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Rheumatology 1999; 38: 1081-1087
© 1999 British Society for Rheumatology

Serum levels of matrix metalloproteinase-3 in relation to the development of radiological damage in patients with early rheumatoid arthritis

M. D. Posthumus, P. C. Limburg, J. Westra, H. A. Cats, R. E. Stewart1, M. A. van Leeuwen and M. H. van Rijswijk

Department of Rheumatology, University Hospital Groningen and
1 Northern Centre for Health Care Research, University of Groningen, The Netherlands

Correspondence to: M. D. Posthumus, Department of Rheumatology, University Hospital Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.

Objective. To evaluate the significance of serum matrix metalloproteinase-3 (MMP-3) levels in relation to the development of radiological damage (X-ray damage) in early rheumatoid arthritis (RA).

Methods. Serum MMP-3 levels were measured in 46 healthy controls (CTRL), 19 osteoarthritis (OA) and 78 RA patients with joint symptoms for <1 yr at presentation (T0): 48 patients without and 30 with X-ray damage at T0. Serum MMP-3, measured by ELISA, and X-ray damage, scored according to Sharp's method, were assessed at 0, 6, 12 and 24 months.

Results. MMP-3 levels in CTRL and OA were low or undetectable with no differences between the groups (P=0.19). Levels in RA were higher than in CTRL (P<0.01). Initial MMP-3 levels in patients with X-ray damage at T0 (n=30) were higher than the levels in patients without any X-ray damage during follow-up (n=19) (P<0.01), but were not different from those in patients who developed X-ray damage during the study (n=29) (P=0.11). In the patients without X-ray damage at T0, there was a significant correlation between MMP-3 at T0 and the total X-ray damage after 6 months (r=0.34, P=0.02) and 12 months (r=0.32, P=0.03). This correlation was almost exclusively determined by joint space narrowing in the Sharp score.

Conclusion. The serum MMP-3 level seems to be an indicator for the development of radiological damage in patients with early RA and appears to be particularly indicative of cartilage degradation.

KEY WORDS: Serum matrix metalloproteinase-3, Early rheumatoid arthritis, Radiological damage


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