Cyclosporin A induces myocardial fibrosis and affects expression of matrix metalloproteinases and their inhibitors in rats

AIM: To investigate the changes of matrix metalloproteinases (MMP2 and MMP9) and tissue inhibitor of metalloproteinases (TIMP2 and TIMP1) in the myocardial fibrosis induced by cyclosporin A (CsA), and to explore the underlying mechanism. METHODS: Female Wistar rats (n=64, 6~8 weeks old) weighing (200±25) g were randomly divided into 4 groupscontrol, low dose of CsA (5 mg·kg^-1·d^-1), medium dose of CsA (12.5 mg·kg^-1·d^-1) and high dose of CsA (25 mg·kg^-1·d^-1)]. The rats were intraperitoneally injected with saline and different doses of CsA, respectively. CsA was continuously administered for 1, 2 and 3 weeks, and then the animals were killed to collect samples. HE staining was used to observe the morphological structure of myocardium. Masson staining was used to observe the deposition of myocardial collagen and the degree of myocardial fibrosis. The protein expression levels of MMP2, MMP9, TIMP2 and TIMP1 were determined by immunohistochemistry and Western blot. RESULTS: HE staining showed that CsA induced cardiomyocyte edema, eosinophilic changes in the cytoplasm, fine granular and vacuolar changes in cardiomyocytes, disappearance of myocardial striae, nuclear condensation, and myocardial focal necrosis and fibrosis. Masson staining showed that the degree of myocardial interstitial fibrosis was getting worse with the increase in the duration and doses of CsA exposure. The results of immunohistochemistry and Western blot showed that the expression of MMP2 in CsA groups was significantly increased in the process of CsA-induced myocardial fibrosis. In each CsA dose group, MMP2 was highly expressed at the first week, and the expression was gradually decreased over time. In contrast, the expression of TIMP2 was increased gradually in a time-and dose-dependent manner (P<0.05). Compared with control group, MMP9 expression level was low at the first week, increased at the second week, and decreased at the third week (P<0.05). Compared with control group, the expression of TIMP1 was dose-dependently increased (P<0.05). CONCLUSION: CsA induces myocardial injury and interstitial fibrosis in rats in a dose-and time-dependent manner. CsA-induced myocardial fibrosis is associated with changes of MMPs and TIMPs, and is affected by the imbalance of MMPs/TIMPs.