Clinically, microbiome-directed therapy can reduce MMP-9 in select settings: in ulcerative colitis, mesalazine plus a bifidobacteria-based probiotic lowered fecal MMP-9 alongside improved microbial composition versus mesalazine alone, indicating that correcting dysbiosis can attenuate protease tone in vivo [150]. Here, MMP9 is linked to ulcerative colitis.