{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T16:53:44Z","timestamp":1770396824462,"version":"3.49.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to conduct a systematic review of the expression levels of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in cerebral amyloid angiopathy (CAA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PubMed, Embase, and Web of Science databases were searched to identify relevant studies. Two researchers independently screened the literature, extracted data, and assessed the study quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five studies evaluating a total of 442 participants were included. The findings revealed dysregulation of the MMP\/TIMP system in the cerebral blood vessels of patients with CAA. Specifically, in comparison with patients without CAA, those with CAA showed significantly upregulated expression of TIMP-3 and TIMP-4 in the cerebral blood vessels, and TIMP-4 levels were positively correlated with the severity of CAA. MMP-9 expression in patients with CAA-related intracerebral hemorrhage (CAA-ICH) was significantly higher than in those without hemorrhage, while TIMP-3 expression was lower in patients with CAA-ICH; these findings suggest that an imbalance between MMP-9 and TIMP-3 may increase the risk of hemorrhage. Cerebrospinal fluid (CSF) and serum biomarker studies showed that patients with CAA had decreased TIMP-4 levels in the CSF and significantly lower serum MMP-2 levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings of this study indicated an imbalance in the MMP\/TIMP system in CAA, which may be involved in its vascular pathological mechanism. However, the existing evidence is insufficient to support the use of MMPs\/TIMPs as reliable biomarkers for CAA. Therefore, further evaluation of their diagnostic and therapeutic value is required in future studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      This systematic review was registered in PROSPERO (Unique Identifier: CRD420251230405). The protocol can be accessed at:\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251230405<\/jats:ext-link>\n                      , CRD420251230405.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1753708","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T05:21:56Z","timestamp":1770355316000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Expression of matrix metalloproteinases in cerebral amyloid angiopathy-a systematic review"],"prefix":"10.3389","volume":"17","author":[{"given":"Hanying","family":"Gu","sequence":"first","affiliation":[{"name":"Emergency Department, Chengde Medical College","place":["Chengde, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiuxia","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Chengde Central Hospital","place":["Chengde, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiangtao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chengde Central Hospital","place":["Chengde, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1177\/17474930221144911","article-title":"Cerebral small vessel disease: recent advances and future directions","volume":"18","author":"Markus","year":"2023","journal-title":"Int J Stroke"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1016\/j.rcl.2023.01.009","article-title":"Cerebral amyloid Angiopathy","volume":"61","author":"Szidonya","year":"2023","journal-title":"Radiol Clin North 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