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Among these, Matrix Metalloproteinases (MMPs), zinc-dependent endopeptidases responsible for extracellular matrix (ECM) degradation, play a central role. The clinical severity of envenomation is therefore strongly influenced by the balance between MMPs and their specific inhibitors, the TIMPs. This study investigated the contribution of MMP-1, MMP-2, MMP-7, MMP-9, and MMP-10 and TIMP-1, TIMP-2, TIMP-3, and TIMP-4 to the inflammatory response following\n                      <jats:italic>Bothrops<\/jats:italic>\n                      snakebites.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and findings<\/jats:title>\n                    <jats:p>In this study, we prospectively enrolled 30 patients, classified them as Mild or Severe, and quantified circulating MMPs and TIMPs concentrations before and after antivenom administration using a multiplex Luminex platform. Early inflammatory markers and initial MMPs activation (MMP-2, MMP-7, MMP-9, MMP-10) did not differ significantly between groups. However, post-antivenom molecular trajectories diverged sharply. Mild cases exhibited effective enzymatic regulation, restoring the MMPs\/TIMPs profile toward a state that favored ECM turnover and tissue repair. In contrast, Severe cases showed persistent dysregulation, with a sustained imbalance that hindered ECM reorganization and perpetuated damaging inflammatory pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest that the regulation of MMP\/TIMP balance following antivenom therapy may be associated with clinical evolution. Further studies are required to determine whether these molecular patterns can be validated as prognostic markers or therapeutic targets.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013831","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T17:55:44Z","timestamp":1777053344000},"page":"e0013831","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Look what you make my tissues do: The role of metalloproteinases and their inhibitors in Bothrops snakebites"],"prefix":"10.1371","volume":"20","author":[{"given":"Juliana Costa","family":"Ferreira Neves","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e1bio","family":"Magalh\u00e3es-Gama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiochelson Najibe 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