In addition, MMPs have also been shown to be important in many malignant and inflammatory diseases with tissue destruction [7, 8]. The cleavages of non-matrix substrates including cytokines and chemokines can be decisive and direct both pro- and anti-inflammatory actions of MMPs . The mechanism of action of MMPs in arterial disease and aneurysm formation has largely been attributed to their ability to proteolytically process the extracellular matrix of the aortic wall . Endogenous tissue inhibitors of MMP (TIMPs) provide a balancing mechanism to prevent excessive extracellular matrix
degradation . Degranulation BMS-907351 order of neutrophils upon the stimuli of inflammatory and microbial virulence factors Afatinib mw releases also oxidative proinflammatory myeloperoxidase (MPO), and a serine protease neutrophil elastase (HNE), which can further promote the cascades of inflammatory tissue destruction . Series of inflammatory reactions as measured by increased serum inflammatory markers have been shown to be associated with atherosclerosis, carotid artery stenosis, and AAA [12–14]. The role of MMPs and their regulators in arterial disease remains; despite several existing publications,
unclear, and the balance between MMPs and their regulators requires further investigation. Identification of markers reflecting the MMP-system may help to identify patients with arterial disease. Thus, we investigated the serum concentrations of these markers
in the patients with degenerative arterial disease including occlusive manifestations, i.e. aorto-occlusive disease and carotid disease as well as aneurysmal manifestations, i.e. abdominal aortic aneurysms. In addition, we studied, if the values differ from those of generally healthy subjects. The study population comprised 126 patients, who underwent surgery because of symptomatic AOD (n = 18), carotid artery stenosis (n = 67) or AAA (n = 41) in the Department Adenosine of Vascular Surgery, Helsinki University Central Hospital between the years 2002–2004. Preoperative blood samples were collected from all patients before the induction of anaesthesia from an upper arm arterial line in the operation theatre. Demographic characteristics and vascular risk factors are described in Table 1. Carotid surgery was performed on symptomatic patients with a moderate (50–69%) or high-grade (70–99%) carotid stenosis. Aneurysm operations were all elective repairs for AAAs with a mean maximum diameter of 61.6 mm (range 40–112 mm). Three patients with small aneurysms had disabling claudication as well. All patients with AOD had disabling claudication caused by aortoiliac lesions, which were so extended that endovascular treatment was not feasible. None of the patients had chronic critical limb ischaemia. The serum reference values were determined from samples provided by healthy blood donors (n = 100) collected by the Finnish Red Cross, Oulu, Finland.