Transforming growth factor (TGF)-β1, a cytokine released into the cerebrospinal fluid (CSF) after intraventricular hemorrhage (IVH), stimulates the expression of the components of the extracellular matrix (ECM), which causes progressive ventricular dilatation by impaired CSF absorption. Matrix metalloproteinase-9 (MMP-9), a proteinase involved in the removal of ECM proteins, has been shown to contribute to the resolution of progressive ventricular dilation after IVH. The aim of this study is to clarify the mechanism by which MMP-9 is expressed following IVH.Cultured human meningeal cells were treated with human recombinant TGF-β1. RT-PCR demonstrated that TGF-β1 induced MMP-9 expression in the meningeal cells in a dose-dependent manner. The TGF-β1-induced MMP-9 expression was attenuated in the presence of either MEK or Smad 3 inhibitor. Our data indicated that MMP-9 is released into the CSF from meningeal cells in response to TGF-β1, most probably through the activation of ERK and Smad pathways. Of these, approximately 15% of the infants require a shunt operation; however, the remaining 85% of the infants exhibit a resolution of ventricular dilation without a shunt operation [1]. The mechanisms for this remain unknown. Thus, elucidating the intrinsic mechanism underlying the resolution of ventricular dilation will contribute to the development of a novel treatment strategy for PHH.Transforming growth factor (TGF)-β1, a cytokine released into the cerebrospinal fluid (CSF) after IVH, is considered to play an important role in the pathogenesis of PHH [2].This cytokine causes progressive ventricular dilation by stimulating the expression of the components of the extracellular matrix (ECM) [3]. In contrast, the removal of ECM is mediated by matrix metalloproteinases (MMPs) [4]. We previously 4 measured MMP-9 activity in the CSF of infants with PHH and showed that there was higher MMP-9 activity in patients who avoided a shunt operation than in patients who required a shunt operation [5]. Thus, our earlier data may indicate that MMP-9 contributes to the resolution of progressive ventricular dilation after IVH. However, the mechanism by which MMP-9 is produced in the CSF of infants with PHH remains to be elucidated. The aim of this study is to clarify the mechanism by which MMP-9 is expressed following IVH.Expression of MMP-9 has been shown to be regulated by various growth factors and cytokines, including TGF-β1 [6][7][8][9]. TGF-β1 stimulates the expression of MMP-9 in various human cell lines through the activation of mitogen-activated protein kinase (MAPK) and/or Smad pathways [6][7][8][9].These data suggest that TGF-β1 may not only play a role in the progression of PHH but also has a beneficial role in the resolution of PHH by enhancing MMP-9 expression.We hypothesized that meningeal cells may be a source of MMP-9 5 production because TGF-β1-mediated deposition of the ECM proteins occurs in the channels of CSF absorption [3]. Here, we show that cultured human meningeal cells express MMP-9 in response to TG...