Background: Moyamoya disease (MMD) is an uncommon cerebrovascular disease characterized by progressive stenosis of the intracranial internal carotid arteries and their proximal branches. The important role of genetic factors in the etiology and pathogenesis of MMD is being increasingly recognized. The study was designed to examine the association of single nucleotide polymorphisms in matrix metalloproteinase (MMP) and tissue inhibitors of metalloproteinase (TIMP) genes with MMD occurrence. Methods: A case-control study was performed. Five functional promoter polymorphisms in the MMP-2, MMP-3, MMP-9 and MMP-13 genes and a potentially functional promoter polymorphism in the TIMP-2 gene were determined by polymerase chain reaction-restriction fragment length polymorphism. Their associations with MMD were analyzed by multivariate logistic regression. Results: In total, 208 definite patients with MMD (including 31 familial MMD, FMMD, patients) and 224 healthy subjects were recruited. The frequency of the MMP-3 5A/6A and 5A/5A genotypes was significantly lower in MMD patients (OR = 0.57, 95% CI 0.38–0.86, pcorr = 0.042) compared with healthy controls in a dominant genetic model. Significant differences of the MMP-3 5A/6A polymorphism were also detected between FMMD patients and controls both in the dominant genetic model (OR = 0.23, 95% CI 0.08–0.68, pcorr = 0.048) and the additive genetic model (OR = 0.24, 95% CI 0.08–0.69, pcorr = 0.048). Conclusion: The functional polymorphism in the MMP-3 promoter might be associated with susceptibility to both MMD and FMMD in the Chinese Han population. The findings need to be validated in further studies including more subjects from different populations.

1.
Ikezaki K, Han DH, Kawano T, Kinukawa N, Fukui M: A clinical comparison of definite moyamoya disease between South Korea and Japan. Stroke 1997;28:2513–2517.
2.
Yonekawa Y, Ogata N, Kaku Y, Taub E, Imhof HG: Moyamoya disease in Europe, past and present status. Clin Neurol Neurosurg 1997;99(suppl 2):S58–S60.
3.
Chiu D, Shedden P, Bratina P, Grotta JC: Clinical features of moyamoya disease in the United States. Stroke 1998;29:1347–1351.
4.
Kuriyama S, Kusaka Y, Fujimura M, Wakai K, Tamakoshi A, Hashimoto S, Tsuji I, Inaba Y, Yoshimoto T: Prevalence and clinicoepidemiological features of moyamoya disease in Japan: findings from a nationwide epidemiological survey. Stroke 2008;39:42–47.
5.
Fukui M, Kono S, Sueishi K, Ikezaki K: Moyamoya disease. Neuropathology 2000;20(suppl):S61–S64.
6.
Ikeda H, Sasaki T, Yoshimoto T, Fukui M, Arinami T: Mapping of a familial moyamoya disease gene to chromosome 3p24.2–p26. Am J Hum Genet 1999;64:533–537.
7.
Inoue TK, Ikezaki K, Sasazuki T, Matsushima T, Fukui M: Linkage analysis of moyamoya disease on chromosome 6. J Child Neurol 2000;15:179–182.
8.
Sakurai K, Horiuchi Y, Ikeda H, Ikezaki K, Yoshimoto T, Fukui M, Arinami T: A novel susceptibility locus for moyamoya disease on chromosome 8q23. J Hum Genet 2004;49:278–281.
9.
Yamauchi T, Tada M, Houkin K, Tanaka T, Nakamura Y, Kuroda S, Abe H, Inoue T, Ikezaki K, Matsushima T, Fukui M: Linkage of familial moyamoya disease (spontaneous occlusion of the circle of Willis) to chromosome 17q25. Stroke 2000;31:930–935.
10.
Kono S, Oka K, Sueishi K: Histopathologic and morphometric studies of leptomeningeal vessels in moyamoya disease. Stroke 1990;21:1044–1050.
11.
Scott RM, Smith ER: Moyamoya disease and moyamoya syndrome. N Engl J Med 2009;360:1226–1237.
12.
Masuda J, Ogata J, Yutani C: Smooth muscle cell proliferation and localization of macrophages and t cells in the occlusive intracranial major arteries in moyamoya disease. Stroke 1993;24:1960–1967.
13.
Ross R: Atherosclerosis – an inflammatory disease. N Engl J Med 1999;340:115–126.
14.
Badimon L: New challenges in the etiopathogenesis of atherothrombosis. Cerebrovasc Dis 2001;11(suppl 1):80–84.
15.
Kang HS, Kim JH, Phi JH, Kim YY, Kim JE, Wang KC, Cho BK, Kim SK: Plasma matrix metalloproteinases, cytokines, and angiogenic factors in moyamoya disease. J Neurol Neurosurg Psychiatry 2010;81:673–678.
16.
Fujimura M, Watanabe M, Narisawa A, Shimizu H, Tominaga T: Increased expression of serum matrix metalloproteinase-9 in patients with moyamoya disease. Surg Neurol 2009;72:476–480.
17.
Price SJ, Greaves DR, Watkins H: Identification of novel, functional genetic variants in the human matrix metalloproteinase-2 gene: role of sp1 in allele-specific transcriptional regulation. J Biol Chem 2001;276:7549–7558.
18.
Ye S, Eriksson P, Hamsten A, Kurkinen 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;271:13055–13060.
19.
Ye S: Polymorphism in matrix metalloproteinase gene promoters: implication in regulation of gene expression and susceptibility of various diseases. Matrix Biol 2000;19:623–629.
20.
Zhang B, Ye S, Herrmann SM, Eriksson P, de Maat M, Evans A, Arveiler D, Luc G, Cambien F, Hamsten A, Watkins H, Henney AM: Functional polymorphism in the regulatory region of gelatinase B gene in relation to severity of coronary atherosclerosis. Circulation 1999;99:1788–1794.
21.
Yu C, Zhou Y, Miao X, Xiong P, Tan W, Lin D: Functional haplotypes in the promoter of matrix metalloproteinase-2 predict risk of the occurrence and metastasis of esophageal cancer. Cancer Res 2004;64:7622–7628.
22.
Yoon S, Kuivaniemi H, Gatalica Z, Olson JM, Buttice G, Ye S, Norris BA, Malcom GT, Strong JP, Tromp G: MMP13 promoter polymorphism is associated with atherosclerosis in the abdominal aorta of young black males. Matrix Biol 2002;21:487–498.
23.
Ye S: Influence of matrix metalloproteinase genotype on cardiovascular disease susceptibility and outcome. Cardiovasc Res 2006;69:636–645.
24.
Kang HS, Kim SK, Cho BK, Kim YY, Hwang YS, Wang KC: Single nucleotide polymorphisms of tissue inhibitor of metalloproteinase genes in familial moyamoya disease. Neurosurgery 2006;58:1074–1080.
25.
Letovsky J, Dynan WS: Measurement of the binding of transcription factor Sp1 to a single GC box recognition sequence. Nucleic Acids Res 1989;17:2639–2653.
26.
Fukui M: Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (‘moyamoya’ disease). Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Clin Neurol Neurosurg 1997;99(suppl 2):S238–S240.
27.
Kang S, Zhao X, Xing H, Wang N, Zhou R, Chen S, Li W, Zhao J, Duan Y, Sun D, Li Y: Polymorphisms in the matrix metalloproteinase-2 and tissue inhibitor of metalloproteinase-2 and the risk of human adenomyosis. Environ Mol Mutagen 2008;49:226–231.
28.
Chen D, Wang Q, Ma ZW, Chen FM, Chen Y, Xie GY, Wang QT, Wu ZF: MMP-2, MMP-9 and TIMP-2 gene polymorphisms in Chinese patients with generalized aggressive periodontitis. J Clin Periodontol 2007;34:384–389.
29.
Chen QJ, Lu L, Peng WH, Hu J, Yan XX, Wang LJ, Zhang Q, Zhang RY, Shen WF: Polymorphisms of MMP-3 and TIMP-4 genes affect angiographic coronary plaque progression in non-diabetic and type 2 diabetic patients. Clin Chim Acta 2009;405:97–103.
30.
Lein M, Jung K, Laube C, Hubner T, Winkelmann B, Stephan C, Hauptmann S, Rudolph B, Schnorr D, Loening SA: Matrix-metalloproteinases and their inhibitors in plasma and tumor tissue of patients with renal cell carcinoma. Int J Cancer 2000;85:801–804.
31.
Fatar M, Stroick M, Griebe M, Hennerici M: Matrix metalloproteinases in cerebrovascular diseases. Cerebrovasc Dis 2005;20:141–151.
32.
Shi Y, Patel S, Niculescu R, Chung W, Desrochers P, Zalewski A: Role of matrix metalloproteinases and their tissue inhibitors in the regulation of coronary cell migration. Arterioscler Thromb Vasc Biol 1999;19:1150–1155.
33.
Maqbool A, Turner NA, Galloway S, Riches K, O’Regan DJ, Porter KE: The –1562C/T MMP-9 promoter polymorphism does not predict MMP-9 expression levels or invasive capacity in saphenous vein smooth muscle cells cultured from different patients. Atherosclerosis 2009;207:458–465.
34.
Gnasso A, Motti C, Irace C, Carallo C, Liberatoscioli L, Bernardini S, Massoud R, Mattioli PL, Federici G, Cortese C: Genetic variation in human stromelysin gene promoter and common carotid geometry in healthy male subjects. Arterioscler Thromb Vasc Biol 2000;20:1600–1605.
35.
Rauramaa R, Vaisanen SB, Luong LA, Schmidt-Trucksass A, Penttila IM, Bouchard C, Toyry J, Humphries SE: Stromelysin-1 and interleukin-6 gene promoter polymorphisms are determinants of asymptomatic carotid artery atherosclerosis. Arterioscler Thromb Vasc Biol 2000;20:2657–2662.
36.
Risch N, Merikangas K: The future of genetic studies of complex human diseases. Science 1996;273:1516–1517.
37.
Wu N, Lu X, Hua Y, Song L, Ye J, Li J, Meng X, Gu D, Yang Y: Haplotype analysis of the stromelysin-1 (MMP3) and gelatinase B (MMP9) genes in relation to coronary heart disease. Ann Hum Genet 2009;73:404–410.
38.
Okamoto K, Mimura K, Murawaki Y, Yuasa I: Association of functional gene polymorphisms of matrix metalloproteinase (MMP)-1, MMP-3 and MMP-9 with the progression of chronic liver disease. J Gastroenterol Hepatol 2005;20:1102–1108.
39.
Paez MT, Yamamoto T: Single nucleotide polymorphisms of tissue inhibitor of metalloproteinase genes in familial moyamoya disease. Neurosurgery 2007;60:E582.
40.
Suzuki J, Takaku A: Cerebrovascular ‘moyamoya’ disease. Disease showing abnormal net-like vessels in base of brain. Arch Neurol 1969;20:288–299.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.