Folate-Dependent Hypermobility Syndrome: A Proposed Mechanism and Diagnosis

In their model, scientists found decreased methylenetetrahydrofolate reductase activity disrupts the regulation of the ECM-specific proteinase matrix metalloproteinase 2 (MMP-2), leading to high levels of MMP-2 and elevated MMP-2-mediated cleavage of the proteoglycan decorin. Cleavage of decorin leads ultimately to ECM disorganization and increased fibrosis.