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BioMedCentralPage1of6(pagenumbernotforcitationpurposes)JournalofCardiothoracicSurgeryOpenAccessResearcharticleSerumlevelsofmatrixmetalloproteinases-1,-2,-3and-9inthoracicaorticdiseasesandacutemyocardialischemiaGeorgiosTKarapanagiotidis*,PolychronisAntonitsis,NicholasCharokopos,ChristophorosNForoulis,KyriakosAnastasiadis,EfthymiaRouska,HelenaArgiriadou,KyriakosRammosandChristosPapakonstantinouAddress:DepartmentofThoracicandCardiovascularSurgery,AHEPAUniversityHospital,Thessaloniki,GreeceEmail:GeorgiosTKarapanagiotidis*[e-mail];[e-mail];[e-mail];[e-mail];[e-mail];[e-mail];[e-mail];[e-mail];[e-mail]*CorrespondingauthorAbstractBackground:Matrixmetalloproteinases(MMPs)constituteafamilyofzinc-dependentproteases(endopeptidases)whosecatalyticactionisthedegradationoftheextracellularmatrixcomponents.Inaddition,theyplaythemajorroleinthedegradationofcollagenandintheprocessoftissueremodeling.Thepresentclinicalstudyinvestigatedbloodserumlevelsofmetalloproteinases-1,-2,-3and-9inpatientswithacuteandchronicaorticdissection,thoracicaorticaneurysmandacutemyocardialischemiacomparedtohealthyindividuals.Methods:ThebloodserumlevelsofMMP-1,-2,-3and-9werecalculatedin31patientswithacuteaorticdissection,18patientswithchronicaorticdissection,18patientswithaorticaneurysmandin13patientswithacutemyocardialischemia,aswellasin15healthyindividualswhoservedasthecontrolgroup.SerumMMPlevelsweremeasuredbyusinganELISAtechnique.Results:ThereweresignificantlyhigherlevelsofMMP-3inpatientswithacutemyocardialischemiaascomparedtoacuteaorticdissection(17.33±2.03ng/mlversus12.92±1.01ng/ml,p0.05).SignificantlylowerlevelsofMMP-1werefoundinhealthycontrolscomparedtoallgroupsofpatients(1.1±0.38ng/mlversus2.97±0.68inacuteaorticdissection,3.09±0.98inchronicdissection,3.16±0.51inthoracicaorticaneurysmand4.58±1.04inacutemyocardialischemia,p0.05).HigherlevelsofMMP-1andMMP-3weredetectedonmales.Therewasapositivecorrelationwithincreasingage(r=0.38,p0.05).InpatientsoperatedforacutetypeAaorticdissection,thelevelsofMMP-1,MMP-3andMMP-9increasedimmediatelyaftersurgery,whilethelevelsofMMP-2decrease.At24hourspostoperatively,levelsofMMP-1,-2and-9arealmostequaltothepreoperativeones.Conclusion:MeasurementofserumMMPlevelsinthoracicaorticdiseaseandacutemyocardialischemiaisasimpleandrelativelyrapidlaboratorytestthatcouldbeusedasabiochemicalindicatorofaorticdiseaseoracutemyocardialischemia,whenevaluatedincombinationwithimagingtechniques.Published:3November2009JournalofCardiothoracicSurgery2009,4:59doi:10.1186/1749-8090-4-59Received:25July2009Accepted:3November2009Thisarticleisavailablefrom:©2009Karapanagiotidisetal;licenseeBioMedCentralLtd.ThisisanOpenAccessarticledistributedunderthetermsoftheCreativeCommonsAttributionLicense(),whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited.JournalofCardiothoracicSurgery2009,4:59(pagenumbernotforcitationpurposes)BackgroundMatrixmetalloproteinases(MMPs)constitutealargefam-ilyofproteolyticenzymescontainingametalintheirorganicstructureplayingkeyrolesindegradationofpro-teinsinextracellularmatrixandintissueremodelingthroughcomplicatedbiologicalprocedures[1-3].Thisdoubleactionhasbeenproventobeinvolvedinthepathologyofseriouscardiovasculardiseases,suchasaor-ticaneurysm,dissectionandcoronaryarterydisease,whichconstitutethemostcommoncauseofdeathindevelopedcountries[4-6].Inalltheabovepathologicalprocesses,butmostlyinacuteaorticdissection,acomplexprocessisinitiatedfortherepairandremodelingoftheinvolvedaorticwall.Thisprocessincludesthrombusdegradationthroughfibrino-lyticactivityandproteolysisoftheextracellularmatrix[7-9].MMPsareproteolyticenzymes,specificallyendopepti-dases,whosecatalyticmechanisminvolvesametalionsuchaszinc(Zn2+)andcalcium(Ca2+)[10].Metallopro-teinases,alsocalledmatrixins,includealargefamilyofproteolyticenzymes,knownasmetzincinsuper-family.Theircatalyticactionisthedegradation,mainlyinneutralpHenvironment,ofallproteinsoftheextracellularmatrix[11].Inaddition,theymodulatemanybioactivemole-culesatthecellsurfaceandcanactinconcepttoinfluencecellbehavioursuchasangiogenesis,migration,reproduc-tionandimmunesystemactivity[12].Anumberofmetalloproteinaseshavebeenidentifiedinbloodserumthatarecategorizedmainlyinfourgroups:a)collagenases(MMP-1,MMP-8,MMP-13,MMP-18),b)gelatinases(MMP-2,MMP-9)c)stromelysins(MMP-3,MMP-10)andd)membrane-boundmetalloproteinases(MMP-14,MMP-15,MMP-16,MMP-17,MMP-24,MMP-25)[13].TheaimofourstudyistoevaluatethelevelsofserumMMP-1,-2,-3and-9inacuteandchronicaorticdissec-tion,thoracicaorticaneurysmandacutemyocardialischemiacomparedtonormalindividualsandas