Hypoxia impairs normal neonatal pulmonary artery remodeling and alveolar development. Matrix metalloproteinase-2 (MMP-2), which regulates collagen breakdown, is important during development. Our objective was to test the hypothesis that hypoxia attenuates the normal postnatal increase in MMP-2 and evaluate alveolar development and pulmonary arterial remodeling in Mmp2 Ϫ/Ϫ mice. C57BL/6 wild-type (WT), Mmp2 ϩ/Ϫ , Mmp2 Ϫ/Ϫ , and MMP-inhibited (with doxycycline) mice were exposed to hypoxia (12% O 2 ) or air from birth to 2 wk of age. Pulmonary arterial remodeling, alveolar development, and vascular collagen and elastin were evaluated. MMP-2 was estimated by quantitative real-time polymerase chain reaction, enzyme-linked immunosorbent assay, immunohistochemistry, and zymography. We observed that 1) in WT mice, hypoxia led to thicker-walled pulmonary arteries and impaired alveolarization, accompanied by decreased MMP-2 and increased tissue inhibitor of metalloproteinases-2 (TIMP-2); 2) Mmp2 Ϫ/Ϫ mice in air had thicker-walled arteries, impaired alveolarization, and increased perivascular collagen and elastin compared with WT; 3) hypoxia further inhibited alveolarization but did not alter arterial thickening in Mmp2 Ϫ/Ϫ mice. Mmp2 ϩ/Ϫ and MMP-inhibited mice also had thicker-walled arteries than WT in air, but alveolarization was not different. We conclude that hypoxia reduces the postnatal MMP-2 increase in the lung, which may contribute to abnormal pulmonary arterial remodeling and impaired alveolarization. C hronic hypoxia leads to abnormal pulmonary arterial remodeling with excessive collagen and elastin deposition (1), similar to that observed in persistent pulmonary hypertension of the newborn (2), bronchopulmonary dysplasia (BPD) (3), and congenital heart disease (4,5). Chronic hypoxia also permanently inhibits alveolar development (6,7), which normally begins in late gestation in humans and postnatally in mice (8,9).The hypoxia-induced effects on pulmonary arterial remodeling and alveolarization suggest that hypoxia alters extracellular matrix (ECM) turnover. Matrix metalloproteinases (MMPs) regulated by tissue inhibitors of metalloproteinases (TIMPs) regulate ECM turnover (10), and only specific MMPs can initiate collagen breakdown (11). The gelatinases (MMP-2 and MMP-9) degrade collagen more efficiently than other MMPs (12). MMP-2 is the predominant gelatinase in the developing lung (13), and the fetal human lung has a proteolytic profile with higher MMP-2 compared with the adult lung (14). Pro-MMP-2 (72 kD) is converted to an active form (66 kD) that in turn cleaves many substrates, including collagen, fibronectin, and elastin (15). The other gelatinase, MMP-9, is chiefly expressed by inflammatory and epithelial cells (16) and not by pulmonary arteries (17). MMP-2 activity is primarily regulated at the level of activation of pro-MMP-2 by TIMP-2 and MMP-14 (18 -20). TIMP-2 potentiates MMP-2 activation at low concentrations and inhibits it at higher concentrations (21).In the current study, we focuse...