Matrix Metalloproteinases in the Pathogenesis of Viral Heart Disease
Dainius Daunoravičius, Algimantas Jasulaitis, Valerija Jablonskienė, Virginija Grabauskienė
Summary
Myocarditis is an inflammatory disease of the myocardium, commonly caused by different infectious agents. It is one of the important causes of dilated cardiomyopathy worldwide and dilated cardiomyopathy is currently the most frequent reason for heart transplantation. The mechanisms of progression to persistent cardiomyopathy or healing by spontaneous recovery still remain poorly understood, however many authors agree, that extracellular matrix remodeling by metalloproteinases could be one of the important factors. It was assumed that degradation of matrix components is the only role of the proteolytic enzymes - matrix metalloproteinases (MMPs). Recent studies demonstrated some new functions of the MMPs as powerful modulatory factors in inflammatory disorders: MMPs can process cytokines and chemokines modulating their function, ease the migration of immune cells through the basement membrane and regulate the relationship of cells with ECM components. Although further investigations by controlled randomized studies are still needed to definitely determine the role of MMPs in pathogenesis of viral myocarditis and inflammatory cardiomyopathy, this study progress not only widened our knowledge but could also lead to developing the specific treatment in the future. The development of new treatment strategies is even more important knowing, that despite a remarkable achievement in diagnostics and understand ing the pathophysiological mechanisms there is still no aetiology-based treatment.
Keywords: matrix metalloproteinases, biomarkers, fibrosis, remodeling, heart failure, prognosis.
