Abstract-Extracellular proteolysis plays a key role in many pathophysiologic processes including cancer, inflammatory diseases, and cardiovascular conditions such as atherosclerosis and restenosis. Whereas matrix metalloproteinases are their best known member, many others are becoming better known. The extracellular proteases are a complex and heterogeneous superfamily of enzymes. They include metalloproteinases (matrix metalloproteinases, adamalysins, or pappalysins), serine proteases (elastase, coagulation factors, plasmin, tissue plasminogen activator, urokinase plasminogen activator), and the cysteine proteases (such cathepsins). In addition to their matrix degradation capabilities, they have other less well known biologic functions that include angiogenesis, growth factor bioavailability, cytokine modulation, receptor shedding, enhancing cell migration, proliferation, invasion, and apoptosis. This review discusses extracellular proteases relevant to the vasculature, their classification and function, and how protease disorders contribute to arterial plaque growth, including chronic atherosclerosis, acute coronary syndromes, restenosis, and vascular remodeling. These broad extracellular protease functions make them potentially interesting therapeutic targets. Key Words: acute coronary syndromes Ⅲ aneurysms Ⅲ athersclerosis Ⅲ proteases Ⅲ restenosis E xtracellular proteolysis is important to many biological processes including tissue remodeling, wound healing, and embryogenesis. It also has a key role in pathophysiologic processes including cancer, chronic inflammatory diseases, and cardiovascular conditions such as atherosclerosis and restenosis.Extracellular proteases (ECP) form a heterogeneous family that is becoming increasingly well understood. Whereas matrix metalloproteinases are the best described, many others are also becoming known. For example, a new protease family, the pappalysins, is now included. Other enzymes such as cysteine proteases were previously considered intracellular enzymes but have recently been shown to function in the extracellular space. In parallel with these discoveries, ECP have generated special interest because they degrade extracellular matrix (ECM). Although recent attention has focused on their impact in vulnerable plaques, promoting weakness and rupture, they are also involved in many other important biological functions.This review discusses extracellular proteases relevant to the vasculature, their function, and how protease disorders contribute to multiple stages of arterial plaque growth, including chronic atherosclerosis, acute coronary syndromes (ACS), restenosis, and vascular remodeling.
Extracellular Protease ClassificationProteases or peptidases are enzymes that hydrolyze peptide bonds. They are classified as endopeptidases (cleaving the inner regions of peptide chains) and exopeptidases, which act at or near the peptide ends, liberating a single, dipeptide, or a tripeptide amino acid residue. Endopeptidases are the principal enzymes degrading extracellular prote...