血清基质金属蛋白酶-3 水平与青少年特发性关节炎中附着点相关关节炎类别的疾病活动度相关。
Levels of serum matrix metalloproteinase-3 correlate with disease activity in the enthesitis-related arthritis category of juvenile idiopathic arthritis.
机构信息
Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
出版信息
J Rheumatol. 2011 Nov;38(11):2482-7. doi: 10.3899/jrheum.110352. Epub 2011 Sep 1.
OBJECTIVE
Serum matrix metalloproteinase-3 (MMP-3) has been shown to reflect disease activity in ankylosing spondylitis (AS) and rheumatoid arthritis. Elevated levels have been found in juvenile idiopathic arthritis (JIA). In the enthesitis-related arthritis category of JIA (JIA-ERA), we studied whether serum MMP-3 levels and ratios of MMP-3/tissue inhibitor of metalloproteinase (TIMP-1) are correlated with disease activity and whether they are sensitive to change in disease activity.
METHODS
A total of 54 patients with JIA-ERA (International League of Associations for Rheumatology criteria) were enrolled for study. Baseline disease activity measures included tender and swollen joint counts, Maastricht AS Enthesitis Score, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), patient assessment of pain and global disease activity, physician assessment of global disease activity, and erythrocyte sedimentation rate (ESR). Serum MMP-3 and TIMP-1 levels were measured using ELISA. A group of 24 patients were followed up for longitudinal study.
RESULTS
The mean age of 54 patients (48 males) at disease onset was 11.8 ± 4.19 years and duration of disease was 5.2 ± 4.3 years. Median ESR was 65 mm/h (range 46.5-97) and median BASDAI was 3.4 (range 2.5-4.7). Median MMP-3, TIMP-1, and MMP-3/TIMP-1 ratio were 50.4 ng/ml (IQR 13.0-193.8), 228.9 ng/ml (IQR 108.2-290.4), and 0.3 (IQR 0.07-1.13), respectively. At inclusion MMP-3 levels correlated directly with various disease activity measures: tender joint count (TJC; r = 0.60), swollen joint count (SJC; r = 0.45), BASFI (r = 0.29), BASDAI (r = 0.32), ESR (r = 0.49), physician global assessment (r = 0.40), patient visual analog scale for pain (r = 0.28), and patient global assessment (r = 0.38; all p < 0.05). MMP-3/TIMP-1 ratio correlated only with TJC (r = 0.51), SJC (r = 0.39), and ESR (r = 0.34; p < 0.05). At followup, change in MMP-3 correlated with changes in TJC (r = 0.42) and SJC (r = 0.44; p < 0.05), while change in ESR did not correlate with change in any disease activity measure.
CONCLUSION
MMP-3 levels are a good marker for disease activity in JIA-ERA.
目的
血清基质金属蛋白酶-3（MMP-3）已被证明可反映强直性脊柱炎（AS）和类风湿关节炎（RA）的疾病活动度。在幼年特发性关节炎（JIA）中发现其水平升高。在 JIA 的附着点关节炎类别（JIA-ERA）中，我们研究了血清 MMP-3 水平和 MMP-3/组织金属蛋白酶抑制剂（TIMP-1）的比值是否与疾病活动度相关，以及它们是否对疾病活动度的变化敏感。
方法
共纳入 54 例 JIA-ERA 患者（国际风湿病协会联合会标准）进行研究。基线疾病活动度评估包括压痛关节计数、肿胀关节计数、马斯特里赫特附着点炎评分、 Bath AS 疾病活动指数（BASDAI）、 Bath AS 功能指数（BASFI）、患者疼痛和整体疾病活动度评估、医生对整体疾病活动度的评估、红细胞沉降率（ESR）。采用 ELISA 法检测血清 MMP-3 和 TIMP-1 水平。对 24 例患者进行了纵向研究。
结果
54 例（48 例男性）患者疾病发病时的平均年龄为 11.8±4.19 岁，病程为 5.2±4.3 年。中位 ESR 为 65mm/h（范围 46.5-97），中位 BASDAI 为 3.4（范围 2.5-4.7）。中位 MMP-3、TIMP-1 和 MMP-3/TIMP-1 比值分别为 50.4ng/ml（IQR 13.0-193.8）、228.9ng/ml（IQR 108.2-290.4）和 0.3（IQR 0.07-1.13）。纳入时，MMP-3 水平与各种疾病活动度指标直接相关：压痛关节计数（TJC；r=0.60）、肿胀关节计数（SJC；r=0.45）、BASFI（r=0.29）、BASDAI（r=0.32）、ESR（r=0.49）、医生总体评估（r=0.40）、患者疼痛视觉模拟评分（r=0.28）和患者总体评估（r=0.38；均 p<0.05）。MMP-3/TIMP-1 比值仅与 TJC（r=0.51）、SJC（r=0.39）和 ESR（r=0.34；p<0.05）相关。随访时，MMP-3 的变化与 TJC（r=0.42）和 SJC（r=0.44；p<0.05）的变化相关，而 ESR 的变化与任何疾病活动度指标的变化均不相关。
结论
MMP-3 水平是 JIA-ERA 疾病活动度的良好标志物。
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