Matrix metalloproteinases and acute aortic dissection: Et Tu, Brute?
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Updated: Jan 2, 2026
Murine Model of Thoracic Aortic Dissection Induced by Oral β-Aminopropionitrile and Subcutaneous Angiotensin II Infusion
Published on: May 16, 2025
Hisato Takagi1,2, Yosuke Hari1,2, Kouki Nakashima1,2
1Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
Objectives:
To summarize the present evidence for the association of matrix metalloproteinases (MMPs) with acute aortic dissection (AAD), we performed the first meta-analysis of all currently available case-control studies comparing circulating MMP levels between AAD patients and control subjects.
Methods:
To identify all studies investigating the levels of circulating MMPs in AAD patients, PubMed and Web of Science were searched up to July 2019. The levels of MMPs in AAD patients and control subjects were extracted from each study, and the standardized mean differences (SMDs) in MMP levels were generated. The study-specific estimates were combined in the random-effects model.
Results:
Twelve studies enrolling a total of 458 AAD patients and 711 control subjects were identified and included. Pooled analyses demonstrated no significant differences in MMP-1 (4 studies; P = 0.21), MMP-2 (5 studies; P = 0.62) and MMP-3 levels (2 studies; P = 0.94) between AAD patients and control subjects; and significantly higher MMP-8 (2 studies; SMD 2.11; P = 0.020), MMP-9 (9 studies; SMD 1.54; P < 0.001) and MMP-12 levels (2 studies; SMD 1.33; P < 0.001) in AAD patients than in control subjects.
Conclusion:
High circulating MMP-9 levels are associated with AAD, and MMP-8 and MMP-12 levels may be related to AAD.
Insights
This meta-analysis found that matrix metalloproteinase-9 (MMP-9) levels are significantly higher in acute aortic dissection (AAD) patients. Elevated MMP-8 and MMP-12 may also be associated with AAD.
Area of Science:
- Cardiovascular Research
- Biomarkers
- Medical Diagnostics
Background:
- Matrix metalloproteinases (MMPs) play a role in extracellular matrix remodeling.
- Alterations in MMP levels have been implicated in various cardiovascular diseases.
- Acute aortic dissection (AAD) is a life-threatening condition with complex pathophysiology.
Purpose of the Study:
- To synthesize current evidence on the association between circulating matrix metalloproteinases (MMPs) and acute aortic dissection (AAD).
- To conduct the first meta-analysis comparing MMP levels in AAD patients versus control subjects.
Main Methods:
- A systematic literature search was conducted on PubMed and Web of Science up to July 2019.
- Case-control studies comparing circulating MMP levels in AAD patients and controls were included.
- Standardized mean differences (SMDs) were calculated and pooled using a random-effects model.
Main Results:
- Twelve studies with 458 AAD patients and 711 controls were analyzed.
- Significantly elevated levels of MMP-8, MMP-9, and MMP-12 were observed in AAD patients compared to controls.
- No significant differences in MMP-1, MMP-2, or MMP-3 levels were found between groups.
Conclusions:
- Circulating MMP-9 levels are significantly associated with acute aortic dissection (AAD).
- MMP-8 and MMP-12 may also be implicated in the pathophysiology of AAD.
- These findings highlight potential roles for specific MMPs as biomarkers in AAD.
