Περίληψη:
Diabetes mellitus (DM) is associated with an increased incidence of
cardiovascular events and microvascular complications. These
complications contribute to the morbidity and mortality associated with
DM. There is increasing evidence supporting a role for matrix
metalloproteinases (MMPs) and their inhibitors (tissue inhibitors of
matrix metalloproteinases-TIMPs) in the atherosclerotic process.
However, the relationship between MMPs/TIMPs and diabetic angiopathy is
less well defined. Hyperglycemia directly or indirectly (eg, via
oxidative stress or advanced glycation products) increases MMP
expression and activity. These changes are associated with histologic
alterations in large vessels. On the other hand, low proteolytic
activity of MMPs contributes to diabetic nephropathy. Within
atherosclerotic plaques an imbalance between MMPs and TIMPs may induce
matrix degradation, resulting in an increased risk of plaque rupture.
Furthermore, because MMPs enhance blood coagulability, MMPs and TIMPs
may play a role in acute thrombotic occlusion of vessels and consequent
cardiovascular events. Some drugs can inhibit MMP activity. However, the
precise mechanisms involved are still not defined. Further research is
required to demonstrate the causative relationship between MMPs/TIMPs
and diabetic atherosclerosis. It also remains to be established if the
long-term administration of MMP inhibitors can prevent acute
cardiovascular events.
Συγγραφείς:
Kadoglou, NP
Daskalopoulou, SS
Perrea, D
Liapis, CD
