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2015 ; 52
(5-6
): 337-52
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Proteolytic receptor cleavage in the pathogenesis of blood rheology and
co-morbidities in metabolic syndrome Early forms of autodigestion
#MMPMID26600265
Mazor R
; Schmid-Schönbein GW
Biorheology
2015[]; 52
(5-6
): 337-52
PMID26600265
show ga
Abnormal blood rheological properties seldom occur in isolation and instead are
accompanied by other complications, often designated as co-morbidities. In the
metabolic syndrome with complications like hypertension, diabetes and lack of
normal microvascular blood flow, the underlying molecular mechanisms that
simultaneously lead to elevated blood pressure and diabetes as well as abnormal
microvascular rheology and other cell dysfunctions have remained largely unknown.
In this review, we propose a new hypothesis for the origin of abnormal cell
functions as well as multiple co-morbidities. Utilizing experimental models for
the metabolic disease with diverse co-morbidities we summarize evidence for the
presence of an uncontrolled extracellular proteolytic activity that causes
ectodomain receptor cleavage and loss of their associated cell function. We
summarize evidence for unchecked degrading proteinase activity, e.g. due to
matrix metalloproteases, in patients with hypertension, Type II diabetes and
obesity, in addition to evidence for receptor cleavage in the form of receptor
fragments and decreased extracellular membrane expression levels. The evidence
suggest that a shift in blood rheological properties and other co-morbidities may
in fact be derived from a common mechanism that is due to uncontrolled
proteolytic activity, i.e. an early form of autodigestion. Identification of the
particular proteases involved and the mechanisms of their activation may open the
door to treatment that simultaneously targets multiple co-morbidities in the
metabolic syndrome.