MMP-2 and MMP-9 genes have been suggested to play a role in breast cancer. Their functions have been associated with invasion and metastasis of breast cancer; however, their involvement in the development of the disease is not well-established. Herein, we reviewed the literature investigating the association between circulating levels and polymorphisms of MMP-2 and MMP-9 and breast cancer risk. Various studies report conflicting results regarding the relationship of polymorphisms in MMP-2 and MMP-9 and breast cancer risk. Nevertheless, it appears that the T allele in rs243865 and rs2285053 in MMP-2 are associated with reduced risk of breast cancer. In addition, high levels of latent form and low levels of active form of MMP-2 were observed in breast cancer patients compared to controls. For MMP-9, high latent levels and low total levels were found in breast cancer patients compared to controls. Additional studies are needed to comprehend the role of these genes in breast carcinogenesis.Matrix metalloproteinases (MMP) are a family of Zn 2+dependent endopeptidases responsible for cleaving components of the extracellular matrix (1). They are classified into several families according to their structural differences (1, 2). MMP-2 and -9 comprise the gelatinase family that possesses three fibronectin repeats allowing for degradation of denatured collagen (gelatin) and collagens IV and V (2, 3). These gelatinases degrade collagen in the basement membrane (4), as well as other extracellular matrix components, thus promoting extracellular matrix remodeling and consequently play a key role in several physiological processes, such as tissue repair, wound healing, and cell differentiation (5, 6).Gelatinases could be involved in carcinogenesis processes, including cell proliferation, angiogenesis, and tumor metastasis through their proteolytic function (7). Indeed, the literature suggests their involvement in several pathological processes critical for cancer development, including inflammation, angiogenesis, and cell proliferation, as well as in tumor progression (8,9). More specifically, the biological functions of MMP-2 and -9 proteins have been associated with invasive and metastatic stages of breast cancer (10, 11); however, their involvement in breast cancer development is unclear.Herein, we aimed to review and discuss articles which studied the association between gelatinases and breast cancer risk. For this purpose, an electronic search of the MEDLINE (PubMed) database was performed to identify all published studies that evaluated the association of polymorphisms or circulating levels of MMP-2 and MMP-9 with breast cancer risk. Matrix Metalloproteinase-2 (MMP-2)MMP-2 is located on chromosome 16 and codes for gelatinase A. The substrates for this enzyme include gelatin, collagen V, and collagen VI (12). The MMP-2 gene has been studied in several abnormal physiological processes, such as obesity and cancer (13). Polymorphisms that alter the function and efficacy of this protein could be associated with breast cancer ri...
Background Continuing professional development (CPD) for health professionals includes educational activities to maintain or improve skills. We evaluated the impact of a series of CPD courses by identifying factors influencing physicians' intention to adopt targeted behaviors and assessing self-reported behavior adoption six months later. Methods In this pre-post study, eligible participants attended at least one in-person course at the Fédération des Médecins Spécialistes du Québec annual meeting in November 2019. Before and afterwards, participants completed CPD-REACTION, a validated questionnaire based on Godin’s integrated model for health professional behavior change that measures intention and psychosocial factors influencing intention. We used Wilcoxon signed-rank test to compare pre- and post-course intention scores and linear regression analyses to identify factors influencing intention. We also compared the post-course intention scores of participants reporting a behavior change six months later with the scores of those reporting no behavior change six months later. Qualitative data were analyzed using the Theoretical Domains Framework. Results A total of 205/329 course attendees completed CPD-REACTION (response rate 62.3%). Among these participants, 158/329 (48%) completed the questionnaire before CPD courses, 129/329 (39.2%) only after courses and 47/329 (14.3%) at 6 months. Study population included 192 physicians of which 78/192 (40.6%) were female; 59/192 (30.7%) were between 50 and 59 years old; and 72/192 (37.5%) were surgical specialists. Mean intention scores before (n = 158) and after (n = 129) courses were 5.74 (SD = 1.52) and 6.35 (SD = 0.93) respectively. Differences in mean (DM) intention before and afterwards ranged from − 0.31 (p = 0.17) to 2.25 (p = 0.50). Multivariate analysis showed that beliefs about capabilities (β = 0.15, p = 0.001), moral norm (β = 0.75, p < 0.0001), and beliefs about consequences (β = 0.11, p = 0.04) influenced post-course intention. Post-course intention was correlated with behavior six months later (DM = 0.63; p = 0.02). Qualitative analysis showed that facilitators to behavior adoption after six months were most often related to the TDF domains of beliefs about capabilities. Most frequent barriers to adoption related to lack of resources. Conclusions To increase effectiveness of future CPD courses, CPD providers could increase participants’ intention by including interventions that emphasize beliefs about capabilities, moral norm and beliefs about consequences.
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