Proteinases and glomerular matrix turnover.

The mesangial cell MMPs and their inhibitor may represent proteins through which biological modifiers such as cytokines and growth factors can control and influence the organization of the glomerulus. At the present we can only speculate on their exact function in glomerular disease. They could conceivably play a role in glomerular conditions where mesangial hypercellularity and cytoplasmic interposition between the endothelium and the basement membrane are frequent occurrences, and in which cytokine-enhanced synthesis of matrix-degrading enzymes could result in severe structural damage. A number of glomerular diseases such as diabetic nephropathy are characterized by the accumulation of glomerular matrix proteins. This could be explained by the inappropriate expression of intrinsic mesangial cell MMPs or TIMP. Further investigation of these proteins in experimental models of glomerular disease or in situ hybridization studies using the available probes promises to be a rewarding area of research during the next few years. For these studies the availability of rTIMP and recent developments in the design of synthetic inhibitors of MMPs may allow more searching investigations into the role of MMP in the pathophysiology of glomerular disease.