Unravelling Thymidine phosphorylase: Mechanisms and multifunctional impact on cardiovascular system - from bench to bedside.

Thymidine phosphorylase (TYMP) is a multifunctional enzyme responsible for pyrimidine metabolism. Interestingly, its impact extends beyond that function. This review aims at summarising the role of TYMP in different biological processes, with particular attention paid to the cardiovascular system. TYMP regulates platelet activation and, within the vascular wall, promotes cell migration by modulating focal adhesion. Moreover, it affects cellular defence mechanisms activated under oxidative stress, thereby preventing vascular injury. Additionally, by modulating several pivotal signalling cascades, TYMP promotes tumour growth, and exerts anti-apoptotic action. Furthermore, the TYMP activation status correlates with outcomes of pharmacological treatment during chemotherapy with microtubule-interfering agents. TYMP is also expressed in the central nervous system, where it regulates transmembrane proteins essential in maintaining the blood-brain barrier. The thoroughly described pathophysiological basis of TYMP activity corresponds with the pathological mechanisms of numerous disorders. Modulating its actions may serve as an attractive novel therapeutic target in: the COVID-19-associated thrombotic complications, resistance to myocardial infarction-associated cardiomyocyte damage, aneurysm development, atherosclerosis progression, and neurological diseases, including stroke.