Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Fırat University, Elazığ, Turkey.
Department of Physical Medicine and Rehabilitation, Elazığ Training and Research Hospital, Turkey.
Adv Clin Exp Med. 2019 May;28(5):665-670. doi: 10.17219/acem/94065.
Rheumatoid arthritis (RA) is a chronic inflammatory and systemic disease of unknown etiology that primarily affects synovial joints and involves progressive destruction around the joints. Inflammation starting in the joint synovium causes the destruction of cartilage, bone and other adjacent tissues with pannus formation.
The aim of this study was to evaluate serum matrix metalloproteinase-3 (MMP-3) levels and their clinical and radiological significance in patients with rheumatoid arthritis.
The study included 59 patients with RA and 30 healthy controls. Serum MMP-3 levels were measured using the enzyme-linked immunosorbent assay (ELISA) method. Patients with a Disease Activity Score 28 (DAS28) ≤3.2 were categorized as having lower disease activity, while a DAS28 score >3.2 indicated patients with moderate/high disease activity. Additionally, the patients were divided into 2 groups in terms of disease duration: early RA (disease duration ≤2 years) and established RA (disease duration ≥2 years). Functional disability was evaluated using the Health Assessment Questionnaire (HAQ) and Nottingham Health Profile (NHP). Radiographs were scored using modified Larsen scoring.
Serum MMP-3 levels in patients with RA were significantly higher than in controls (p = 0.001). Serum MMP-3 levels were correlated with laboratory and clinical parameters of disease activity, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), DAS28, and HAQ score; the exceptions were rheumatoid factor (RF) and cyclic citrullinated peptides (CCP). The serum MMP-3 levels of RA patients with moderate/high disease activity were found to be significantly higher than those of the patients with low disease activity (p < 0.001). However, MMP-3 levels were found to be similar in both established and early RA patients (p = 0.927). Additionally, the modified Larsen scores, which indicate structural damage, correlated significantly with serum MMP-3 levels (p = 0.001).
These results indicate that serum MMP-3 levels may be used as an indicator for structural damage such as erosions in the early stages of the disease, and to monitor disease activity.
类风湿关节炎（RA）是一种病因不明的慢性炎症性和全身性疾病，主要影响滑膜关节，涉及关节周围的进行性破坏。关节滑膜炎症引起软骨、骨和其他相邻组织的破坏，伴有血管翳形成。
本研究旨在评估血清基质金属蛋白酶-3（MMP-3）水平及其在类风湿关节炎患者中的临床和放射学意义。
本研究纳入了 59 例 RA 患者和 30 例健康对照者。采用酶联免疫吸附试验（ELISA）法检测血清 MMP-3 水平。DAS28 评分≤3.2 的患者归为疾病活动度较低组，DAS28 评分>3.2 的患者归为中/高度疾病活动度组。此外，根据疾病病程将患者分为两组：早期 RA（病程≤2 年）和已确立的 RA（病程≥2 年）。采用健康评估问卷（HAQ）和诺丁汉健康量表（NHP）评估功能障碍。采用改良 Larsen 评分评估 X 线片。
RA 患者的血清 MMP-3 水平明显高于对照组（p=0.001）。血清 MMP-3 水平与疾病活动的实验室和临床参数相关，包括红细胞沉降率（ESR）、C 反应蛋白（CRP）、DAS28 和 HAQ 评分；类风湿因子（RF）和环瓜氨酸肽（CCP）除外。中/高度疾病活动度的 RA 患者的血清 MMP-3 水平明显高于低疾病活动度的患者（p<0.001）。然而，早期和已确立的 RA 患者的 MMP-3 水平相似（p=0.927）。此外，表明结构损伤的改良 Larsen 评分与血清 MMP-3 水平显著相关（p=0.001）。
这些结果表明，血清 MMP-3 水平可作为疾病早期侵蚀等结构损伤的指标，并可用于监测疾病活动度。
