ABSTRACT
To investigate whether serum levels of MMPs and TIMPs are specifically elevated in rheumatoid arthritis as compared to other inflammatory and degenerative joint diseases. We compared serum levels of matrix metalloproteinases [MMP-3, MMP-9] and tissue inhibitor of metalloproteinase [TIMP-1] of RA with psoriatic arthritis [PsA] and osteoarthritis [OA]. Serum samples were obtained from 30 RA, 20 psoriatic arthritis and 30 knee osteoarthritis patients. Serum concentration of stromelysin-1 [MMP-3], gelatinase B [MMP-9] and TIMP-1 were measured with quantitative sandwich enzyme-linked immunosorbent assay [ELISA] technique. Clinical examination and assessment of disease activity in RA using disease activity score [DAS] were carried out. Radiological evaluation in RA patients using the Larsen scale and in OA patients using the Kellgren and Lawrence scale were also done. Unique serum profiles of MMPs and TIMP-1 were identified in the two inflammatory arthritis groups [RA and PsA]. The serum concentrations of MMP-3 and MMP-9 were significantly higher in RA patients than in OA patients used as a control groups [p<0.001]. These two MMPs dominated in the serum of RA patients than PsA patients [p<0.001]. The analysis of the serum concentrations of TIMP-1 was also elevated in RA patients as compared with OA knee patients [p<0.001]. Also TIMP-1 was found in a significantly higher concentration in the serum of RA patients than PsA patients [p<0.05]. MMP-3 and MMP-9 correlate significantly with disease activity [DAS] in RA patients and with radiological scores. Serum levels of MMP-3, MMP-9, and TIMP-1 were significantly higher in RA and PsA than OA patients. MMP-3 and MMP-9 could be specific markers of joint inflammation and destruction. These variables are neither specific for RA nor for diseases in which bone erosions occur. These markers were correlated with the clinical activity of the disease. Early detection of these markers may herald progressive course and modulate the lines of treatment