Serum MMP-3 and MMP-1 and progression of joint damage in early rheumatoid arthritis.
OBJECTIVE
Expression and activation of matrix metalloproteinases such as MMP-3 (stromelysin-1) and MMP-1 (collagenase-1) are increased in patients with rheumatoid arthritis (RA). Previous negative reports of their value as predictors of joint damage may be due to the lack of a large longitudinal study of early RA patients. This study evaluated their use in assessing early untreated patients with RA and predicting subsequent joint damage.


METHODS
Ninety-eight patients with early untreated RA of less than 12 months duration and 20 normal controls had baseline serum samples tested with a double-antibody enzyme-linked immunosorbent assay for each of MMP-1 and MMP-3. The subsequent changes in Larsen score (DeltaLarsen) and Health Assessment Questionnaire (DeltaHAQ) over the first 12 months were recorded.


RESULTS
Baseline serum levels of MMP-3 and MMP-1 correlated significantly with baseline C-reactive protein (CRP) (r=0.42 and 0.49, P<0.001), DeltaHAQ (r=0.32 and 0.30, P<0.01) and DeltaLarsen (r=0.23 and 0.32, P<0.05) respectively. Analysis of the group of patients with a normal CRP at presentation (n=21) showed correlation of the baseline MMP-3 and MMP-1 with the presence of erosive disease during the first 12 months (r=0.52 and 0.65 respectively, P<0.05). Logistic regression analysis, in the patients who were non-erosive at presentation, showed that the strongest correlation with progression in Larsen score was the baseline MMP-3 level (r=0.30, P=0.01).


CONCLUSIONS
Baseline serum MMP-1 and MMP-3 levels correlate with disease activity and predict functional and radiographic outcome in early untreated RA. They may have a particular value in predicting the progression of erosive disease in patients who are not erosive at presentation.
Green
M J
MJ
Rheumatology and Rehabilitation Research Unit, University of Leeds, Leeds, UK.
Gough
A K S
AK
Devlin
J
J
Smith
J
J
Astin
P
P
Taylor
D
D
Emery
P
P
D001172:Arthritis, Rheumatoid / Q000201:enzymology* / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D018450:Disease Progression; D004789:Enzyme Activation; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D007596:Joints / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000097:blood*; D019278:Matrix Metalloproteinase 3 / Q000097:blood*; D008875:Middle Aged; D011379:Prognosis
D015415:Biomarkers; D002097:C-Reactive Protein; D019278:Matrix Metalloproteinase 3; D020781:Matrix Metalloproteinase 1