Thromb Haemost 2003; 90(01): 132-139
DOI: 10.1055/s-0037-1613609
Vascular Development and Vessel Remodelling
Schattauer GmbH

Synergistic effect of stromelysin-1 (matrix metalloproteinase-3) promoter 5A/6A polymorphism with smoking on the onset of young acute myocardial infarction

Ping-Yen Liu
1   Departments of Internal Medicine, Biochemistry and Institute of Clinical Medicine, College of Medicine, National Cheng-Kung University, Tainan, Taiwan, Republic of China
,
Jyh-Hong Chen
1   Departments of Internal Medicine, Biochemistry and Institute of Clinical Medicine, College of Medicine, National Cheng-Kung University, Tainan, Taiwan, Republic of China
,
Yi-Heng Li
1   Departments of Internal Medicine, Biochemistry and Institute of Clinical Medicine, College of Medicine, National Cheng-Kung University, Tainan, Taiwan, Republic of China
,
Hua-Lin Wu
1   Departments of Internal Medicine, Biochemistry and Institute of Clinical Medicine, College of Medicine, National Cheng-Kung University, Tainan, Taiwan, Republic of China
,
Guey-Yueh Shi
1   Departments of Internal Medicine, Biochemistry and Institute of Clinical Medicine, College of Medicine, National Cheng-Kung University, Tainan, Taiwan, Republic of China
› Author Affiliations
Financial support: This study was supported in part by the MOE Program for Promoting Academic Excellent of Universities under the grant number 91-B-FA09-2-4, and by the Grant NSC91-2314-B-006-106 from National Science Council, Executive Yuan, Taipei, Taiwan.
Further Information

Publication History

Received 13 January 2003

Accepted after revision 14 March 2003

Publication Date:
07 December 2017 (online)

Summary

The objective of this study was to elucidate the association between the polymorphism of stromelysin-1, also called matrix metalloproteinases-3 (MMP-3), and smoking in the pathogenesis of young acute myocardial infarction (MI).

Plaque rupture is well established as a critical factor in the pathogenesis of acute MI. MMP-3 can degrade extracellular matrix and are identified extensively in human coronary atheroslcerotic plaques, and may contribute to the weakening of the cap and subsequent rupture.

We studied 150 consecutive patients with acute MI onset at age under 45 years (84% men) and 150 sex- and age-matched control subjects. 5A/6A genotype in the stromelysin-1 promoter was determined using polymerase chain reaction and direct sequencing.

Results show that the frequency of the 5A allele and the prevalence of 5A/5A + 5A/6A genotypes were both significantly higher in the young MI than the control group (35.0% vs.20.0%, odds ratio [OR] 2.15,95% confidence interval [CI] 1.30 to 6.80, p<0.001; 44.7% vs. 27.4%, OR 2.19, 95% CI 1.21 to 3.98, p=0.009). Multiple logistic regression analysis showed that the 5A allele was an independent risk factor (OR 2.36, 95% CI 1.24 to 5.90, p=0.008) as were as smoking (OR 3.92, 95% CI 1.75 to 9.21, p=0.001), diabetes mellitus (OR 3.51, 95% CI 1.41 to 6.32, p=0.0068) and hypertension (OR 1.85, 95% CI 1.35 to 4.33, p=0.0025) for the premature onset of MI. Compared to 6A/6A subjects, among patients who did not smoke, the 5A allele poly-morphism was associated with a higher risk of MI at a young age (OR 2.69, 95% CI 1.3 to 8.6), but smoking carriers of the 5A allele had a significantly 10-fold higher risk of MI (OR 9.98, 95% CI 2.3 to 12.5).

We can conclude that there was a significant association between the 5A/6A polymorphism in the promoter region of stromelysin-1 gene and young MI in Taiwan. A synergistic effect between smoking and this polymorphism for the premature onset of MI had been shown in this study.

 
  • References

  • 1 Falk E, Shah PK, Fuster V. Coronary plaque disruption. Circulation 1995; 92: 657-71.
  • 2 Libby P. Molecular bases of the acute coronary syndrome. Circulation 1995; 91: 2844-50.
  • 3 Libby P. Current concepts of the pathogenesis of the acute coronary syndrome. Circulation 2001; 104: 365-72.
  • 4 Shah PK, Falk E, Badimon JJ. et al. Human monocyte-derived macrophages induce collagen breakdown in fibrous caps of atheroslcerotic plaques. Circulation 1995; 92: 1565-9.
  • 5 Galis ZS. Sukhova GK, Lark MW, Libby P. Increased expression of matrix metalloproteinases and matrix degrading activity in vulnerable regions of human atheroslcerotic plaques. J Clin Invest 1994; 94: 2493-503.
  • 6 Woessner JJ. Matrix metalloproteinases and their inhibitors in connective tissue remodeling. FASEB J 1991; 5: 2145-54.
  • 7 Henney AM, Wakeley PR, Davies MJ. et al. Localization of stromelysin gene expression in atheroslcerotic plaque by in situ hybridization. Proc Natl Acad Sci USA 1991; 88: 8154-8.
  • 8 Galis ZS, Sukhova GK, Kranzhofer R, Clark S, Libby P. Macrophage foam cells from experimental atheroma constitutively produce matrix-degrading proteinases. Proc Natl Acad Sci USA 1995; 92: 402-6.
  • 9 Libby P, Geng YJ, Aikawa M, Schonbeck U. et al. Macrophage and atherosclerosis plaque stability. Curr Opin Lipidol 1996; 7: 330-5.
  • 10 Carty CS, Soloway PD, Kayastha S. et al. Nicotine and cotinine stimulate secretion of basic fibroblast growth factor and affect expression of matrix metalloproteinases in cultured human smooth muscle cells. J Vasc Surg 1996; 24: 927-34.
  • 11 Barua RS, Ambrose JA, Saha DC, Eales-Reynolds LJ. Smoking is associated with altered endothelial-derived fibrinolytic and antithrombotic factors, an in vitro demonstration. Circulation 20-02. 106: 905-8.
  • 12 Brikerdal-Hansen H, Moore W, Bodden MK. et al. Matrix metalloproteinases: a review. Crit Rev Oral Biol Med 1993; 4: 197-250.
  • 13 Matrisian LM. Metalloproteinases and their inhibitors in matrix remodeling. Trends Genet 1990; 6: 121-5.
  • 14 Quinones S, Buttice G, Kurkinen M. Promoter elements in the transcriptional activation of the human stromelysin-1 gene by the inflammatory cytokine, interleukin 1. Biochem J 1994; 302: 471-7.
  • 15 Galis ZS, Muszynski M, Sukova GK, Simon-Morrissey E. Libby P, Enhanced expression of vascular matrix metalloproteinases induced in vitro by cytokines and in regions of human atheroslcerotic lesions. Ann NY Acad Sci 1995; 748: 501-7.
  • 16 Diaz-Meco MT, Quinones S, Municio MM. et al. Protein Kinase C-independent expression of stromelysin by platelet-derived growth factor, ras oncogene, and phosphatidylcholine. Hydrolyzing phospholipase C. J Biol Chem 1991; 266: 22597-602.
  • 17 Ye S, Watts GF, Mandatia S, Humphries SE, Henney AM. Preliminary report: genetic variation in the human stromelysin promoter is associated with progression of coronary atherosclerosis. Br Heart J 1995; 73: 209-15.
  • 18 Ye S, Eriksson P, Hamsten A, Kirkinen M, Humphries SE, Henney AM. Progression of coronary atherosclerosis is associated with a common genetic variant of the human stromelysin-1 promoter which results in reduced gene expression. J Biol Chem 1996; 271: 13055-60.
  • 19 Feldman LJ, Mazighi M, Scheuble A. et al. Differential expression of matrix metalloproteinases after stent implantation and balloon angioplasty in the hypercholesterolemic rabbit. Circulation 2001; 103: 3117-28.
  • 20 Hojo Y, Ikeda U, Katsuki T, Mizuno O, Fujikawa H, Shimada K. Matrix metalloproteinase expression in the coronary circulation induced by coronary angioplasty. Atheroslcerosis 2002; 161: 185-92.
  • 21 Lijnen HR. Soloway P, Collen D. Tissue inhibitor of matrix metalloproteinases-1 impairs arterial neointima formation after vascular injury in mice. Circ Res 1999; 85: 1186-91.
  • 22 Doll R, Hill AB. Mortality of British doctors in relation to smoking: observation on coronary thrombosis. Natl Cancer Inst Monogr 1996; 19: 205-68.
  • 23 Allen DR, Browse NL, Rutt DL, Butler L, Fletcher C. The effect of cigarette smoke, nicotine, and carbon monoxide on the permeability of the arterial wall. J Vasc Surg 1988; 7: 139-52.
  • 24 Blann AD. The acute influence of smoking on the endothelium. Atheroslcerosis 1992; 96: 249-50.
  • 25 Lowe GD. Blood viscosity and cardiovascular risk. Curr Opin Lipidol 1993; 4: 283-7.
  • 26 Eliasson B, Mero N, Taskinen MR, Smith U. The insulin resistance syndrome and postprandial lipid intolerance in smokers. Atheroslcerosis 1997; 129: 79-88.
  • 27 Dalmon J, Laurent M, Courtois G. The human beta fibrinogen promoter contains a hepatocyte nuclear factor 1-dependent interleukin-6-responsive element. Mol Cell Biol 1993; 13: 1183-93.
  • 28 Meade TW, Mellow S, Brozovic M. et al. Haemostatic function and ischemic heart disease: principle results of the Northwick Park Heart Study. Lancet 1986; 2: 533-7.
  • 29 Talmud PJ, Bujac S, Hall S, Miller GJ, Humphries SE. Substitution of asparagines for aspartic acid at residue 9 (D9N) of lipoprotein lipase markedly augments risk of coronary heart disease in male smokers. Atheroslcerosis 2000; 149: 75-81.
  • 30 Humphries SE, Talmud PJ, Hawe E, Bolla M, Day INM, Miller GJ. Apolipoprotein E4 and coronary heart disease in middle-aged men who smoke: a prospective study. Lancet 2001; 358: 115-9.
  • 31 Li R, Boerwinkle E, Olshan AF. et al. Glutathione S-transferase genotype as a susceptibility factor in smoking-related coronary heart disease. Atherosclerosis 2000; 149: 451-62.
  • 32 Li YH, Chen JH, Tsai WC, Chao TH. et al. Synergistic effect of thrombomodulin promoter &ndash;33G/A polymorphism and smoking on the onset of acute myocardial infarction. Thromb Haemost 2002; 87: 86-91.
  • 33 Terashima M, Akita H, Kanazawa K. et al. Stromelysin promoter 5A/6A polymorphism is associated with acute myocardial infarction. Circulation 1999; 99: 2717-9.
  • 34 Humphries SE, Marin S, Cooper J, Miller G. Interaction between smoking and the stromelysi-1 (MMP3) gene 5A/6A promoter poly-morphism and risk of coronary heart disease in healthy men. Ann Hum Genet 2002; 66: 343-52.
  • 35 Humphries S, Bauters C, Meirhaeghe A, Luong L, Bertrand M, Amouyel P. The 5A6A polymorphism in the promoter of the stromelysin-1 (MMP-3) gene as a risk factor for restenosis. Eur Heart J 2002; 23: 721-5.
  • 36 Rundek T, Elkind M, Pittman J. et al. Carotid intima-media thickness is associated with allelic variants of stromelysin-1, interleikin-6 and hepatic lipase genes. (The Northern Man-hattan Prospective Cohort Study) Stoke 2002; 33: 1420-3.
  • 37 Humphries SE, Luong LA, Talmud PJ. et al. The 5A/6A polymorphism in the promoter of the stromelysin-1 (MMP-3) gene predicts progression of angiographically determined coronary artery disease in men in LOCAT gemfibrozil study. Atherosclerosis 1998; 139: 49-56.
  • 38 de Maat MP, Jukema JW, Ye S. et al. Effect of the stromelysin-1 promoter on efficacy of pravastatin in coronary atheroslcerosis and restenosis. (REGRESS study) Am J Cardiol 1999; 83: 852-6.
  • 39 Park HY, Jang Y, Kim Y, Shim WH, Kwon HM. Common genetic variants of the thrombomodulin gene as a risk factor for myocardial infarction. (Abstr) J Am Coll Cardiol 2000; 35: 327A
  • 40 Ireland H, Kunz G, Kyriakoulis K, Stubbs PJ, Lane DA. Thrombomodulin gene mutations associated with myocardial infarction. Circulation 1997; 96: 15-18.
  • 41 Zucker S, Hymowitz M, Conner C. et al. Measurement of matrix metalloproteinases and tissue inhibitors of metalloproteinases in blood and tissues. Ann NY Acad Sci 1999; 878: 212-27.
  • 42 Silence J, Lupu F, Collen D, Lijen HR. Persistence of atherosclerotic plaque but reduced aneurysm formation in mice with stromelysin-1 (MMP-3) gene inactivation. Arterioscler Thromb Vasc Biol 2001; 21: 1440-5.
  • 43 Teng JK, Lin LJ, Tsai LM, Kwan CM, Chen JH. Acute myocardial infarction in young and very old Chinese adults: clinical and therapeutic implications. Int J Cardiol 1994; 44: 29-36.
  • 44 Sharp DS, Benowitz NL, Bath PM, Martin JF, Beswick AD, Elwood PC. Cigarette smoking sensitizes and desensitizes impedance-measured ADP-induced platelet aggregation in whole blood. Thromb Haemost 1995; 74: 730-5.
  • 45 Haustein UF, Anderegg U. Premature skin aging caused by smoking. Hautarzt 2000; 51: 807-8.
  • 46 Zheng T, Zhu Z, Wang Z. et al. Inducible targeting of IL-13 to the adult lung causes matrix metalloproteinase-and cathepsin-dependent emphysema. J Clin Invest 2000; 106: 1081-93.
  • 47 Galateau-Salle FB, Luna RE, Horiba K. et al. Matrix metalloproteinases and tissue inhibitor of metalloproteinases in bronchial squamous preinvasive lesions. Hum Pathol 2000; 31: 296-305.