基质金属蛋白酶及其抑制剂在器官纤维化中的研究进展

器官纤维化共同的基本特征是ECM过度沉积和组织结构改建 ,而病变组织内ECM降解减少是导致其过度沉积的主要原因之一。正常或异常的ECM代谢基于基质降解限速酶MMPs及其抑制剂TIMPs的平衡或失衡 ,MMPs/TIMPs受多种细胞因子和转录因子的调节 ,对肺、肝、肾等器官纤维化的发生、发展及其临床监测与治疗具有重要意义。     

基质金属蛋白酶及其抑制剂对肝纤维化的影响

肝纤维化(liver fibrosis)是各种病因(病毒性、酒精性、化学性等)引起的细胞外基质(extracelluIar matrix,ECM)合成超过降解,而导致的细胞外基质在肝脏过度沉积的一类疾病,肝纤维化继续发展可以导致肝硬化而严重威胁人类健康.     

肺间质纤维化大鼠肺组织基质金属蛋白酶及其组织抑制因子含量变化

观察肺纤维化形成过程中基质金属蛋白酶（Matrix Metallo proteinas简称MMPs)及其组织抑制因子（Tissue inhibitors of Metallo proteinases简称TIMPs)含量的变化,探讨其在肺纤维化发病中的作用。将Wistar大鼠60只,随机均分为对照组及模型组,气管内注入博莱霉素A5 5mg/kg,制备肺间质纤维化动物模型,观察注药后1、3、7、14及28d肺脏病理变化,利用酶谱法及免疫印记法分析肺组织MMP－2、MMP－9、TIMP－1的含量变化。结果显示各模型组pro-MMP-2、MMP－2、TIMP－1蛋白含量均较对照组增加,尤其7、14及28d组MMP－2较前明显增多。而MMP－9变化不很明显。提示在肺纤维化形成过程中,pro-MMP-2、MMP－2及TIMP－1都有所增高,MMP／TIMP比例失衡是最终导致肺间质纤维化形成的重要因素。     

脓毒症大鼠心脏基质金属蛋白酶及其抑制物基因的表达变化

目的：探讨脓毒症大鼠心脏中基质金属蛋白酶（MMP）及其组织抑制物（TIMP）的基因表达谱变化及其与脓毒症导致的心脏损伤的关系。方法：雄性3月龄Wistar大鼠20只，随机均分为2组，分别以盲肠结扎针刺法建立脓毒症动物模型或行假手术作为对照组。术后24 h快速摘取心脏，以Langendorff 离体鼠心灌注法测量大鼠心功能参数，其后做心脏病理检查，并以寡核苷酸基因芯片检测基质金属蛋白酶及其抑制物基因在2组大鼠心脏组织中的表达差异。结果：脓毒症大鼠心脏无明显病理改变，但心功能明显下降，表明大鼠心脏处于抑制状态；基因芯片结果显示：20个MMP基因中14个表达上调3倍以上，包括胶原酶MMP8、明胶酶（MMP2和MMP9）、基质溶解素（MMP3、MMP7及MMP10）和膜型金属蛋白酶（MMP15、MMP17和MMP24）等；4个TIMP基因中仅TIMP3基因表达上调。结论：脓毒症时心脏组织中多种MMP基因表达上调、MMP/TIMP基因表达失衡，可能导致心肌抑制和ECM重构，是脓毒症诱发心脏损伤的重要分子机制。     

基质金属蛋白酶及其抑制物与子宫内膜癌的研究进展

基质金属蛋白酶（MMPs）及其抑制物（TIMPs）在细胞外基质（ECM）的降解中起重要作用,国内外大量研究表明,ECM降解是恶性子宫内膜浸润子宫内膜和开始转移的重要提示。某些类型MMPs在子宫内膜癌中的表达明显增加,由此提出MMPs及TIMPs在子宫内膜癌的诊断和治疗中有较大的研究空间。因此就MMPs及TIMPs与子宫内膜癌的关系及研究情况进行如下综述。     

耐力运动大鼠跟腱胶原、基质金属蛋白酶1及其抑制剂1的表达

背景：胶原是肌腱细胞外基质中的主要成分,基质金属蛋白酶是降解肌腱细胞外基质蛋白的重要蛋白酶。 目的：观察12周跑台运动对大鼠跟腱胶原、胶原Ⅰ、基质金属蛋白酶1及其抑制剂1表达的影响。 方法：将20只雄性SD大鼠随机分为对照组和运动组。第1周每天运动20 min,速度由12 m/min递增至20 m/min;以后跑台速度均为20 m/min,第2周坡度为5%,时间为30 min,第3~12周坡度为10%,时间为40 min,共运动12周。对照组正常饲养。 结果与结论：末次运动后24 h取大鼠跟腱。与对照组比较,运动组大鼠跟腱前胶原Ⅰα1、基质金属蛋白酶1及其抑制剂1 mRNA的表达明显升高(P < 0.05或P < 0.01),羟脯氨酸的含量也有所增多,但与对照组比较差异无显著性意义(P > 0.05)。表明长期耐力运动可以提高跟腱中胶原的合成和降解能力。     

子宫内膜异位症中基质金属蛋白酶及其抑制剂表达的探讨

基质金属蛋白酶(MMPs)及其抑制剂(TIMP)在子宫内膜异位症的发生发展过程中具有重要作用。MMPs及TIMP与细胞外基质的相互作用,使得异位子宫内膜得以在子宫腔外生存,从而引发机体一系列病理生理改变。MMPs/TIMP的比例失衡是促使子宫内膜异症形成的关键因素之一。     

肥厚心肌胶原及基质金属蛋白酶的活性变化

探讨压力负荷增高性心肌肥厚时心肌胶原网络及心肌细胞外基质金属蛋白酶（ ＭＭＰｓ）活性的变化。腹主动 脉部分结扎术致大鼠压力负荷增高性心肌肥厚,ＶＧ染色和图像处理观察心肌胶原网络,酶谱法（Ｚｙｍｏｇｒａｐｈｙ）测定 心肌ＭＭＰｓ活性。结果：手术组大鼠术后２周即出现明显心肌肥厚,术后４周左室肥厚程度进一步加重。与假手术组 比较,左室心肌总胶原容积百分比（ＣＶＥ－Ｔ）于术后２周即增高（Ｐ＜０．０５）,术后４、８周大鼠ＣＶＦ－Ｔ和无小血管视野 ＣＶＦ（ＣＶＦ－ＮＶ）均明显增高（Ｐ＜０．０１）,手术组大鼠左室心肌组织ＭＭＰ－１活性明显低于相应假手术大鼠,但经胰蛋 白酶激活后其活性反而高于假手术大鼠。结论：压力负荷增高性心肌肥厚时伴有心肌胶原网络的重构,心肌组织内 ＭＭＰ－１活性调节异常可能与心肌胶原网络重构的形成有关。     

环孢霉素A对大鼠单个核细胞雄激素和雌激素受体的影响及意义

研究了环孢霉素Ａ（ＣａＡ）、环磷酰胺（ＣＴＸ）及甲基强的松龙（ＭＰ）对大鼠单个核细胞（ＭＮＬ）雄激素受体（ＡＲ）及雌激素受体（ＥＲ）的影响。结果表明：静注ＣｓＡ２０ｍｇ／ｋｇ，ＥＲ明显降低，３ｈ作用达高峰，持续低水平达８ｈ；而ＡＲ无明显影响。静注ＣａＡ１００ｍｇ／ｋｇ用ＣＴＡ和ＭＰ使ＡＲ、ＥＲ均明显降低。而ＣＴＸ和ＭＰ使ＥＲ降低，也使ＡＲ降低，故ＣｓＡ免疫抑制作用优于ＣＴＸ和ＭＰ。     

Matrix metalloproteinases and matrix metalloproteinase inhibitors in acute lung injury

The objective of this study was to assess matrix metalloproteinase (MMP) and MMP inhibitor expression in the airspace of patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) and to determine the prognostic significance of MMP expression in this patient population. Twenty-eight patients with ALI or ARDS were prospectively enrolled in this study; bronchoalveolar lavage (BAL) fluid obtained from these patients was examined for expression of MMP-1 (interstitial collagenase), MMP-2 (gelatinase A), MMP-3 (stromelysin-1), MMP-8 (neutrophil collagenase), and MMP-9 (gelatinase B). Levels of MMP inhibitors (ie, tissue inhibitor of metalloproteinases-1 and -2 [TIMP-1 and TIMP-2]) were examined in parallel. Expression of MMPs was correlated with relevant clinical outcomes in patients with ALI/ARDS. In nearly all specimens obtained from patients with ALI/ARDS, there were high levels of MMP-2, MMP-8, MMP-9, and TIMP-1, but in only a small subset of patients (6/28) were there detectable levels of MMP-1 and/or MMP-3. In the patients with elevated MMP-1 and/or MMP-3, the mortality rate was higher (83%) than in the group without detectable levels of these enzymes (32%). Likewise, the overall severity of disease as indicated by Acute Physiology and Chronic Health Evaluation III scores was higher in this group (98 +/- 30) than in the group without detectable MMP-1 or MMP-3 (78 +/- 28). The percentage of individuals in whom lung disease was complicated by multiorgan failure was also higher in the group with detectable MMP-1 and/or MMP-3 (83%) than in the group without (64%), as was the number of organs that failed. In contrast, there was no correlation between MMP-1 and/or MMP-3 expression and impairment in gas exchange, as determined by the ratio of partial pressure of oxygen to fraction of inspired oxygen (Pao(2)/Fio(2)) on the day of BAL sample. Based on these findings, we conclude that elevated MMP-2, MMP-8, and MMP-9 in BAL fluid is a marker of acute lung injury (and, perhaps, a contributor to ALI) but is not necessarily an indicator of a poor outcome. On the other hand, the presence of detectable MMP-1 and/or MMP-3 is an indicator of more ominous disease progression.     

Regulation of matrix metalloproteinases and their inhibitors in the left ventricular myocardium of patients with aortic stenosis

Aortic stenosis (AS) results in myocyte and extracellular matrix remodeling in the human left ventricle (LV). The myocardial renin-angiotensin system is activated and collagens I and III and fibronectin accumulate. We determined the yet unknown regulation of enzymes that control collagen turnover, i.e., LV matrix metalloproteinases (MMP) and their tissue inhibitors (TIMPs) in human AS. We compared LV samples from AS patients undergoing elective aortic valve replacement (n=19) with nonused donor hearts with normal LV function (controls, n=12). MMP-2, MMP-9, MT1-MMP, and extracellular matrix metalloproteinase inducer (EMMPRIN), TIMP-1, TIMP-2, TIMP-3, and TIMP-4 mRNA were quantitated by real-time RCR. MMP-1, MMP-2, MMP-3, TIMP-3, TIMP-4, and EMMPRIN protein were measured by immunoblotting and MMP-9 and TIMP-1 protein by ELISA. Gelatinolytic MMP-2 and MMP-9 activity was measured by zymography. MMP-2 was increased in AS at mRNA, protein, and activity levels (131%, 193%, and 138% of controls). MMP-3 protein (308%) and EMMPRIN mRNA and protein were also upregulated (171% and 200%). In contrast, MMP-1 (37%) and MMP-9 mRNA, protein, and activity (26%, 21%, and 52%) were downregulated. MMP-9 activity was inversely correlated with LV size. TIMP-1 mRNA and protein were decreased (55% and 73%). In contrast, TIMP-2 mRNA (358%), TIMP-3 mRNA and protein (145% and 249%) were increased. TIMP-4 mRNA was not altered, but TIMP-4 protein was upregulated to 350%. Changes were similar in AS patients with normal and impaired LV ejection fraction. The dysregulation of myocardial MMPs and TIMPs in human AS starts at an early disease stage when LV function is still normal. In spite of upregulation of some MMPs the balance between MMP and TIMP is shifted towards MMP inhibition in human AS and may contribute to collagen accumulation.     

基质金属蛋白酶及其组织抑制因子在左心室机械辅助减负荷模型中的表达

目的 研究基质金属蛋白酶(MMP)及其组织抑制因子(TIMP)在左心室机械辅助减负荷模型中的表达,探讨左心室减负荷后心肌逆向重构的分子机制.方法 结扎Lewis大鼠冠状动脉左前降支诱导心力衰竭,4周后将14只心力衰竭大鼠随机分为心力衰竭组(n=7)与移植组(n=7).将供体移植组心力衰竭大鼠的心脏及右肺移植到受体正常Lewis大鼠的腹部,通过供体的升主动脉与受体的降主动脉吻合.7只正常Lewis大鼠作为正常组.结扎左前降支4周后心脏超声测量3组大鼠心室直径和心肌梗死范围.移植2周后,称取各组大鼠心脏、左心室质量;显微镜观测左心室心肌细胞直径与心肌纤维化程度;采用实时荧光定量PCR检测MMP-1、MMP-9、TIMP-1的mRNA表达及计算MMP-1mRNA/TIMP-1 mRNA的比值.结果 结扎左前降支4周后,心力衰竭组及移植组舒张末直径(LVEDD)较正常组升高、左心室短轴缩短率(LVFS)较正常组下降,而此两组间LVEDD、LVFS及心肌梗死范围比较差异无统计学意义,两组的心力衰竭严重程度差异也无统计学意义.心力衰竭组心脏、左心室质量和左心室心肌细胞直径大于移植组与正常组;移植组心脏、左心室质量、左心室心肌细胞直径接近正常组.心肌纤维化的程度移植组＞心力衰竭组＞正常组[(7.90±2.32)％比(4.20±1.84)％比(1.54±0.31)％,均P＜0.05].心力衰竭组和移植组MMP-1、MMP-9mRNA表达均高于正常组(1.89±0.23、1.32±0.16比0.41±0.01,2.03±0.15、1.50±0.13比0.46+0.01,均P＜0.05),但心力衰竭组与移植组比较差异无统计学意义.心力衰竭组TIMP-1mRNA表达低于正常组与移植组(0.72±0.18比1.21±0.02、1.68±0.21,均P＜0.05);正常组与移植组比较差异无统计学意义.心力衰竭组MMP-1 mRNA/TIMP-1mRNA比值较正常组及移植组明显增高(2.03±0.15比0.30±0.01、0.81±0.11,均P＜0.05);正常组与移植组差异则无统计学意义.结论 左心室减负荷后,心肌逆向重塑的过程伴随着心肌细胞MMP及TIMP水平的改变.     

Expression of matrix metalloproteinases, their tissue inhibitors, and osteopontin in the wall of thoracic and abdominal aortas with dilatative pathology

Matrix metalloproteinases (MMPs) degrade extracellular matrix and may play a central role in the pathogenesis of aortic aneurysms. We studied 2 groups of patients: 15 with dilatative pathology of the ascending thoracic aorta and 17 with aneurysm of the abdominal aortic wall (AAA). We compared the expression of MMPs, tissue inhibitors of matrix metalloproteinases (TIMPs), and osteopontin in the wall of thoracic and abdominal aneurysms. In AAA, MMP-9 and TIMP-1 expression in inflammatory cells was higher than in smooth muscle cells (SMCs) (median score: 3.5 versus 1, P < .0001; 2 versus 1, P < .04, respectively), whereas MMP-2 demonstrated higher expression in SMCs than in inflammatory cells (median score: 0 versus 4, P < .0001). In ATA, MMP-2, MMP-9, TIMP-1, TIMP-2, TIMP-3, and osteopontin expression in SMCs was higher than in inflammatory cells (median score: 3 versus 0, P < .0001; 4 versus 1, P < .0005; 2 versus 0, P < .001; 5 versus 2, P < .0001; 2 versus 0, P < .005; and 5 versus 1.5, P < .0001, respectively), when both inflammatory cells of the media and the adventitia were considered together. The cellular expression of MMP-9 and their tissue inhibitors TIMP-1, TIMP-2, and TIMP-3 differs in the dilatative pathology of abdominal and thoracic aortas, so the hypothetical model of morphogenesis of AAA cannot completely explain the formation of dilatative pathology of the ascending thoracic aorta.     

基质金属蛋白酶在心肌缺血大鼠心室间质重构中的作用

目的:探讨大鼠心肌缺血后心肌间质基质金属蛋白酶(MMPs)活性变化与心室间质重构的关系。方法:用异丙肾上腺素(ISP)复制大鼠心肌缺血模型,用酶谱法测定心肌间质MMPs活性,氯胺T法测定胶原含量,免疫组化法测定I/III胶原比例,电镜观察心肌超微结构。结果:心肌缺血组(M组)MMP-2活性在1、2、4周分别是对照组(C组)的5.8倍、2.3倍(P＜0.01)和1.7倍(P＜0.05),MMP-9活性则分别是对照组的4.9倍、1.9倍(P＜0.01)和1.4倍(P＜0.05)。胶原含量、I/III胶原比例在2周、4周时均显著高于对照组。电镜见缺血组心肌细胞坏死、间质胶原大量增生、结构紊乱。结论:心肌缺血后心肌间质内MMPs活性升高,可能是心室重构的重要原因。     

MMP-9/TIMP-1表达在糖尿病鼠皮肤伤口愈合过程中的变化及意义初探

目的：观察基质金属蛋白酶-9（MMP-9）、组织金属蛋白酶抑制剂-1（TIMP-1）的表达和MMP-9/TIMP-1比值在糖尿病组和正常组大鼠皮肤伤口愈合过程中不同时点表达的动态变化，探讨其可能的作用机制。 方法:糖尿病大鼠形成6周后行皮肤伤口造模，采用HE染色、Masson染色和免疫组织化学方法评估伤口形成后3、7、14 d伤口组织的再上皮化、炎症细胞浸润、肉芽组织厚度、新生血管形成和胶原纤维密度的情况；通过逆转录-聚合酶链反应(RT-PCR)和Western印迹检测术后不同时点MMP-9、TIMP-1在伤口组织中的表达情况。结果:糖尿病大鼠伤口愈合明显迟缓。术后第3 d两组间胶原纤维、肉芽组织、新生血管和再上皮化没有差异，术后第7 d糖尿病组以上指标得分均低于正常组，第14 d这种趋势更加明显；而第3 d至14 d，糖尿病组的单核巨噬细胞浸润得分均低于正常组。术后第3 d两组MMP-9表达均达高峰，第7、14 d呈逐渐下降趋势，糖尿病组MMP-9表达水平在各时点均高于正常组；术后第3 d两组TIMP-1表达均达高峰，第7、14 d呈逐渐下降趋势，糖尿病组TIMP-1表达水平在各时点均低于正常组；正常组MMP-9/TIMP-1蛋白水平比值始终维持在一个动态平衡的稳定水平，而糖尿病组却长期处于高水平状态。结论:异常的胶原产生、新生血管重建、炎症反应、再上皮化、肉芽形成可能是糖尿病鼠创面愈合减慢的组织病理学基础；皮肤组织MMP-9/TIMP-1的平衡性改变可能是这种组织病理学异常的重要原因之一。     

Protein kinase C activation by phorbol ester increases in vitro invasion through regulation of matrix metalloproteinases/tissue inhibitors of metalloproteinases system in D54 human glioblastoma cells

To elucidate possible mechanisms of phorbol 12-myristate 13-acetate (PMA) induced in vitro invasiveness of glioblastoma cells, we examined expression levels of membrane-type 1 matrix metalloproteinase (MT1-MMP), MMP-2, MMP-9 and tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-2 using Western blotting and gelatin zymography assay, and found that PMA induced the secretion of MMP-9, activated MMP-2 proenzyme to fully active form of 59 kDa, down-regulated the TIMP-1 and TIMP-2 secretion, and increased MT1-MMP on the cell surface. However, PKC inhibitor Go 6983 reversed all of these effects brought about by PMA. We, therefore, conclude the activation of PKC by PMA in these cells plays a critical role in the regulation of MMPs/TIMPs system, which has a major role in tumor invasion and metastasis.     

基质金属蛋白酶及其组织型抑制剂活性及表达失衡与高血压性左心室重塑的关系

目的： 探讨慢性压力负荷增高时，大鼠左心室（LV）基质金属蛋白酶（MMPs）/组织型基质金属蛋白酶抑制剂（TIMPs）失衡与LV重塑的关系。方法：40只6周龄雄性卒中易感性自发性高血压大鼠（SHR-SPs）作为研究对象，10只同周龄雄性Wistar-Kyoto（WKY）大鼠作为对照。6个月后，以Millar压力容积导管评价2组大鼠的在体LV血流动力学，并对2组大鼠的心脏进行组织病理学、明胶酶谱和免疫印迹法分析。结果：反映LV收缩与舒张功能的血流动力学参数在2组间有显著差异（P＜0.05）；SHR-SPs心脏胶原容积分数、血管周胶原面积/管腔面积、心肌横断面积、心室壁动脉中膜面积/管腔面积均增高（P＜0.05）；心肌MMP-2活性、蛋白含量及TIMP-1蛋白含量在SHR-SPs中明显增高（P＜0.05）。结论：慢性压力超负荷能够导致心脏细胞外基质代谢失调及MMPs/TIMPs系统失衡，继而产生心室腔扩张、LV收缩与舒张功能障碍。     

血管紧张素Ⅱ对肥厚心肌基质金属蛋白酶及细胞外基质的影响

目的: 探讨血管紧张素Ⅱ(AngⅡ)受体（AT₁,AT₂）拮抗剂对梗死心脏肥厚心肌组织基质金属蛋白酶(MMPs)及细胞外基质成份的影响。方法: 结扎大鼠左冠状动脉建立心肌梗死模型，术前7 d起分别用安慰剂、AT₁受体拮抗剂撷沙坦（valsartan）（10 mg·kg^-1·d^-1）、AT₂受体拮抗剂PD123319（30 mg·kg^-1·d^-1）。术后1、3、7、14 d分别检测室间隔（IS）MMP-2,3,9及其抑制物-1（TIMP-1）蛋白表达，以及细胞基质纤连蛋白（FN）、肌腱蛋白（TN-C）表达，免疫荧光分析FN、TN-C分布。结果: 心肌梗死14 d, IS呈典型的肥厚心肌病变。 手术组大鼠室间隔MMP-2、3、9及TN-C蛋白表达显著高于假手术组（P<0.01），TIMP-1和FN蛋白表达显著降低（P<0.01）; 手术加valsartan组 MMP-2、3、9 和 TN-C 蛋白表达明显低于手术组及手术加PD123319组, 相反， TIMP-1 和FN 蛋白表达显著高于手术组及手术加PD123319组 (P<0.01); 手术组与手术加PD123319组间MMP-2、3、9、TIMP-1、FN、TN-C蛋白表达差异无显著（P>0.05）。结论: AngⅡ参与心肌梗死心肌组织的重塑，通过AT1起作用调节MMPs降解细胞外基质， AT₁受体拮抗剂的心脏保护作用与其抑制MMPs有关。