Metalloproteinases 2 and 9 as Biomarkers in Acute Elevation of Blood Pressure

Vascular remodeling, a common feature of hypertension and its complications, involves the reconstruction of blood vessel layers through mechanisms of vascular matrix degradation and reorganization. This process is an important step in development, morphogenesis, and tissue repair. Normally, it is regulated by physiological conditions, but when dysregulated, it may contribute to the pathogenesis of several diseases, such as arthritis, cancer, chronic ulcers, and fibrosis. Uncontrolled remodeling of the extracellular matrix (ECM) in the myocardium and vasculature is characteristic of cardiovascular diseases (CVDs). Matrix metalloproteinases (MMPs) have been highlighted as an important class of enzymes with cleavage capacity linked to remodeling processes in CVDs. These proteolytic enzymes are involved in collagen degradation, contribute to the formation and breakdown of various ECM proteins, and participate in cell migration and growth regulation. They are present in several cell types and tissues, including vascular smooth muscle cells, fibroblasts, endothelium, and inflammatory cells. Activation of the renin-angiotensin-aldosterone system affects vascular structure by promoting fibrosis and growth and is also an important regulator of inflammation and vascular remodeling. In this context, this review aims to provide insight into the biological role of MMPs (focusing on MMP-2 and MMP-9) and tissue inhibitors of metalloproteinases (TIMPs) in the development and progression of CVDs, as well as the severe implications of acute blood pressure elevations, such as eclampsia, stroke, and other related conditions, highlighting the varied roles of MMPs in vascular remodeling processes.