Matrix metalloproteinases in kidney disease progression and repair: a case of flipping the coin.

Matrix metalloproteinases (MMPs) have pleiotropic enzymatic actions that go far beyond degradation of extracellular matrix. Both the multiplicity of their targets and the complexity of their regulation account for a variety of biological effects. In renal diseases, MMP effects may be different and/or opposite during the different phases of the pathology evolution. The major challenge with future therapeutic interventions using MMP inhibitors remains how to accomplish temporal and spatial control of their activity without flipping the coin.