title: Serum insulin-like growth factor-axis and matrix metalloproteinases in patients with rheumatic arthritis or rheumatic heart disease.
abstract: BACKGROUND
  Insulin-like growth factor (IGF)-I plays an important role for maintaining cardiac functions. We clarified the unknown role of IGF-axis in rheumatic heart disease (RHD).
  
  
  METHODS
  Interleukin (IL)-10, growth hormone (GH), IGF, IGF binding protein (IGFBP)-3 and matrix metalloproteinase (MMP) were measured by ELISA and zymography in 30 age range-matched normal subjects (control), 36 patients with acute phase of rheumatoid arthritis (RA) with positive rheumatoid factor (RF) and C-reactive protein (CRP), and in 43 patients with RHD with negative RF and CRP.
  
  
  RESULTS
  Compared with normal subjects, increased IL-10 level and decreased GH were found in RA group whereas unchanged IL-10 and decreased GH were found in RHD group. Compared with age range-matched normal subjects, decreased IGFBP-3, MMP-9 levels, unchanged IGF-I were found in RA group whereas decreased IGF-I levels, unchanged IGFBP3 and increased MMP-9 at age>30 years were found in RHD group. IGF-II was not changed in RA and RHD groups.
  
  
  CONCLUSIONS
  These findings may imply that during inflammatory phase, the levels of anti-inflammation was high and total IGF-I and IGF bioavailability were maintained in patients with RA. Our findings in RHD may speculate that the long-term reduction of GH and IGF-I as well as the compensating effects of upregulated MMP-9 activity may be partially involved in the long-term pathogenesis from RHD to heart failure. Decreased GH, decreased IGF-I and increased MMP-9 activities may be possible diagnostic markers in RHD for developing heart failure.
authors.affiliation: School of Physical Therapy, Chung-Shan Medical University, and Division of Medical Technology, Armed-Force Taichung General Hospital, Taichung, Taiwan.
authors.forename: Shin-Da
authors.initials: SD
authors.lastname: Lee
authors.forename: Li-Mien
authors.initials: LM
authors.lastname: Chen
authors.forename: Wei-Wen
authors.initials: WW
authors.lastname: Kuo
authors.forename: Win-Tom
authors.initials: WT
authors.lastname: Shu
authors.forename: Wu-Hsien
authors.initials: WH
authors.lastname: Kuo
authors.forename: Erh-Jung
authors.initials: EJ
authors.lastname: Huang
authors.forename: Chin-Chuan
authors.initials: CC
authors.lastname: Tsai
authors.forename: Ping-Chun
authors.initials: PC
authors.lastname: Li
authors.forename: Jer-Yuh
authors.initials: JY
authors.lastname: Liu
authors.forename: Ter-Hsin
authors.initials: TH
authors.lastname: Chen
authors.forename: Chih-Yang
authors.initials: CY
authors.lastname: Huang
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000150:complications / Q000473:pathology; D013006:Growth Hormone / Q000097:blood; D006331:Heart Diseases / Q000097:blood* / Q000150:complications / Q000473:pathology; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D007335:Insulin-Like Growth Factor II / Q000378:metabolism*; D016753:Interleukin-10 / Q000097:blood; D020778:Matrix Metalloproteinase 2 / Q000097:blood* / Q000235:genetics; D020780:Matrix Metalloproteinase 9 / Q000097:blood* / Q000235:genetics; D008875:Middle Aged
chemical_list: D016753:Interleukin-10; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II; D013006:Growth Hormone; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9