Association of serum interleukin-17 and matrix metalloproteinase-9 with disease severity in Iraqi Asthmatics

Abstract

Asthma is involved in airway remodeling driven by inflammatory mediators. Interleukin-17 (IL-17) and matrix metalloproteinase-9 (MMP-9) are implicated in neutrophilic inflammation and extracellular matrix degradation; however, their interplay in patients with Iraqi asthma remains underexplored. This study evaluates the serum IL-17 and MMP-9 levels in Iraqi asthma patients, correlate them with pulmonary function (FEV₁%, FEV₁/FVC), and assess their diagnostic utility. This case-control study enrolled 100 adults (50 patients with asthma and 50 healthy controls) from Babylon Province, Iraq (September 2024–April 2025). Asthma was diagnosed according to the GINA guidelines. Serum IL-17 and MMP-9 levels were quantified via ELISA. Spirometry-Assessed Lung Function. Statistical analyses were performed using independent t-tests, Pearson’s correlations, and ROC curves. Asthmatics showed significantly elevated IL-17 (335.3 ± 74.5 vs. 144.1 ± 62.8 ng/L; p < 0.001) and MMP-9 (68.7 ± 15.1 vs. 38.9 ± 8.4 ng/mL; p < 0.001) versus controls. Both biomarkers were inversely correlated with FEV₁% (IL-17: r = −0.698; MMP-9: r = −0.501) and FEV₁/FVC (IL-17: r = −0.670; MMP-9: r = −0.612; P < 0.001). ROC analysis indicated a high diagnostic precision for MMP-9 (AUC: 97%; cutoff >52.3 ng/mL) and IL-17 (AUC: 95%; cutoff >240.7 ng/L). Biomarker levels increased stepwise with worsening lung function (P < 0.001). Elevated serum IL-17 and MMP-9 levels correlate with impaired lung function and disease severity in patients with Iraqi asthma, highlighting their roles in neutrophilic inflammation and airway remodeling. Both biomarkers showed high diagnostic potential for asthma detection.