title: Age-related macular degeneration and changes in the extracellular matrix.
abstract: Age-related macular degeneration (AMD) is the leading cause of permanent, irreversible, central blindness (scotoma in the central visual field that makes reading and writing impossible, stereoscopic vision, recognition of colors and details) in patients over the age of 50 years in European and North America countries, and an important role is attributed to disorders in the regulation of the extracellular matrix (ECM). The main aim of this article is to present the crucial processes that occur on the level of Bruch's membrane, with special consideration of the metalloproteinase substrates, metalloproteinase, and tissue inhibitor of metalloproteinase (TIMP). A comprehensive review of the literature was performed through MEDLINE and PubMed searches, covering the years 2005-2012, using the following keywords: AMD, extracellular matrix, metalloproteinases, tissue inhibitors of metalloproteinases, Bruch's membrane, collagen, elastin. In the pathogenesis of AMD, a significant role is played by collagen type I and type IV; elastin; fibulin-3, -5, and -6; matrix metalloproteinase (MMP)-2, MMP-9, MMP-14, and MMP-1; and TIMP-3. Other important mechanisms include: ARMS2 and HTR1 proteins, the complement system, the urokinase plasminogen activator system, and pro-renin receptor activation. Continuous rebuilding of the extracellular matrix occurs in both early and advanced AMD, simultaneously with the dysfunction of retinal pigment epithelium (RPE) cells and endothelial cells. The pathological degradation or accumulation of ECM structural components are caused by impairment or hyperactivity of specific MMPs/TIMPs complexes, and is also endangered by the influence of other mechanisms connected with both genetic and environmental factors.
authors.affiliation: Domestic and Specialized Medicine Centre "Dilmed", Katowice, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Nita
authors.affiliation: Department of Molecular Biology, Medical University of Silesia, Sosnowiec, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Strzałka-Mrozik
authors.affiliation: Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Grzybowski
authors.affiliation: Department of Molecular Biology, Medical University of Silesia, Sosnowiec, Poland.
authors.forename: Urszula
authors.initials: U
authors.lastname: Mazurek
authors.affiliation: Department of Ophthalmology, Medical University of Silesia, Independent Public Clinical Hospital, Katowice, Poland.
authors.forename: Wanda
authors.initials: W
authors.lastname: Romaniuk
mesh_terms: D005109:Extracellular Matrix / Q000201:enzymology / Q000473:pathology*; D006801:Humans; D008268:Macular Degeneration / Q000201:enzymology / Q000473:pathology*; D020782:Matrix Metalloproteinases / Q000378:metabolism; D019714:Tissue Inhibitor of Metalloproteinases / Q000378:metabolism; D057135:Wet Macular Degeneration / Q000473:pathology
chemical_list: D019714:Tissue Inhibitor of Metalloproteinases; D020782:Matrix Metalloproteinases