChSDH while also exploring their associations with selected clinically relevant parameters.<\/jats:p>","DOI":"10.3390\/jcm15176499","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:47:19Z","timestamp":1787572039000},"page":"6499","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Matrix Metalloproteinase-2 and Matrix Metalloproteinase-9 Profiles in Acute and Chronic Subdural Hematomas"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9973-9571","authenticated-orcid":false,"given":"Bart\u0142omiej","family":"Kulesza","sequence":"first","affiliation":[{"name":"Institute of Medical Sciences, Faculty of Medicine, John Paul II Catholic University of Lublin, Rac\u0142awickie Avenue 14, 20-950 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9366-3978","authenticated-orcid":false,"given":"Mateusz","family":"Krakowiak","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences and Health Sciences, Radom University, 29 Malczewskiego Street, 26-600 Radom, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota","family":"Luchowska-Kocot","sequence":"additional","affiliation":[{"name":"Department of Medical Chemistry, Faculty of Medical Sciences, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7524-8831","authenticated-orcid":false,"given":"Jacek","family":"Kurzepa","sequence":"additional","affiliation":[{"name":"Department of Medical Chemistry, Faculty of Medical Sciences, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2938-885X","authenticated-orcid":false,"given":"Cezary","family":"Grochowski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stefan Cardinal Wyszy\u0144ski Provincial Specialist Hospital Independent Public Health Care Centre, Kra\u015bnicka 100, 20-718 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2115-9649","authenticated-orcid":false,"given":"Ryszard","family":"Maciejewski","sequence":"additional","affiliation":[{"name":"Institute of Medical Sciences, Faculty of Medicine, John Paul II Catholic University of Lublin, Rac\u0142awickie Avenue 14, 20-950 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1016\/S1474-4422(22)00309-X","article-title":"Traumatic brain injury: Progress challenges in prevention clinical care research","volume":"21","author":"Maas","year":"2022","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s12974-017-0881-y","article-title":"Pathophysiology of chronic subdural haematoma: Inflammation, angiogenesis and implications for pharmacotherapy","volume":"14","author":"Edlmann","year":"2017","journal-title":"J. Neuroinflamm."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Kulesza, B., Krakowiak, M., Brzozowska, A., Grochowski, C., and Maciejewski, R. (2026). Clinical, Laboratory, and Radiological Predictors of Three-Month Outcome After Surgical Treatment of Acute Extra-Axial Hematomas. J. Clin. Med., 15.","DOI":"10.3390\/jcm15155797"},{"key":"ref_4","first-page":"215","article-title":"Urazowe uszkodzenie m\u00f3zgu = Traumatic brain injury","volume":"6","author":"Kulesza","year":"2016","journal-title":"J. Educ. Health Sport"},{"key":"ref_5","first-page":"11","article-title":"Chronic Subdural Hematoma","volume":"3","author":"German","year":"1930","journal-title":"Yale J. Biol. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1007\/s10143-023-02175-1","article-title":"Risk factors for recurrence of chronic subdural hematoma after surgical evacuation: A systematic review and meta-analysis","volume":"46","author":"Maroufi","year":"2023","journal-title":"Neurosurg. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1089\/neu.2014.3724","article-title":"Role of Matrix Metalloproteinase-2, Matrix Metalloproteinase-9, and Vascular Endothelial Growth Factor in the Development of Chronic Subdural Hematoma","volume":"33","author":"Hua","year":"2016","journal-title":"J. Neurotrauma"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1007\/s13770-023-00536-x","article-title":"Development of Matrix Metalloproteinases-Mediated Extracellular Matrix Remodeling in Regenerative Medicine: A Mini Review","volume":"20","author":"Chen","year":"2023","journal-title":"Tissue Eng. Regen. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1089\/neu.2014.3764","article-title":"Matrix Metalloproteinase Expression in Contusional Traumatic Brain Injury: A Paired Microdialysis Study","volume":"32","author":"Guilfoyle","year":"2015","journal-title":"J. Neurotrauma"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1186\/s12974-018-1173-x","article-title":"Neutrophils in traumatic brain injury (TBI): Friend or foe?","volume":"15","author":"Liu","year":"2018","journal-title":"J. Neuroinflamm."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s00701-011-1203-2","article-title":"Chemokines as markers of local inflammation and angiogenesis in patients with chronic subdural hematoma: A prospective study","volume":"154","author":"Stanisic","year":"2012","journal-title":"Acta Neurochir."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1227\/01.NEU.0000351768.11363.48","article-title":"Elevation of matrix metalloproteinases 3 and 9 in cerebrospinal fluid and blood in patients with severe traumatic brain injury","volume":"65","author":"Grossetete","year":"2009","journal-title":"Neurosurgery"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1038\/nrn1807","article-title":"Metalloproteinases: Mediators of pathology and regeneration in the CNS","volume":"6","author":"Yong","year":"2005","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1177\/0271678X16655551","article-title":"Matrix metalloproteinases in the brain and blood-brain barrier: Versatile breakers and makers","volume":"36","author":"Rempe","year":"2016","journal-title":"J. Cereb. Blood Flow Metab."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Yu, W., Peng, J., Chen, Z., Li, H., Yang, J., Wu, Y., Zhang, M., and Wu, M. (2023). Association of plasma MMP-2 levels and prognosis of patients with intracerebral hemorrhage: A prospective cohort study. Front. Neurol., 14.","DOI":"10.3389\/fneur.2023.1259339"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Su, G.J., Gao, J., Wu, C.W., Zou, J.F., Zhang, D., Zhu, D.L., Liu, J., Zhang, J.H., and Huang, X.J. (2022). Serum Levels of MMP-8 and MMP-9 as Markers in Chronic Subdural Hematoma. J. Clin. Med., 11.","DOI":"10.3390\/jcm11040902"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Edlmann, E., Giorgi-Coll, S., Thelin, E.P., Hutchinson, P.J., and Carpenter, K.L.H. (2022). Dexamethasone reduces vascular endothelial growth factor in comparison to placebo in post-operative chronic subdural hematoma samples: A target for future drug therapy?. Front. Neurol., 13.","DOI":"10.3389\/fneur.2022.952308"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s007010050008","article-title":"Expression of matrix metalloproteinases in the chronic subdural haematoma membrane","volume":"142","author":"Nakagawa","year":"2000","journal-title":"Acta Neurochir."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/1757-7241-20-83","article-title":"Matrix metalloproteinase 9 and cellular fibronectin plasma concentrations are predictors of the composite endpoint of length of stay and death in the intensive care unit after severe traumatic brain injury","volume":"20","author":"Copin","year":"2012","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"418","DOI":"10.5935\/0103-507X.20200071","article-title":"Prognostic utility of early plasma matrix metalloproteinases -2 and -9 concentrations after severe traumatic brain injury","volume":"32","author":"Lima","year":"2020","journal-title":"Rev. Bras. Ter. Intensiv."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6499\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T12:07:24Z","timestamp":1787573244000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,22]]},"references-count":20,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15176499"],"URL":"https:\/\/doi.org\/10.3390\/jcm15176499","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,22]]}}}