Our current understanding of the pathophysiology of atherosclerosis suggests the involvement of complex mechanisms that go beyond mere lipid storage disorders.1,2) It is of great importance to investigate causative factors in the destabilization of atherosclerotic plaques, which should help develop new therapeutic and diagnostic (imaging) agents of atherosclerosis, leading to the establishment of novel therapeutic strategies for preventing acute coronary syndromes and stroke.To date, several factors, including enhanced inflammatory responses and expression of matrix metalloproteinases (MMPs), have been suggested to play important roles in the destabilization of atherosclerotic plaques.1-4) Plaques prone to rupture are morphologically characterized by a thin fibrous cap overlying a large lipid core. MMPs have been shown to degrade extracellular matrix (ECM) that constitutes the fibrous cap of the plaques, resulting in the destabilization of atherosclerotic plaques. [3][4][5] Increased expression of MMP-2 and MMP-9 has been demonstrated within human atherosclerotic lesions and critically implicated in plaque rupture.5-7) MMP-2 and MMP-9 are known to cleave native type IV, V, VII, and X collagens and elastin, as well as the products of collagens types I, II, and III after proteolysis by collagenases, such as MMP-1 and MMP-13, and are considered to be involved in plaque instability.3) The MMPs can be divided into two groups: soluble MMPs and membranebound MMPs. Most soluble MMPs, including MMP-2 and MMP-9, are released from cells as zymogens and require extracellular posttranslational cleavage to gain biological activity.3,8) A membrane-bound MMP, membrane type-1 MMP (MT1-MMP or MMP-14), has been demonstrated to mediate the activation of pro-MMP-2 to active MMP-2 on the cell surface.8,9) The expression of MT1-MMP has also been found within human atherosclerotic plaques.10,11) Thus, MT1-MMP, an activator of pro-MMP-2 to active MMP-2, has been speculated to be an important determinant of the destabilization of atherosclerotic plaques.Production of MMP-2 and MMP-9 by monocytes/ macrophages occurs through a prostaglandin (PG) E 2 / cAMP-dependent pathway.1,12,13) Recently, Shankavaram et al. demonstrated that induction of monocyte MT1-MMP is also regulated through the PG E 2 /cAMP pathway. 14) These findings indicate the involvement of cyclooxygenases (COXs), rate-limiting enzymes in the conversion of arachidonic acid into PGs and thromboxanes, in the regulation of MMP biosynthesis. 1,15) To date, at least 2 distinct isoforms of the COXs-a constitutive form (COX-1) and an inducible isoform (COX-2)-and several of their variants have been discovered.16) COX-1 is constitutively expressed in most tissues and is responsible for maintaining homeostasis, whereas COX-2 is induced in response to inflammatory stimuli.17) Overexpression of COX-2 has been shown within human atherosclerotic plaques, localized predominantly in macrophages/foam cells, and to a lesser extent in medial smooth muscle cells and endothelial cells. 18,19) E...