Abstract-Matrix metalloproteinases (MMPs), and in particular MMP-9 secreted by neutrophils, are capable of degrading the matrix components of the heart and are thought to be the driving force behind myocardial matrix remodeling after infarction. Adenosine, a naturally produced nucleoside, has been shown to have cardioprotective effects and to inhibit secretion of various cytokines. The aim of our study was to determine the effect of adenosine on the secretion of MMP-9 by neutrophils. Neutrophils were isolated from healthy volunteers through Ficoll and Dextran sedimentation. Neutrophils were activated by N-formylmethionyl-leucyl-phenylalanine (fMLP) in the presence or absence of adenosine or adenosine analogs. Zymography and enzyme linked immunosorbent assay were used to measure MMP-9 secretion. Adenosine (1 mol/L) decreased the fMLP-induced MMP-9 secretion by 30Ϯ2% (nϭ8, PϽ0.001). The effect was dose-dependent and was not specific to fMLP because adenosine also inhibited MMP-9 secretion by LPS-or H 2 O 2 -stimulated neutrophils. The effect of adenosine was mimicked by the adenosine A2a receptor agonist CGS21680 and was inhibited by both the A2a antagonist SCH5826 and A2a RNA silencing. The A3 agonist IB-MECA moderately decreased fMLP-induced MMP-9 secretion. Agonists and antagonists of the other types of adenosine receptors had no significant effect. Adenosine increased intracellular cAMP concentration and accelerated the return to baseline of the intracytoplasmic calcium peak. The inhibition of MMP-9 secretion by adenosine, as well as the calcium effect, was prevented by the protein kinase A inhibitor H-89. In conclusion, we show here that adenosine inhibits MMP-9 secretion by neutrophils. Our results suggest that this effect implies the A2a receptor and is mediated through the cAMP/PKA/ Ca 2ϩ pathway. Therefore, adenosine may represent a new approach to prevent matrix degradation and remodeling after myocardial injury. (Circ Res. 2006;99:590-597.) Key Words: adenosine Ⅲ neutrophils Ⅲ myocardial remodeling Ⅲ protein kinase A Ⅲ matrix metalloproteinase-9 D espite reperfusion therapy with thrombolysis or percutaneous intervention, the development of left ventricular remodeling and heart failure after myocardial infarction has not significantly decreased and remains associated with a more than 10-fold elevated risk of death. 1 Enhanced activity of matrix metalloproteinases (MMPs) and in particular MMP-9 after infarction breaks down collagen contributing to myocyte slippage and ventricular remodeling. Recent observations 2 and the Framingham study have shown that levels of MMP-9 are elevated after myocardial infarction both in the acute and chronic phases. 3 We have identified MMP-9 as a risk marker for the development of left ventricular remodeling and heart failure after acute myocardial infarction. 4 Animal studies have shown that ventricular remodeling after infarction can be attenuated through the use of MMPs inhibitors. [5][6][7] However, recent results from the PREMIER (Prevention of Myocardial Infarction Ea...