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.
Reference
Mashaqi, S., Mansour, H., Alameddin, H., Combs, D., Patel, P., Estep, L., & Parthasarathy, G. (2020). Matrix metalloproteinase-9 as a messenger in the crosstalk between obstructive sleep apnea and comorbid systemic hypertension, cardiac remodeling, and ischemic stroke: a literature review. https://doi.org/10.5664/jcsm.8928
Abstract