Objective-Although it has been reported that matrix metalloproteinase (MMP)-2 is a major proteinase in atherosclerotic plaque lesions, there is no direct evidence of the role of MMP-2 in atherosclerotic lesion formation. In the present study we determined the role of MMP-2 in atherosclerosis plaque development using apolipoprotein E-deficient (apoE Ϫ/Ϫ ) mice. Methods and Results-To generate MMP-2-deficient, apoE-deficient mice (MMP-2 Ϫ/Ϫ :apoE Ϫ/Ϫ ), MMP-2 Ϫ/Ϫ mice were crossed with apoE Ϫ/Ϫ mice. After 8 weeks of feeding with a lipid-rich diet, morphological and biochemical studies of the aortic sinus and arch were conducted. A significant reduction of the atherosclerotic plaque in the aortic sinus and arch with the decrease in smooth muscle cell-positive area was observed in MMP-2 Ϫ/Ϫ :apoE Ϫ/Ϫ mice compared with that of MMP-2 ϩ/ϩ :apoE Ϫ/Ϫ mice. Macrophage-and collagen-positive areas were less in aortic sinus but not in aortic arch in MMP-2 Ϫ/Ϫ :apoE Ϫ/Ϫ mice. There was no difference of MMP-9 mRNA expression in the plaque lesion between the 2 genotypes. A much lower level of mRNA expression of TIMP-1 and TIMP-2 was detected in the atherosclerotic plaque lesions of MMP-2 Ϫ/Ϫ :apoE Ϫ/Ϫ mice than in those of MMP-2 ϩ/ϩ :apoE Ϫ/Ϫ mice. Key Words: atherosclerosis Ⅲ collagen Ⅲ metalloproteinases Ⅲ plaque I n human or animal models of atherosclerosis, varying matrix metalloproteinases (MMPs) have been demonstrated to increase in atherosclerotic lesions, including MMP-1, -2, -3, -7, -9, -12, -13, and MT-MMPs. 1-3 MMPs have been believed to contribute to the development and progression of atherosclerosis. 1-3 However, there are only limited data providing direct evidence of the contribution of MMPs to the development of atherosclerotic lesions. Although MMP activity is commonly considered instrumental to the development of atherosclerotic lesions, this notion has been challenged by recent studies in gene-targeting mice. It has been reported that overexpression of the tissue inhibitor of metalloproteinases-1 (TIMP-1) reduced atherosclerotic lesions in apolipoprotein E-deficient (apoE Ϫ/Ϫ ) mice. 4 The deletion of the TIMP-1 gene resulted in either a reduction of or no change in the plaque size in the apoE Ϫ/Ϫ mice. 5,6 Atherosclerotic lesions were significantly larger in mice with a combined deficiency of apoE and MMP-3 than in apoE Ϫ/Ϫ mice. 7 Overexpression of MMP-1 in apoE Ϫ/Ϫ mice, which is not normally expressed in mice, decreased the extent of atherosclerosis. 8 A more recent study demonstrated that MMP-9 deficiency but not MMP-12 deficiency reduced the atherosclerotic lesion growth in apoE Ϫ/Ϫ mice. 9 MMP-13 deficiency had no effect on atherosclerotic plaque formation with similar accumulation of plaque macrophages and smooth muscle cells, but contained more interstitial collagen in apoE Ϫ/Ϫ mice. 10 These results seemingly contradict a central tenet in our understanding of atherosclerosis-that increased MMP activity leads to the formation of a thicker neointima-suggesting that the role of individual MMPs in pla...