Rheumatology Advance Access originally published online on July 27, 2005
Rheumatology 2005 44(11):1383-1389; doi:10.1093/rheumatology/kei025
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Levels of matrix metalloproteinase (MMP)-1 in paired sera and synovial fluids of juvenile idiopathic arthritis patients: relationship to inflammatory activity, MMP-3 and tissue inhibitor of metalloproteinases-1 in a longitudinal study
Musculoskeletal Research Group, School of Clinical Medical Sciences, University of Newcastle-upon-Tyne and 1 Department of Paediatrics, Newcastle Hospitals NHS Trust, Newcastle-upon-Tyne, UK.
Correspondence to: T. E. Cawston, School of Clinical Medical Sciences (MRG), Medical School Cookson Building, University of Newcastle-upon-Tyne NE2 4HH, UK. E-mail: t.e.cawston{at}ncl.ac.uk
Objectives. To measure levels of the collagenases matrix metalloproteinase (MMP)-1 and -13 in the synovial fluid (SF) and serum of patients with juvenile idiopathic arthritis (JIA), and to correlate these measurements with inflammatory activity, levels of the collagenase activator MMP-3 and the tissue inhibitor of metalloproteinases-1 (TIMP-1).
Methods. Levels of MMP-1, -3, -13 and TIMP-1 were measured in paired SF and serum from 82 JIA patients using enzyme-linked immunsorbent assay and compared between subtypes and patients of different ages and disease durations. These levels were also correlated to the active joint count (AJC) and standard measures of inflammatory activity and therapeutic response, including erythrocyte sedimentation rate (ESR) and platelet count (PLT).
Results. MMP-1 was detected in JIA SF and correlated with PLT. MMP-3 levels were high in SF and detectable in serum where they correlated with PLT, ESR and AJC. MMP-13, however, was not detected in SF or serum. No differences were observed between patients grouped by subtype, age or disease duration. MMP-3 contributed the majority of total MMP in SF samples resulting in excess MMP levels over TIMP-1.
Conclusions. MMP-1 is up-regulated in SF concordant with inflammatory activity in JIA. This was true for patients in all JIA subtypes and age groups, suggesting that the capability for degradation of type II collagen is present in early disease, and throughout the disease course. MMP-3 may be important in the activation of collagenases and the saturation of exogenous inhibitors. Serum MMP-3 may therefore be a useful, measurable and specific marker of active disease in JIA.
KEY WORDS: MMP, TIMP, Collagenase, Stromelysin, JIA
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