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Abstract
<p class="first" id="P1">ADAMTS proteins are a superfamily of 26 secreted molecules
comprising two related,
but distinct families. ADAMTS proteases are zinc metalloendopeptidases, most of whose
substrates are extracellular matrix (ECM) components, whereas ADAMTS-like proteins
lack a metalloprotease domain, reside in the ECM and have regulatory roles vis-à-vis
ECM assembly and/or ADAMTS activity. Evolutionary conservation and expansion of ADAMTS
proteins in mammals is suggestive of crucial embryologic or physiological roles in
humans. Indeed, Mendelian disorders or birth defects resulting from naturally occurring
<i>ADAMTS2, ADAMTS3, ADAMTS10, ADAMTS13, ADAMTS17, ADAMTS20, ADAMTSL2</i> and
<i>ADAMTSL4</i> mutations as well as numerous phenotypes identified in genetically
engineered mice
have revealed ADAMTS participation in major biological pathways. Important roles have
been identified in a few acquired conditions. ADAMTS5 is unequivocally implicated
in pathogenesis of osteoarthritis via degradation of aggrecan, a major structural
proteoglycan in cartilage. ADAMTS7 is strongly associated with coronary artery disease
and promotes atherosclerosis. Autoantibodies to ADAMTS13 lead to a platelet coagulopathy,
thrombotic thrombocytopenic purpura, which is similar to that resulting from
<i>ADAMTS13</i> mutations. ADAMTS proteins have numerous potential connections to
other human disorders
that were identified by genome-wide association studies. Here, we review inherited
and acquired human disorders in which ADAMTS proteins participate, and discuss progress
and prospects in therapeutics.
</p>