. TNF-␣ and myocardial matrix metalloproteinases in heart failure: relationship to LV remodeling. Am J Physiol Heart Circ Physiol 282: H1288-H1295, 2002; 10.1152/ajpheart.00526. 2001.-The cytokine tumor necrosis factor (TNF)-␣ has been causally linked to left ventricular (LV) remodeling, but the molecular basis for this effect is unknown. Matrix metalloproteinases (MMPs) have been implicated in cardiac remodeling and can be regulated by TNF-␣. This study tested the central hypothesis that administration of a TNF-␣ blocking protein would prevent the induction of MMPs and alter the course of myocardial remodeling in developing LV failure. Adult dogs were randomly assigned to the following groups: 1) chronic pacing (250 beats/min, 28 days, n ϭ 12), 2) chronic pacing with concomitant administration of a TNF-␣ blocking protein (TNF block) using a soluble p75 TNF receptor fusion protein (TNFR:Fc; administered at 0.5 mg/kg twice a week subcutaneously, n ϭ 7), and 3) normal controls (n ϭ 10). LV end-diastolic volume increased from control with chronic pacing (83 Ϯ 12 vs. 118 Ϯ 10 ml, P Ͻ 0.05) and was reduced with TNF block (97 Ϯ 9 ml, P Ͻ 0.05). MMP zymographic levels (92 kDa, pixels) increased from control with chronic pacing (36,848 Ϯ 9,593 vs. 87,247 Ϯ 12,912, P Ͻ 0.05) and was normalized by TNF block. Myocardial MMP-9 and MMP-13 levels by immunoblot increased with chronic pacing relative to controls (130 Ϯ 10% and 118 Ϯ 6%, P Ͻ 0.05) and was normalized by TNF block. These results provide evidence to suggest that TNF-␣ contributes to the myocardial remodeling process in evolving heart failure through the local induction of specific MMPs.tumor necrosis factor-␣; chronic pacing A MILESTONE IN THE DEVELOPMENT of left ventricular (LV) failure is myocardial remodeling. Myocardial remodeling can be defined as structural changes in the cellular and extracellular matrix resulting in compositional changes within the LV wall. An acceleration of the LV remodeling process is associated with greater morbidity and mortality in patients with LV failure (3, 16). While a number of biological systems influence myocardial matrix structure and function, a family of proteases called matrix metalloproteinases (MMPs) likely contributes to the remodeling process (4, 8, 12-15, 18, 26, 29-31). MMP activity is regulated at several levels, including transcription and posttranslational modification (8, 21). MMP activity can be inhibited by an endogenous class of proteins called the tissue inhibitors of MMPs (TIMPs). A number of biologically active molecules can induce MMP expression, including the pleotrophic cytokine tumor necrosis factor (TNF)-␣, which has been demonstrated to increase MMPs in vitro (10, 25). Increased TNF-␣ levels have been previously associated with LV myocardial remodeling (1, 17). TNF-␣ is synthesized as a membrane-bound protein and subsequently processed and cleaved to a soluble form that circulates as a stable homotrimer (5). TNF-␣ binding to cell surface receptors results in the activation of intracellular signaling ...