STUDY OBJECTIVES: Obstructive sleep apnea is a common sleep disorder. There is a strong link between sleep related breathing disorders and cardiovascular and cerebrovascular diseases. Matrix metalloproteinase-9 (MMP-9) is a biological marker for extracellular matrix degradation which plays a significant role systemic hypertension, myocardial infarction and post-MI heart failure, and ischemic stroke. This manuscript reviews MMP-9 as an inflammatory mediator and a potential messenger between OSA and OSA-induced comorbidities.
METHODS: We reviewed MEDLINE database (PubMed) for publications on MMP-9, OSA and cardiovascular disease. 1,592 studies were identified and of these, 50 articles were included and reviewed.
RESULTS: There is strong evidence that MMP-9 and tissue inhibitor of metalloproteinases-1 (TIMP-1) levels are elevated in patients with obstructive sleep apnea (mainly MMP-9), systemic hypertension, myocardial infarction, post-MI heart failure. Study showed variable results and that could be related to the sample size or laboratory methodology.
CONCLUSIONS: MMP-9 and its endogenous inhibitor TIMP-1 are a common denominator in obstructive sleep apnea, systemic hypertension, myocardial infarction, and heart failure. This makes MMP-9 a target for developing novel selective inhibitors that can serve as adjuvant therapy in patients with OSA. This may potentially ameliorate the cardiovascular and cerebrovascular mortality associated with OSA.