# Matrix Metalloproteinases in Ureteropelvic Junction Obstruction: Their Role in Pathogenesis and Their Use as Clinical Markers

## TL;DR

This paper reviews the role of matrix metalloproteinases in ureteropelvic junction obstruction and their potential as biomarkers for kidney damage and disease monitoring.

## Contribution

The paper highlights the underexplored role of MMPs in UPJO pathogenesis and their potential as non-invasive clinical markers.

## Key findings

- MMPs are involved in extracellular matrix remodeling and growth factor modulation during urinary tract obstruction.
- MMPs may serve as detectable biomarkers in bodily fluids like urine for monitoring UPJO and hydronephrosis.
- Current understanding of MMP roles in UPJO and obstructive nephropathy remains limited and requires further investigation.

## Abstract

The obstruction of the urinary tract is responsible for obstructive nephropathy (ON), also known as uropathy, which may then evolve in a renal parenchymal disease (hydronephrosis). Regarding the etiology of ON, it has been linked to the perturbation of processes occurring during the urinary tract development such as morphogenesis, maturation, and growth. Despite the research carried out in recent years, there is still a pressing need to elucidate the molecular processes underlying the disease. This may then result in the definition of novel biomarkers that can help in patient stratification and the monitoring of therapeutic choices. Matrix metalloproteinases (MMPs) are a family of zinc-dependent endopeptidases with key roles in extracellular matrix remodeling due to their wide cleavage specificity and ability to modulate the bioavailability of growth factors. Despite the known changes in the local tissue microenvironment at the site of the urinary tract obstruction, the role of MMPs in ureteropelvic junction obstruction (UPJO) and, therefore, in the pathogenesis of renal damage in ON is not well-documented. In this review, we underline the possible roles of MMPs both in the pathogenesis of UPJO and in the progression of related hydronephrosis. The potential use of MMPs as biomarkers detectable in bodily fluids (such as the patient’s urine) is also discussed.