Observation of matrix metalloproteinase-9 levels in patients with neurocysticercosis at a tertiary care super specialty institute in North India

Objectives Elevated levels of matrix metalloproteinase-9 (MMP-9) in both serum and cerebrospinal fluid have been observed in patients diagnosed with cysticercus granuloma. These elevated levels significantly contribute to the onset of symptoms, such as active seizures, in patients with neurocysticercosis (NCC). This study aimed to compare and correlate MMP-9 levels between NCC cases and control subjects. Materials and Methods In this prospective case-control study, 45 symptomatic cases of NCC and 30 controls were enrolled. Serum MMP-9 levels were measured using a commercially procured enzyme-linked immunosorbent assay kit (QayeeBio, Shanghai, China) in all collected serum samples, following the manufacturer’s instructions. Statistical analysis Data were presented as mean ± standard deviation (SD), frequencies, and percentages. Chi-square and unpaired t -tests were used for comparisons, while receiver operating curve analysis was performed to assess diagnostic accuracy metrics, with a significance threshold of P < 0.05. Results The mean age of cases and controls was 31.20 ± 11.98 years and 55.40 ± 9.80 years, respectively. The mean ± SD values of MMP-9 were significantly higher in NCC cases (13.42 ± 5.70 ng/mL) compared to controls (8.49 ± 4.21 ng/mL) ( P < 0.00001). At a cutoff of >10 ng/mL, serum MMP-9 levels correctly identified 73.3% of the 45 confirmed NCC cases (33/45; sensitivity) and correctly excluded 63.3% of the 30 controls (19/30; specificity). This threshold resulted in a positive predictive value of 75.0% and a negative predictive value of 61.3%. Conclusions MMP-9 demonstrated the ability to distinguish NCC cases from controls with a sensitivity of >73% and may serve as a marker for predicting and diagnosing symptomatic NCC. However, due to its moderate sensitivity and specificity, MMP-9 should not be used as a standalone diagnostic marker. Instead, it may complement existing serological and imaging tools to diagnose NCC.