In this episode we explore ways in which the extracellular matrix can be manipulated, including the story of doxycycline, TGF-beta in Marfan syndrome and whether beta blockers can reduce vascular events in vascular EDS. · Intro 0:12* · Review of previous episode 0:28* · In this episode 2:26 · The pressure against the vessels 4:06 · The pressure against the wall 8:44 · Matrix metalloproteinases 10:16 · Tadpole study – collagen breakdown 10:35 · Tetracycline antibiotics 14:05 · Rat model – periodontal disease and hydroxyproline 14:24 · Chemically modified tetracyclines 20:14 · Mouse model – tetracycline use 22:00 · Tetracyclines and other autoimmune conditions 23:22 · Marfan syndrome 24:45 · Fibrillin and Marfan syndrome 28:48 · TGF-beta 29:36 · Mouse model – Marfan syndrome and fibrillin 31:14 · ARBs and TGF-beta 33:51 · TGF-beta and vascular EDS 37:25 · Back to the mouse model 38:38 · Protein kinase C 39:56 · Summary 40:26 Disclosures: Brown reports no relevant financial disclosures. We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]). Follow us on Twitter @HRheuminations) @AdamJBrownMD) @HealioRheum). References: Bowen CJ, et al. J Clin Invest. 2020;130:686-698.) Brooke BS. Lancet. 2010;doi:10.1016/S0140-6736(10)61155-5) Dietz HC, et al. Am J Med Genet C Semin Med Genet. 2005;doi:10.1002/ajmg.c.30068.) Dubacher N, et al. Cardiovasc Res. 2020;116:457-465.) Golub LM, et al. SAGE. 1998;doi:10.1177/08959374980120010501.) Gross J, et al. PNAS. 1962;doi:10.1073/pnas.48.6.1014) Habashi JP, et al. Science. 2006;312:117-121.) Morissette R, et al. Circ Cardiovasc Genet. 2014;7:80-88.) Mullen M, et al. Lancet. 2019;394:2263-2270.) Neptune ER, et al. Nat Genet. 2003;33:407-411.)