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Published in: Arthritis Research & Therapy 6/2009

Open Access 01-12-2009 | Research article

Matrix metalloproteinase 28, a novel matrix metalloproteinase, is constitutively expressed in human intervertebral disc tissue and is present in matrix of more degenerated discs

Authors: Helen E Gruber, Jane A Ingram, Gretchen L Hoelscher, Natalia Zinchenko, H James Norton, Edward N Hanley Jr

Published in: Arthritis Research & Therapy | Issue 6/2009

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Abstract

Introduction

The regulation and elevation in expression of the catabolic matrix metalloproteinases (MMPs) is of high importance in the human intervertebral disc since upregulation of these matrix-degrading enzymes results in matrix destruction associated with disc degeneration. MMP28 (epilysin) is a newly discovered MMP believed to play a role in matrix composition and turnover in skin. It is present in basal keratinocytes where its expression is upregulated with wound repair, and in cartilage and synovium where it is upregulated in osteoarthritis. Recent work has shown that mechanical compression can act to modulate expression of MMP28. The expression of MMP28 is unexplored in the intervertebral disc.

Methods

Following approval by our human subjects institutional review board, we employed microarray analyses to evaluate in vivo expression of MMP28 and the MMP28 precursor in human disc tissue, and utilized immunohistochemistry to determine cellular and extracellular matrix localization of MMP28 in 35 human disc tissue specimens. The percentage of cells positive for MMP28 immunocytochemical localization was also determined.

Results

The present work documents the expression and presence of MMP28 in cells and extracellular matrix (ECM) of the human intervertebral disc. Gene expression levels in human disc tissue were detectable for both MMP28 and the MMP28 precursor. MMP28 cytoplasmic localization was present in cells of the outer annulus; it was also present in some, but not all, cells of the inner annulus and nucleus. MMP28 was not found in the ECM of healthier Grade I to II discs, but was identified in the ECM of 61% of the more degenerated Grade III to V discs (P = 0.0018). There was a significant difference in cellular MMP28 distribution in the disc (P = 0.008): the outer annulus showed the largest percentage of cells positive for MMP28 immunolocalization, followed by the inner annulus and then the nucleus. Herniated discs showed a significantly greater proportion of MMP28-positive cells compared with nonherniated discs (P = 0.034).

Conclusions

Findings presented here show the first documentation of intervertebral disc expression and production of MMP28. MMP28 was found in both disc cell cytoplasm and in the ECM of more degenerated specimens, with greater cellular localization in the outer annulus and in herniated disc specimens. These findings are important because of the key role of MMPs in disc turnover and homeostasis, and previous indications of a role for this MMP in matrix repair and matrix turnover in other tissues. Our data, which show the presence of MMP28 in human disc tissue, suggest that MMP28 may have a potentially important role in ECM modulation in the healthy and degenerating disc.
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Literature
1.
go back to reference Millward-Sadler SJ, Costello PW, Freemont AJ, Hoyland JA: Regulation of catabolic gene expression in normal and degenerate human intervertebral disc cells: implications for the pathogenesis of intervertebral disc degeneration. Arthritis Res Ther. 2009, 11: R65-10.1186/ar2693.PubMedCentralCrossRefPubMed Millward-Sadler SJ, Costello PW, Freemont AJ, Hoyland JA: Regulation of catabolic gene expression in normal and degenerate human intervertebral disc cells: implications for the pathogenesis of intervertebral disc degeneration. Arthritis Res Ther. 2009, 11: R65-10.1186/ar2693.PubMedCentralCrossRefPubMed
2.
go back to reference Crean JKG, Roberts S, Jaffray DC, Eisenstein SM, Duance VC: Matrix metalloproteinases in the human intervertebral disc: role in disc degeneration and scoliosis. Spine. 1997, 22: 2877-2884. 10.1097/00007632-199712150-00010.CrossRefPubMed Crean JKG, Roberts S, Jaffray DC, Eisenstein SM, Duance VC: Matrix metalloproteinases in the human intervertebral disc: role in disc degeneration and scoliosis. Spine. 1997, 22: 2877-2884. 10.1097/00007632-199712150-00010.CrossRefPubMed
3.
go back to reference Kozaci LD, Guner A, Oktay G, Guner G: Alterations in biochemical components of extracellular matrix in intervertebral disc herniation: role of MMP-2 and TIMP-2 in type II collagen loss. Cell Biochem Funct. 2006, 24: 431-436. 10.1002/cbf.1250.CrossRefPubMed Kozaci LD, Guner A, Oktay G, Guner G: Alterations in biochemical components of extracellular matrix in intervertebral disc herniation: role of MMP-2 and TIMP-2 in type II collagen loss. Cell Biochem Funct. 2006, 24: 431-436. 10.1002/cbf.1250.CrossRefPubMed
4.
go back to reference Shen B, Melrose J, Ghosh P, Taylor TKF: Induction of matrix metalloproteinase-2 and -3 activity in ovine nucleus pulposus cells grown in three-dimensional agarose gel culture by interleukin-β: a potential pathway of disc degeneration. Eur Spine J. 2003, 12: 66-75.PubMed Shen B, Melrose J, Ghosh P, Taylor TKF: Induction of matrix metalloproteinase-2 and -3 activity in ovine nucleus pulposus cells grown in three-dimensional agarose gel culture by interleukin-β: a potential pathway of disc degeneration. Eur Spine J. 2003, 12: 66-75.PubMed
5.
go back to reference Nemoto O, Yamagishi M, Yamada H, Kikuchi T, Takaishi H: Matrix metalloproteinase-3 production by human degenerated intervertebral disc. J Spinal Disord. 1997, 10: 493-498. 10.1097/00002517-199712000-00006.CrossRefPubMed Nemoto O, Yamagishi M, Yamada H, Kikuchi T, Takaishi H: Matrix metalloproteinase-3 production by human degenerated intervertebral disc. J Spinal Disord. 1997, 10: 493-498. 10.1097/00002517-199712000-00006.CrossRefPubMed
6.
go back to reference Roberts S, Caterson B, Menage J, Evans EH, Jaffray DC, Eisenstein SM: Matrix metalloproteinases and aggrecanase - their role in disorders of the human intervertebral disc. Spine. 2000, 25: 3005-3013. 10.1097/00007632-200012010-00007.CrossRefPubMed Roberts S, Caterson B, Menage J, Evans EH, Jaffray DC, Eisenstein SM: Matrix metalloproteinases and aggrecanase - their role in disorders of the human intervertebral disc. Spine. 2000, 25: 3005-3013. 10.1097/00007632-200012010-00007.CrossRefPubMed
7.
go back to reference Momohara S, Okamoto H, Komiya K, Ikari K, Takeuchi M, Tomatsu T, Kamatani N: Matrix metalloproteinase 28/epilysin expression in cartilage from patients with rheumatoid arthritis and osteoarthritis: comment on the article by Kevorkian et al. Arthritis Rheum. 2004, 50: 4074-4080. 10.1002/art.20799.CrossRefPubMed Momohara S, Okamoto H, Komiya K, Ikari K, Takeuchi M, Tomatsu T, Kamatani N: Matrix metalloproteinase 28/epilysin expression in cartilage from patients with rheumatoid arthritis and osteoarthritis: comment on the article by Kevorkian et al. Arthritis Rheum. 2004, 50: 4074-4080. 10.1002/art.20799.CrossRefPubMed
8.
go back to reference Le Maitre CL, Freemont AJ, Hoyland JA: Localization of degradative enzymes and their inhibitors in the degenerate human intervertebral disc. J Pathol. 2004, 204: 47-54. 10.1002/path.1608.CrossRefPubMed Le Maitre CL, Freemont AJ, Hoyland JA: Localization of degradative enzymes and their inhibitors in the degenerate human intervertebral disc. J Pathol. 2004, 204: 47-54. 10.1002/path.1608.CrossRefPubMed
9.
go back to reference Weiler C, Nerlich AG, Zipperer J, Bachmeier BE, Boos N: 2002 SSE Award Competition in Basic Science: expression of major matrix metalloproteinases is associated with disc degradation and resorption. Eur Spine J. 2002, 11: 308-320. 10.1007/s00586-002-0472-0.PubMedCentralCrossRefPubMed Weiler C, Nerlich AG, Zipperer J, Bachmeier BE, Boos N: 2002 SSE Award Competition in Basic Science: expression of major matrix metalloproteinases is associated with disc degradation and resorption. Eur Spine J. 2002, 11: 308-320. 10.1007/s00586-002-0472-0.PubMedCentralCrossRefPubMed
10.
go back to reference MacLean JJ, Lee CR, Alini M, Iatridis JC: The effects of short-term load duration on anabolic and catabolic gene expression in the rat tail intervertebral disc. J Orthop Res. 2005, 23: 1120-1127. 10.1016/j.orthres.2005.01.020.CrossRefPubMed MacLean JJ, Lee CR, Alini M, Iatridis JC: The effects of short-term load duration on anabolic and catabolic gene expression in the rat tail intervertebral disc. J Orthop Res. 2005, 23: 1120-1127. 10.1016/j.orthres.2005.01.020.CrossRefPubMed
11.
go back to reference Gruber HE, Ingram JA, Hanley EN: Immunolocalization of MMP-19 in the human intervertebral disc: implications for disc aging and degeneration. Biotech Histochem. 2005, 80: 157-162. 10.1080/10520290500387607.CrossRefPubMed Gruber HE, Ingram JA, Hanley EN: Immunolocalization of MMP-19 in the human intervertebral disc: implications for disc aging and degeneration. Biotech Histochem. 2005, 80: 157-162. 10.1080/10520290500387607.CrossRefPubMed
12.
go back to reference Richardson SM, Doyle P, Minogue BM, Gnanalingham K, Hoyland JA: Increased expression of matrix metalloproteinase-10, nerve growth factor and substance P in the painful degenerate disc. Arthritis Res Ther. 2009, 11: R126-10.1186/ar2793.PubMedCentralCrossRefPubMed Richardson SM, Doyle P, Minogue BM, Gnanalingham K, Hoyland JA: Increased expression of matrix metalloproteinase-10, nerve growth factor and substance P in the painful degenerate disc. Arthritis Res Ther. 2009, 11: R126-10.1186/ar2793.PubMedCentralCrossRefPubMed
13.
go back to reference Lohi J, Wilson CL, Roby JD, Parks WC: Epilysin, a novel human matrix metalloproteinase (MMP-28) expressed in testis and keratinocytes and in response to injury. J Biol Chem. 2001, 276: 10134-10144. 10.1074/jbc.M001599200.CrossRefPubMed Lohi J, Wilson CL, Roby JD, Parks WC: Epilysin, a novel human matrix metalloproteinase (MMP-28) expressed in testis and keratinocytes and in response to injury. J Biol Chem. 2001, 276: 10134-10144. 10.1074/jbc.M001599200.CrossRefPubMed
14.
go back to reference Marchenko GN, Strongin AY: MMP-28, a new human matrix metalloproteinase with an unusual cysteine-switch sequence is widely expressed in tumors. Gene. 2001, 265: 87-93. 10.1016/S0378-1119(01)00360-2.CrossRefPubMed Marchenko GN, Strongin AY: MMP-28, a new human matrix metalloproteinase with an unusual cysteine-switch sequence is widely expressed in tumors. Gene. 2001, 265: 87-93. 10.1016/S0378-1119(01)00360-2.CrossRefPubMed
15.
go back to reference Saarilho-Kere U, Kerkalä E, Jahkola T, Suomela S, Keski-Oji J, Lohi J: Epilysin (MMP-28) expression is associated with cell proliferation during epithelial repair. J Invest Dermatol. 2002, 119: 14-21. 10.1046/j.1523-1747.2002.01790.x.CrossRef Saarilho-Kere U, Kerkalä E, Jahkola T, Suomela S, Keski-Oji J, Lohi J: Epilysin (MMP-28) expression is associated with cell proliferation during epithelial repair. J Invest Dermatol. 2002, 119: 14-21. 10.1046/j.1523-1747.2002.01790.x.CrossRef
16.
go back to reference Renò F, Sabbatini M, Stella M, Magliacani G, Cannas M: Effect of in vitro mechanical compression on Epilysin (matrix metalloproteinase-28) expression in hypertrophic scars. Wound Repair Regen. 2005, 13: 255-261. 10.1111/j.1067-1927.2005.130307.x.CrossRefPubMed Renò F, Sabbatini M, Stella M, Magliacani G, Cannas M: Effect of in vitro mechanical compression on Epilysin (matrix metalloproteinase-28) expression in hypertrophic scars. Wound Repair Regen. 2005, 13: 255-261. 10.1111/j.1067-1927.2005.130307.x.CrossRefPubMed
17.
go back to reference Bernal F, Hartung H-P, Kieseier BC: Tissue mRNA expression in rat of newly described matrix metalloproteinases. Biol Res. 2005, 38: 267-271. 10.4067/S0716-97602005000200016.CrossRefPubMed Bernal F, Hartung H-P, Kieseier BC: Tissue mRNA expression in rat of newly described matrix metalloproteinases. Biol Res. 2005, 38: 267-271. 10.4067/S0716-97602005000200016.CrossRefPubMed
18.
go back to reference Rodgers UR, Kevorkian L, Surridge AK, Waters JG, Swingler TE, Culley K, Illman S, Lohi J, Parker AE, Clark IM: Expression and function of matrix metalloproteinase (MMP)-38. Matrix Biol. 2009, 28: 263-272. 10.1016/j.matbio.2009.04.006.PubMedCentralCrossRefPubMed Rodgers UR, Kevorkian L, Surridge AK, Waters JG, Swingler TE, Culley K, Illman S, Lohi J, Parker AE, Clark IM: Expression and function of matrix metalloproteinase (MMP)-38. Matrix Biol. 2009, 28: 263-272. 10.1016/j.matbio.2009.04.006.PubMedCentralCrossRefPubMed
19.
go back to reference Illman SA, Keski-Oha J, Lohi J: Promoter characterization of the human and mouse epilysin (MMP-28) genes. Gene. 2001, 275: 185-194. 10.1016/S0378-1119(01)00664-3.CrossRefPubMed Illman SA, Keski-Oha J, Lohi J: Promoter characterization of the human and mouse epilysin (MMP-28) genes. Gene. 2001, 275: 185-194. 10.1016/S0378-1119(01)00664-3.CrossRefPubMed
21.
go back to reference Thompson JP, Pearce RH, Schechter MT, Adams ME, Tsang IKY, Bishop PB: Preliminary evaluation of a scheme for grading the gross morphology of the human intervertebral disc. Spine. 1990, 15: 411-415. 10.1097/00007632-199005000-00012.CrossRefPubMed Thompson JP, Pearce RH, Schechter MT, Adams ME, Tsang IKY, Bishop PB: Preliminary evaluation of a scheme for grading the gross morphology of the human intervertebral disc. Spine. 1990, 15: 411-415. 10.1097/00007632-199005000-00012.CrossRefPubMed
22.
go back to reference Gruber HE, Mougeot J-L, Hoelscher GL, Ingram JA, Hanley EN: Microarray analysis of laser capture microdissected annulus cells from the human intervertebral disc. Spine. 2007, 32: 1181-1187. 10.1097/BRS.0b013e318053ec89.CrossRefPubMed Gruber HE, Mougeot J-L, Hoelscher GL, Ingram JA, Hanley EN: Microarray analysis of laser capture microdissected annulus cells from the human intervertebral disc. Spine. 2007, 32: 1181-1187. 10.1097/BRS.0b013e318053ec89.CrossRefPubMed
24.
go back to reference Roberts S, Evans H, Trivedi J, Menage J: Histology and pathology of the human intervertebral disc. J Bone Joint Surg Am. 2006, 88 Suppl 2: 10-14. 10.2106/JBJS.F.00019.CrossRefPubMed Roberts S, Evans H, Trivedi J, Menage J: Histology and pathology of the human intervertebral disc. J Bone Joint Surg Am. 2006, 88 Suppl 2: 10-14. 10.2106/JBJS.F.00019.CrossRefPubMed
25.
go back to reference Gruber HE, Ingram JA, Hanley EN: Morphologic complexity of the pericellular matrix in the annulus of the intervertebral disc. Biotech Histochem. 2007, 82: 217-225. 10.1080/10520290701713999.CrossRefPubMed Gruber HE, Ingram JA, Hanley EN: Morphologic complexity of the pericellular matrix in the annulus of the intervertebral disc. Biotech Histochem. 2007, 82: 217-225. 10.1080/10520290701713999.CrossRefPubMed
26.
go back to reference Heiskanen TJ, Illman SA, Lohi J, Keski-Oja J: Epilysin (MMP28) is deposited to the basolateral extracellular matrix of epithelial cells. Matrix Biol. 2009, 28: 74-83. 10.1016/j.matbio.2008.12.004.CrossRefPubMed Heiskanen TJ, Illman SA, Lohi J, Keski-Oja J: Epilysin (MMP28) is deposited to the basolateral extracellular matrix of epithelial cells. Matrix Biol. 2009, 28: 74-83. 10.1016/j.matbio.2008.12.004.CrossRefPubMed
27.
go back to reference Davidson RK, Waters JG, Kevorkian L, Darrah C, Cooper A, Donell ST, Clark IM: Expression profiling of metalloproteinases and their inhibitors in synovium and cartilage. Arthritis Res Ther. 2006, 8: R124-10.1186/ar2013.PubMedCentralCrossRefPubMed Davidson RK, Waters JG, Kevorkian L, Darrah C, Cooper A, Donell ST, Clark IM: Expression profiling of metalloproteinases and their inhibitors in synovium and cartilage. Arthritis Res Ther. 2006, 8: R124-10.1186/ar2013.PubMedCentralCrossRefPubMed
28.
go back to reference Kevorkian L, Young DA, Darrah C, Donell ST, Shepstone L, Porter S, Brockbank SM, Edwards DR, Parker AE, Clark IM: Expression profiling of metalloproteinases and their inhibitors in cartilage. Arthritis Rheum. 2004, 50: 131-141. 10.1002/art.11433.CrossRefPubMed Kevorkian L, Young DA, Darrah C, Donell ST, Shepstone L, Porter S, Brockbank SM, Edwards DR, Parker AE, Clark IM: Expression profiling of metalloproteinases and their inhibitors in cartilage. Arthritis Rheum. 2004, 50: 131-141. 10.1002/art.11433.CrossRefPubMed
29.
go back to reference Abe Y, Akeda K, An HS, Aoki Y, Pichika R, Muehleman C, Kimura T, Masuda K: Proinflammatory cytokines stimulate the expression of nerve growth factor by human intervertebral disc cells. Spine. 2007, 32: 635-642. 10.1097/01.brs.0000257556.90850.53.CrossRefPubMed Abe Y, Akeda K, An HS, Aoki Y, Pichika R, Muehleman C, Kimura T, Masuda K: Proinflammatory cytokines stimulate the expression of nerve growth factor by human intervertebral disc cells. Spine. 2007, 32: 635-642. 10.1097/01.brs.0000257556.90850.53.CrossRefPubMed
30.
go back to reference Seguin CA, Pilliar RM, Roughley PJ, Kandel RA: Tumor nectosis factor-alpha modulates matrix production and catabolism in nucleus pulposus tissue. Spine. 2005, 30: 1940-1948. 10.1097/01.brs.0000176188.40263.f9.CrossRefPubMed Seguin CA, Pilliar RM, Roughley PJ, Kandel RA: Tumor nectosis factor-alpha modulates matrix production and catabolism in nucleus pulposus tissue. Spine. 2005, 30: 1940-1948. 10.1097/01.brs.0000176188.40263.f9.CrossRefPubMed
31.
go back to reference Melrose J, Smith S, Little CB, Kitson J, Hwa S-Y, Ghosh P: Spatial and temporal localization of transforming growth factor-β, fibroblast growth factor-1, and osteonectin, and identification of cells expressing α-smooth muscle actin in the injured annulus fibrosus. Implications for extracellular matrix repair. Spine. 2002, 27: 1756-1764. 10.1097/00007632-200208150-00014.CrossRefPubMed Melrose J, Smith S, Little CB, Kitson J, Hwa S-Y, Ghosh P: Spatial and temporal localization of transforming growth factor-β, fibroblast growth factor-1, and osteonectin, and identification of cells expressing α-smooth muscle actin in the injured annulus fibrosus. Implications for extracellular matrix repair. Spine. 2002, 27: 1756-1764. 10.1097/00007632-200208150-00014.CrossRefPubMed
32.
go back to reference Murakami H, Yoon T, Attallah-Wasif ES, Tsai K-J, Fei Q, Hutton WC: The expression of anabolic cytokines in intervertebral discs in age-related degeneration. Spine. 2006, 31: 1770-1774. 10.1097/01.brs.0000227255.39896.f3.CrossRefPubMed Murakami H, Yoon T, Attallah-Wasif ES, Tsai K-J, Fei Q, Hutton WC: The expression of anabolic cytokines in intervertebral discs in age-related degeneration. Spine. 2006, 31: 1770-1774. 10.1097/01.brs.0000227255.39896.f3.CrossRefPubMed
33.
go back to reference Nerlich AG, Bachmeier BE, Boos N: Expression of fibronectin and TGF-β1 mRNA and protein suggest altered regulation of extracellular matrix in degenerated disc tissue. Eur Spine J. 2005, 14: 17-26. 10.1007/s00586-004-0745-x.PubMedCentralCrossRefPubMed Nerlich AG, Bachmeier BE, Boos N: Expression of fibronectin and TGF-β1 mRNA and protein suggest altered regulation of extracellular matrix in degenerated disc tissue. Eur Spine J. 2005, 14: 17-26. 10.1007/s00586-004-0745-x.PubMedCentralCrossRefPubMed
34.
go back to reference Specchia N, Pagnotta A, Toesca A, Greco F: Cytokines and growth factors in the protruded intervertebral disc of the lumbar spine. Eur Spine J. 2002, 11: 145-151. 10.1007/s00586-001-0361-y.PubMedCentralCrossRefPubMed Specchia N, Pagnotta A, Toesca A, Greco F: Cytokines and growth factors in the protruded intervertebral disc of the lumbar spine. Eur Spine J. 2002, 11: 145-151. 10.1007/s00586-001-0361-y.PubMedCentralCrossRefPubMed
35.
go back to reference Illman SA, Lehti K, Keski-Oja J, Lohi J: Epilysin (MMP-28) induces TGF-β-mediated epithelial to mesenchymal transition in lung carcinoma cells. J Cell Science. 2006, 119: 3856-3865. 10.1242/jcs.03157.CrossRefPubMed Illman SA, Lehti K, Keski-Oja J, Lohi J: Epilysin (MMP-28) induces TGF-β-mediated epithelial to mesenchymal transition in lung carcinoma cells. J Cell Science. 2006, 119: 3856-3865. 10.1242/jcs.03157.CrossRefPubMed
36.
go back to reference Illman SA, Lohi J, Keski-Oja J: Epilysin (MMP-28) - structure, expression and potential functions. Exp Dermatol. 2008, 17: 897-907. 10.1111/j.1600-0625.2008.00782.x.CrossRefPubMed Illman SA, Lohi J, Keski-Oja J: Epilysin (MMP-28) - structure, expression and potential functions. Exp Dermatol. 2008, 17: 897-907. 10.1111/j.1600-0625.2008.00782.x.CrossRefPubMed
37.
go back to reference Blain EJ: Mechanical regulation of matrix metalloproteinases. Front Biosci. 2007, 12: 507-527. 10.2741/2078.CrossRefPubMed Blain EJ: Mechanical regulation of matrix metalloproteinases. Front Biosci. 2007, 12: 507-527. 10.2741/2078.CrossRefPubMed
38.
go back to reference Hsieh AH, Lotz JC: Prolonged spinal loading induces matrix metalloproteinase-2 activation in intervertebral discs. Spine. 2003, 28: 1781-1788. 10.1097/01.BRS.0000083282.82244.F3.CrossRefPubMed Hsieh AH, Lotz JC: Prolonged spinal loading induces matrix metalloproteinase-2 activation in intervertebral discs. Spine. 2003, 28: 1781-1788. 10.1097/01.BRS.0000083282.82244.F3.CrossRefPubMed
39.
go back to reference MacLean JJ, Lee CR, Grad S, Ito K, Alini M, Iatridis JC: Effects of immobilization and dynamic compression on intervertebral disc cell gene expression in vivo. Spine. 2003, 28: 973-981. 10.1097/00007632-200305150-00004.PubMed MacLean JJ, Lee CR, Grad S, Ito K, Alini M, Iatridis JC: Effects of immobilization and dynamic compression on intervertebral disc cell gene expression in vivo. Spine. 2003, 28: 973-981. 10.1097/00007632-200305150-00004.PubMed
Metadata
Title
Matrix metalloproteinase 28, a novel matrix metalloproteinase, is constitutively expressed in human intervertebral disc tissue and is present in matrix of more degenerated discs
Authors
Helen E Gruber
Jane A Ingram
Gretchen L Hoelscher
Natalia Zinchenko
H James Norton
Edward N Hanley Jr
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 6/2009
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar2876

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