Chymase and Matrix Metalloproteinase
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Hypertens Res
Vol.30 (2007) No.1
p.3-4
Editorial Comment
Chymase and Matrix Metalloproteinase
Hidenori URATA1)
(Hypertens Res 2007; 30: 3–4)
Key Words: chymase, matrix metalloproteinase, neointimal proliferation, chymase inhibitor
Matrix metalloproteinases (MMPs) are a family of zinc-binding proteases that are capable of degrading extracellular
matrix (ECM) during tissue remodeling, including organogenesis, wound healing (1), tumor invasion and angiogenesis
(2). MMP-2 (collagenase A) is the major ECM-degrading
protease and specifically degrades the basement membrane.
Regarding vascular remodeling after balloon injury, MMP-2
is expressed abundantly in restenotic lesions, and the inhibition of MMP-2 by thapsigargin reduces neointima formation
(3). In nonhuman primates, MMPs increase with age, and this
increase has been positively correlated with the intimal thickening of the carotid artery (4).
Recently, it has been reported that chymase activates several inactive precursors of MMPs (5–7). This finding revealed
a new aspect of the function of chymase, in addition to its
action as a potent angiotensin II (Ang II)–forming enzyme. It
has been reported that chymase produces Ang II (8), which
may play a crucial role in coronary artery restenosis. Ang II
subtype 1 receptor blocker (ARB) has been proven effective
for preventing restenosis after percutaneous coronary angioplasty, but not angiotensin I converting enzyme inhibitor (9,
10). After balloon injury in dog arteries, vascular chymase
activity significantly increased and a chymase inhibitor and
an ARB were effective in preventing vascular proliferation
(11). These studies suggest that chymase-dependent Ang II
formation is also harmful in that it promotes the development
of vascular hypertrophy in the injured arteries.
In this issue of Hypertension Research, Kishi et al. (12)
report that chymase is involved in the neointimal proliferation
after balloon injury in the dog carotid artery. The oral administration of NK3201, a chymase inhibitor, prevented neointimal formation and significantly suppressed both active
MMP-2 and chymase activities 2 weeks after balloon injury.
These results suggest that chymase inhibitors can prevent the
development of intimal hyperplasia via the inhibition of
MMP-2 activation in the balloon-injured artery.
Disappointingly, the use of drug-eluting stents has not
resulted in a lower rate of adverse events compared to coronary bypass operation, especially in patients with complex
lesions or multiple risk factors (13). It has been reported that
increased arterial chymase activity is associated with development of atherosclerotic lesions in humans (14), and orally
active chymase inhibitor has been shown to reverse this process in high cholesterol–loaded hamsters (15). These data further imply that the clinical application of chymase inhibitor is
warranted to prevent atherosclerosis or restenosis after coronary intervention.
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Suzuki K, Lees M, Newlands GF, Nagase H, Woolley DE:
Activation of precursors for matrix metalloproteinases 1
From the 1)Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Chikushino, Japan.
Address for Reprints: Hidenori Urata, M.D., Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, 1–1–1 Zokumyoin,
Chikushino 818–8502, Japan. E-mail:
Received December 18, 2006.
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