Can matrix metalloproteinase inhibitors provide a realistic therapy in cardiovascular medicine?

Tissue matrix biology has provided potential new mechanisms to control vascular and cardiac ageing if effective means of modifying its control processes can be developed. Changing patterns of matrix composition are well documented in a range of cardiovascular disease processes. Locally active metalloproteinases are known to be mediators of composition but their integration and clinical study is severely limited by low specificity and sensitivity of measures in blood that are not clearly relevant to tissue response. The majority of research involving matrix metalloproteinase inhibition is in cancer management; however, the potential of cardiovascular application of these therapies remains relatively untested. Although there remain significant practical problems to be solved, the importance and therapeutic potential of matrix biology in cardiovascular disease is not in question. It is likely that adjuvant use of matrix metalloproteinase inhibitors can significantly enhance the efficacy of current effective cardiovascular treatments for coronary disease, vascular atherosclerosis, ectasia and aneurysm, collateral vessel development and myocardial remodeling.