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Rheumatology 2003; 42: 83-88
© 2003 British Society for Rheumatology
Serum MMP-3 and MMP-1 and progression of joint damage in early rheumatoid arthritis
Rheumatology and Rehabilitation Research Unit, University of Leeds, Leeds and
1 The Binding Site, Birmingham, UK
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 (
Larsen) and Health Assessment Questionnaire (HAQ) 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), HAQ (r=0.32 and 0.30, P<0.01) and Larsen (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.
KEY WORDS: Early, Arthritis, Prognosis, Outcome, Collagenase, Stromelysin.
Correspondence to: P. Emery, Department of Rheumatology, University of Leeds, Leeds, UK. E-mail: p.emery{at}leeds.ac.uk
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