The specific role of extracellular matrix metalloproteinases in the pathology and therapy of hard-to-heal wounds.

Matrix metalloproteinases (MMPs) are zinc-dependent endoproteases responsible for the metabolism of extracellular matrix (ECM). MMPs can degrade the various ECM components as a variety of non-ECM molecules. Hyperactivity of MMPs and improper regulation or inhibition could lead to certain disorders, like non-healing chronic wounds. In chronic wounds, unlike in acute ones, there are always higher levels of MMPs due to the accompanying inflammation. Different proteases are responsible for this condition; nonetheless, blocking MMPs can help restore the wound's healing ability. The level of MMPs can help indicate the prognosis of chronic wounds. In some cases, the healing process is delayed by microbial wound infections. Bacterial proteases may up-regulate the levels of MMPs produced by host cells. That means that both host MMPs as proteases secreted by the infecting bacteria need to be targeted to increase the healing capacity of the wound. MMPs activity modulating treatments by superabsorbent polymer dressings can improve healing rates of chronic wounds. The main goal of this review was presentation the specific role of metalloproteinases in the pathology and therapy of hard-to-heal wounds.