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[基质金属蛋白酶-3作为类风湿关节炎疾病活动度的生物标志物]

[MMP-3 as a Biomarker of Disease Activity of Rheumatoid Arthritis].

作者信息

Uemura Yuko, Hayashi Hidetoshi, Takahashi Toshio, Saitho Toshiharu, Umeda Ryousuke, Ichise Yoshihide, Sendo Sho, Tsuji Goh, Kumagai Shunichi

出版信息

Rinsho Byori. 2015 Dec;63(12):1357-64.

Abstract

The aim of this study was to confirm the clinical significance of serum MMP-3 measurement in the evalua- tion of disease activity and effectiveness of treatment in patients with rheumatoid arthritis (RA). MMP-3 was measured for 206 outpatients with RA during a period of 4 months, and also serially measured for RA patients treated with methotrexate(MTX) alone or together with infliximab (IFX). Serum MMP-3 was significantly correlated with CRP, SAA, and ESR. Significant correlation of serum MMP-3 was found not only with DAS28 (CRP) in female and male patients (p <0.0001 and p < 0.0051, respectively) but also with the EULAR classification criteria for the disease activity of RA. Among the items of DAS28(CRP), the strongest association of MMP-3 was found with swollen joint counts. Furthermore, MMP-3 levels increased with advances in Stage and Class of RA. MMP-3 levels gradually decreased 12 and 24 weeks after successful treatment with MTX (p=0.0188 and p=0.0179, respectively). Extent of the decrease was more prominent in patients with better response to MTX than in those with poor response. MMP-3 levels significantly decreased 6 weeks after IFX treatment and continued to decrease until 48 weeks. Significant decrease of MMP-3 level from before treatment was shown only in the good response group to IFX after 48 weeks of treatment. MMP-3 level was shown to be useful as a disease activity marker in RA patients. In addition, serial measurement of MMP-3 maybe helpful to evaluate the effect of treatments with MTX and IFX.

摘要

本研究的目的是证实血清基质金属蛋白酶-3(MMP-3)检测在评估类风湿关节炎(RA)患者疾病活动度及治疗效果方面的临床意义。在4个月期间对206例RA门诊患者进行了MMP-3检测,并对单独使用甲氨蝶呤(MTX)或联合英夫利昔单抗(IFX)治疗的RA患者进行了连续检测。血清MMP-3与C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)和红细胞沉降率(ESR)显著相关。不仅在女性和男性患者中血清MMP-3与疾病活动评分28(DAS28)(CRP)显著相关(分别为p<0.0001和p<0.0051),而且与RA疾病活动度的欧洲抗风湿病联盟(EULAR)分类标准也显著相关。在DAS28(CRP)各项中,MMP-3与肿胀关节计数的相关性最强。此外,MMP-3水平随RA分期和分级的进展而升高。MTX成功治疗12周和24周后,MMP-3水平逐渐下降(分别为p=0.0188和p=0.0179)。MTX反应良好的患者下降程度比反应差的患者更显著。IFX治疗6周后MMP-3水平显著下降,并持续下降至48周。仅在治疗48周后,IFX反应良好组的MMP-3水平较治疗前显著下降。MMP-3水平被证明是RA患者疾病活动的有用标志物。此外,连续检测MMP-3可能有助于评估MTX和IFX的治疗效果。

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