Serum insulin-like growth factor-axis and matrix metalloproteinases in patients with rheumatic arthritis or rheumatic heart disease.
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.
Lee
Shin-Da
SD
School of Physical Therapy, Chung-Shan Medical University, and Division of Medical Technology, Armed-Force Taichung General Hospital, Taichung, Taiwan.
Chen
Li-Mien
LM
Kuo
Wei-Wen
WW
Shu
Win-Tom
WT
Kuo
Wu-Hsien
WH
Huang
Erh-Jung
EJ
Tsai
Chin-Chuan
CC
Li
Ping-Chun
PC
Liu
Jer-Yuh
JY
Chen
Ter-Hsin
TH
Huang
Chih-Yang
CY
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
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