Cerebrospinal fluid MMP-2 and TIMP-2 reflect blood–cerebrospinal fluid barrier dysfunction in Guillain–Barré syndrome and CIDP
- 1Zhuhai Campus of Zunyi Medical University
- 2Zhuhai People's Hospital (The Affiliated Hospital of Beijing Institute of Technology), Zhuhai Clinical Medical College of Jinan University
- 3The First School of Clinical Medicine, Guangdong Medical University
Abstract
Background: This study aimed to investigate patterns of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in Guillain–Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP). It also examined how these patterns relate to dysfunction of the blood–cerebrospinal fluid barrier (BCB).
Methods: This prospective observational study enrolled 86 participants: 33 patients with GBS, 34 with CIDP, and 19 with Alzheimer’s disease (AD) as controls. Enzyme-linked immunosorbent assay (ELISA) quantified MMP-2, MMP-9, TIMP-1, and TIMP-2 levels in blood and cerebrospinal fluid (CSF). Analyses included group comparisons, multivariable logistic regression, ROC curve analysis, and multivariable linear regression to assess classification value and association with CSF protein (CSF-Pro).
Results: Compared to controls, patients with immune-mediated peripheral neuropathies had lower blood MMP-2 and TIMP-2 levels and higher blood MMP-9 levels. CSF MMP-2 and TIMP-2 levels were higher in CIDP than in GBS. Multivariable logistic regression showed CSF MMP-2 was associated with disease classification. ROC analysis revealed CSF MMP-2 moderately distinguished CIDP from GBS (AUC = 0.700). Multivariable linear regression showed CSF TIMP-2 was independently and negatively associated with CSF-Pro levels.
Conclusion: The MMP-2/TIMP-2 axis may contribute to BCB dysfunction in immune-mediated peripheral neuropathies. CSF MMP-2 levels are associated with disease classification, while elevated CSF TIMP-2 levels may alleviate barrier damage. These biomarkers may serve as potential reference indicators for assessing barrier dysfunction and could provide a basis for differentiating GBS from CIDP.
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BibTeX
@article{zhong2026cerebrospinal,
title = {{Cerebrospinal fluid MMP-2 and TIMP-2 reflect blood–cerebrospinal fluid barrier dysfunction in Guillain–Barré syndrome and CIDP}},
author = {Jiuheng Zhong and Jia Li and Ziqi Mo and Ya Zeng and Jiewei Peng and Peipei Zhu and Haiying Wang and Caiyun Mo and Yutao Liu and Yu Tu},
journal = {Frontiers in Neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1993595},
url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1993595/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Cerebrospinal fluid MMP-2 and TIMP-2 reflect blood–cerebrospinal fluid barrier dysfunction in Guillain–Barré syndrome and CIDP
AU - Jiuheng Zhong
AU - Jia Li
AU - Ziqi Mo
AU - Ya Zeng
AU - Jiewei Peng
AU - Peipei Zhu
AU - Haiying Wang
AU - Caiyun Mo
AU - Yutao Liu
AU - Yu Tu
PY - 2026
DA - 2026/10/28
JO - Frontiers in Neurology
DO - 10.3389/fneur.2026.1993595
UR - https://www.frontiersin.org/articles/10.3389/fneur.2026.1993595/full
AB - Background: This study aimed to investigate patterns of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in Guillain–Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP). It also examined how these patterns relate to dysfunction of the blood–cerebrospinal fluid barrier (BCB). Methods: This prospective observational study enrolled 86 participants: 33 patients with GBS, 34 with CIDP, and 19 with Alzheimer’s disease (AD) as controls. Enzyme-linked immunosorbent assay (ELISA) quantified MMP-2, MMP-9, TIMP-1, and TIMP-2 levels in blood and cerebrospinal fluid (CSF). Analyses included group comparisons, multivariable logistic regression, ROC curve analysis, and multivariable linear regression to assess classification value and association with CSF protein (CSF-Pro). Results: Compared to controls, patients with immune-mediated peripheral neuropathies had lower blood MMP-2 and TIMP-2 levels and higher blood MMP-9 levels. CSF MMP-2 and TIMP-2 levels were higher in CIDP than in GBS. Multivariable logistic regression showed CSF MMP-2 was associated with disease classification. ROC analysis revealed CSF MMP-2 moderately distinguished CIDP from GBS (AUC = 0.700). Multivariable linear regression showed CSF TIMP-2 was independently and negatively associated with CSF-Pro levels. Conclusion: The MMP-2/TIMP-2 axis may contribute to BCB dysfunction in immune-mediated peripheral neuropathies. CSF MMP-2 levels are associated with disease classification, while elevated CSF TIMP-2 levels may alleviate barrier damage. These biomarkers may serve as potential reference indicators for assessing barrier dysfunction and could provide a basis for differentiating GBS from CIDP.
SN - 1664-2295
ER -