Matrix metalloproteinase‐2 (MMP‐2): A major player in the progression of systemic malignancies besides endometrial serous carcinomas

Abstract

Sir, The recent article by Shaco-Levy et al. about matrix metalloproteinase-2 (MMP-2) expression in endometrial serous carcinoma in comparison with low-grade endometrial endometrioid carcinoma was highly interesting (1). The results of the study clearly show that MMP-2 has a major role to play in the evolution and development of endometrial serous carcinoma. Interestingly, MMP-2 plays a highly significant role in the progression of numerous different systemic malignancies besides endometrial serous carcinoma. For instance, accentuated MMP-2 expression in tumor cells in non-small cell lung cancers is associated with poor prognosis as well as tumor recurrence (2). A similar association between MMP-2 and gastric cancer has been demonstrated. For instance, Alakus et al. have shown that increased MMP-2 expression in gastric carcinomas is associated with poor survival while Wang et al. have shown that metastatic gastric carcinoma demonstrates higher levels of MMP-2 in comparison to primary gastric carcinomas (3), (4). Interestingly, an increased incidence of Mycoplasma infestation has been noticed in gastric carcinomas. It is believed that p37 from Mycoplasma activates MMP-2 thus resulting in enhanced tumor invasion. Similarly, higher MMP-2 levels are associated with a worse prognosis and poor survival in patients with colorectal cancers. Increased MMP-2 expression has also been demonstrated in the stromal cells of vocal cord polyps. Surprisingly, on the other hand, lower levels of serum MMP-2 in patients with prostate carcinomas are associated with poor survival and increased metastasis (5). As it is clearly evident from the above discussion, MMP-2 has a significant role to play in the development of systemic malignancies. The development of anti-MMP-2 antibodies is already underway and the near future may very well see the development of alternate strategies to modulate MMP-2 expression for treating systemic malignancies.