Matrix metalloproteinases are associated with increased blood-brain barrier opening in vascular cognitive impairment
Open accessAbstract
Background and Purpose—: Subcortical ischemic vascular disease (SIVD) is a major form of vascular cognitive impairment (VCI) due to small vessel disease. Matrix metalloproteinases (MMPs) are neutral proteases that disrupt the blood–brain barrier and degrade myelin basic protein under conditions of neuroinflammation. Brain tissues and cerebrospinal fluid (CSF) of patients with VCI have increased levels of MMPs. We hypothesized that patients with SIVD have increased MMPs in the CSF, which are associated with increased CSF albumin. Methods—: We studied 60 patients with suspected VCI. Twenty-five were classified as SIVD, whereas other groups included mixed Alzheimer disease and VCI, multiple strokes, and leukoaraiosis when white matter lesions were present and the diagnosis of VCI was uncertain. MMP-2 and MMP-9 in CSF and plasma were measured by gel zymography and indexed to CSF and plasma albumin. MMP-3 activity was measured by fluorescent assay. Results—: We found reduced MMP-2 index ( P <0.001) in the CSF for the full group of patients (SIVD, multiple strokes, mixed Alzheimer disease and VCI, and leukoaraiosis) compared with control subjects, whose CSF was obtained during spinal anesthesia. MMP-3 activity was increased in VCI compared with control subjects ( P <0.01). In SIVD, MMP-2 index showed a negative correlation with albumin index, which was absent with the MMP-9 index. Combining MMP-2 index and MMP-3 activity separated the patients with SIVD from the control subjects with high specificity ( P <0.0005). Conclusions—: Our results support the hypothesis that MMPs are associated with increased CSF albumin and suggest that they may contribute to the pathophysiology of SIVD.
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Plasma albumin is increased in the cerebrospinal fluid of patients with vascular cognitive impairment, reflecting blood-brain barrier breakdown.
“First, the plasma protein albumin is increased in the CSF of patient with VCI, reflecting BBB breakdown (Candelario-Jalil et al., 2011).”
From The Pathobiology of Vascular Dementia (2013) · cites this paper as Candelario-Jalil et al., 2011
In a similar model, blood-brain barrier alteration was due to MMP9 production by oligodendrocyte precursors, which are increased in ischemic white matter injury in rodents and in patients with vascular cognitive impairment.
“In a similar model, the BBB alteration was found to be due to MMP9 production by oligodendrocyte precursors, which are increased in ischemic white matter injury in rodent models (Seo et al., 2013) and in patients with VCI (Candelario-Jalil et al., 2011).”
From The Pathobiology of Vascular Dementia (2013) · cites this paper as Candelario-Jalil et al., 2011
Pathological studies show markers of oxidative stress and inflammation in damaged white matter associated with vascular cognitive impairment.
“Pathological studies have shown markers of oxidative stress (isoprostanes) and inflammation (cytokines and adhesion molecules) in the damaged white matter associated with VCI (Back et al., 2011; Candelario-Jalil et al., 2011; Fernando et al., 2006).”
From The Pathobiology of Vascular Dementia (2013) · cites this paper as Candelario-Jalil et al., 2011
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- Authors
- Candelario-Jalil, E., Thompson, J., Taheri, S., Grossetete, M., Adair, J. C., Edmonds, E., Prestopnik, J., Wills, J., & Rosenberg, G. A.
- Affiliations
- From the Departments of Neurology (E.C.-J., J.T., S.T., M.G., J.A., E.E., J.P., G.A.R.), Neurosciences (G.A.R.), Cell Biology and Physiology (G.A.R.), and Anesthesiology (J.W.), University of New Mexico Health Sciences Center, Albuquerque, NM.
- University of New Mexico (US)
- Venue
- Stroke
- Published
- 2011-05
- Volume
- 42
- Issue
- 5
- Pages
- 1345-1350
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- PMC
- PMC3119779
- OpenAlex
- W1966214665
- Cited by
- 173
- References
- 28
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 11 · 2023: 14 · 2022: 14 · 2021: 7 · 2020: 11 · 2019: 11 · 2018: 12 · 2017: 12 · 2016: 9 · 2015: 13 · 2014: 15 · 2013: 11 · 2012: 8
- FWCI
- 6.71
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000041, UL1TR001449)
- National Institute of Neurological Disorders and Stroke (R01NS052305)
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Protease and Inhibitor Mechanisms
- Keywords
- matrix metalloproteinases, vascular cognitive impairment, subcortical ischemic vascular disease, blood-brain barrier permeability, cerebrospinal fluid albumin, MMP-2, MMP-3, MMP-9, cerebral small vessel disease, white matter hyperintensities, neuroinflammation, Alzheimer's disease
- MeSH terms
- Albumins, Alzheimer Disease, Blood-Brain Barrier, Cognition Disorders, Female, Humans, Male, Vascular Diseases, Case-Control Studies, Matrix Metalloproteinase 3, Stroke, Matrix Metalloproteinase 2, Matrix Metalloproteinase 9, Leukoaraiosis
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