TIMPs, MMPs and cardiovascular disease

This editorial refers to "Relations of plasma total TIMP-1 levels to cardiovascular risk factors and echocardiographic measures: the Framingham heart study" † by J. Sundstr A¶ m et al. on page 1509 The matrix metalloproteinases (MMPs) are a family of proteolytic enzymes that cleave the extracellular matrix and have been shown to be regulated by a class of proteins called the tissue inhibitors of metalloproteinases (TIMPs). Several studies have shown that extracellular matrix degradation by MMPs, specifically MMP-9, is involved in the pathogenesis of a wide spectrum of cardiovascular disorders, including atherosclerosis, restenosis, cardiomyopathy, congestive heart failure, myocardial infarction, and aortic aneurysm.1,2 This is not surprising since all remodelling, i.e., change in left ventricular geometry and myocardial architecture is associated with a change in the collagen matrix. That both MMPs and TIMPs have recently become fashionable research toys in cardiovascular medicine is documented by the simple fact that a Medline search on June 28, 2004 with the key words "metalloproteinase" and "cardiovascular" revealed 2864 hits, of which more than half (1544) were published within the past five years.Data from the Framingham cohort have challenged the cardiovascular community for more … *Correspondence to: Franz H. Messerli, M.D., Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA. Tel.: +1 504 842 3144; fax: +1 504 842 4220 (E-mail: fmesserli{at}aol.com).