Matrix metalloproteinases (MMPs) are thought to be involved in the growth, destabilization, and eventual rupture of atherosclerotic lesions. Using the mouse brachiocephalic artery model of plaque instability, we compared apolipoprotein E (apoE)͞MMP-3, apoE͞MMP-7, apoE͞MMP-9, and apoE͞MMP-12 double knockouts with their age-, strain-, and sex-matched apoE single knockout controls. Brachiocephalic artery plaques were significantly larger in apoE͞MMP-3 and apoE͞MMP-9 double knockouts than in controls. The number of buried fibrous layers was also significantly higher in the double knockouts, and both knockouts exhibited cellular compositional changes indicative of an unstable plaque phenotype. Conversely, lesion size and buried fibrous layers were reduced in apoE͞MMP-12 double knockouts compared with controls, and double knockouts had increased smooth muscle cell and reduced macrophage content in the plaque, indicative of a stable plaque phenotype. ApoE͞MMP-7 double knockout plaques contained significantly more smooth muscle cells than controls, but neither lesion size nor features of stability were altered in these animals. Hence, MMP-3 and MMP-9 appear normally to play protective roles, limiting plaque growth and promoting a stable plaque phenotype. MMP-12 supports lesion expansion and destabilization. MMP-7 has no effect on plaque growth or stability, although it is associated with reduced smooth muscle cell content in plaques. These data demonstrate that MMPs are directly involved in atherosclerotic plaque destabilization and clearly show that members of the MMP family have widely differing effects on atherogenesis.animal models ͉ atherosclerosis M atrix metalloproteinases (MMPs) are a group of Ͼ20 zinccontaining endopeptidases that are either secreted or expressed at the cell surface of all of the main vascular cell types. MMPs have overlapping specificities, but each can process at least one extracellular matrix component, and many nonmatrix substrates have also been described. Given this complexity it is not surprising that multiple roles for MMPs have been proposed, including regulation of cell migration, proliferation, and death. As a result, roles for MMPs in atherosclerotic plaque growth and fibrous cap formation have been suggested (1). On the other hand, the presence of elevated mRNA, protein, and activity levels of MMPs within atherosclerotic lesions, particularly at the shoulder regions of the fibrous cap (2-5), has led to the suggestion that they degrade strength-giving extracellular matrix components, including fibrillar collagens. By this mechanism MMPs could promote atherosclerotic plaque destabilization, the main cause of myocardial infarction in humans.Intervention studies in animal models have been used to investigate the potential roles of MMPs in cardiovascular disease. For example, inhibition of MMP activity by adenovirusmediated delivery of the gene for human tissue inhibitor of metalloproteinases (TIMP)-1 reduced lesion size in the aortic root of apolipoprotein E (apoE) knockout mice (6). H...