Serum levels of sex steroid hormones and matrix metalloproteinases after intra-articular glucocorticoid treatment in female patients with rheumatoid arthritis.
OBJECTIVE
To study metalloproteinase activity and sex steroid hormone production in serum after intra-articular glucocorticoid treatment for knee synovitis.


METHODS
18 female patients with rheumatoid arthritis and synovitis of the knee with need for intra-articular glucocorticoid treatment were included in this study. Serum samples of matrix metalloproteinases (MMP-1/TIMP complex and MMP-3), dehydroepiandrosterone sulphate, testosterone, oestradiol, steroid hormone binding globulin, follicle stimulating hormone and luteinising hormone were collected before injection with 20 mg triamcinolone hexacetonide, and 24 h, 48 h, 1 week and 2 weeks after injection, respectively.


RESULTS
Serum levels of MMP-3 were significantly decreased, but MMP-1/TIMP complex was unaffected. Dehydroepiandrosterone sulphate, testosterone and oestradiol levels all decreased and tended to return to baseline levels during the observation period. Steroid hormone binding globulin, follicle stimulating hormone and luteinising hormone levels were unchanged.


CONCLUSIONS
Intra-articular glucocorticoid treatment causes a temporary, but considerable suppression of sex steroid hormone secretion. The reduction of MMP-3 indicates an inhibition of the inflammatory, but probably also the cartilage destructive processes within the treated joint.
Weitoft
T
T
Department of Research and Development, County Council of Gävleborg/Uppsala University, Section of Rheumatology, Gävle Hospital, Sweden. tomas.weitoft@lg.se
Larsson
A
A
Rönnblom
L
L
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000188:drug therapy; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint; D020781:Matrix Metalloproteinase 1 / Q000097:blood / Q000187:drug effects; D019278:Matrix Metalloproteinase 3 / Q000097:blood / Q000187:drug effects; D020782:Matrix Metalloproteinases / Q000097:blood* / Q000187:drug effects; D008875:Middle Aged; D013585:Synovitis / Q000097:blood / Q000188:drug therapy; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D012739:Gonadal Steroid Hormones; D020782:Matrix Metalloproteinases; D019278:Matrix Metalloproteinase 3; D020781:Matrix Metalloproteinase 1; D014222:Triamcinolone Acetonide; C005900:triamcinolone hexacetonide