Journal of Peking University(Health Sciences) ›› 2018, Vol. 50 ›› Issue (6): 981-985. doi: 10.19723/j.issn.1671-167X.2018.06.007

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Value of serum matrix metalloproteinase 3 in the assessment of early rheumatoid arthritis

Meng-ke LIU1,2,3,Lu-chen WANG1,2,3,Fan-lei HU1,2,()   

  1. 1. Department of Rheumatology and Immunology, Peking University People’s Hospital & Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135) Beijing 100044, China
    2. State Key Laboratory of Natural and Biomimetic Drugs,Peking University School of Pharmaceutical Sciences,Beijing 100191, China
    3. Nanchang University Queen Mary School, Nanchang 330000, China
  • Received:2018-07-23 Online:2018-12-18 Published:2018-12-18
  • Contact: Fan-lei HU E-mail:fanleihu@bjmu.edu.cn
  • Supported by:
    Supported by the National Natural Science Foundation of China(81671604);Supported by the National Natural Science Foundation of China(81302554);Supported by the National Natural Science Foundation of China(31530020);Supported by the National Natural Science Foundation of China(81501396);Supported by the National Natural Science Foundation of China(81871281);the Beijing Nova Program(Z181100006218044);Peking University Clinical Medcine + X Project PKU2018LCXQ003(PKU2018LCXQ003)

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Abstract:

Objective: To investigate the expression level of serum matrix metalloproteinase 3 (MMP3) in early rheumatoid arthritis (ERA) patients with normal C-reaction protein (CRP) or erythrocyte sedimentation rate (ESR), and the significance in disease assessment.Methods:In the study, 133 cases of early RA patients, 25 osteoarthritis (OA) patients and 60 healthy controls in Peking University People’s Hospital from 2011 to 2015 were included. The RA patients were further divided into 4 groups according to levels of CRP and ESR: 88 patients with increased CRP and increased ESR, 15 patients with normal CRP and normal ESR, 17 patients with normal CRP but increased ESR, and 13 patients with increased CRP but normal ESR. All the clinical information of the patients was collected, and the serum MMP3 levels of both patients and healthy controls were detected by enzyme-linked immune sorbent assay (ELISA).Results:The serum MMP3 level of RA patients with normal CRP and/or normal ESR [(72.89±6.34) μg/L] was obviously higher than that of OA patients [(42.87±4.14) μg/L](P=0.002) and healthy controls [(31.62±2.88) μg/L](P<0.001). The serum MMP3 levels of the patients with normal CRP and normal ESR[(47.04±9.64) μg/L] were higher than those of the healthy controls, and there was statistical significance between the two groups (P<0.05). The serum MMP3 levels of the patients with increased CRP but normal ESR [(94.18±9.11) μg/L] and the patients with normal CRP but increased ESR [(79.42±10.60) μg/L] were both higher than those of the OA patients and healthy controls, and there was obvious statistical difference (P<0.05). In the early RA patients with normal CRP and/or normal ESR, the serum MMP3 level was positively correlated with the CRP level (r=0.336,P=0.024). The positive rate of MMP3 in the patients with normal CRP and/or normal ESR was 44.44%, higher than the positive rate of CRP (28.89%) and the positive rate of ESR (37.78%).In these early RA patients, the positive rate was 52.94% in the patients with normal CRP but increased ESR and 53.85% in the patients with increased CRP but normal ESR.Conclusion:The detection of the serum MMP3 level was significant in the assessment of early RA patients within 2-year duration who had normal CRP or ESR value.

Key words: Matrix metalloproteinase 3, Early rheumatoid arthritis, C-reaction protein, Erythrocyte sedimentation rate, Assessment value

CLC Number: 

  • R593.22

Table 1

Comparison of CRP, ESR, MMP3 positive rate in CRP normal and/or ESR normal early RA patients"

Items Total cases Positive cases Positive rate/%
MMP3 45 20 44.44
CRP 45 13 28.89
ESR 45 17 37.78

Table 2

Comparison of the positive rate of MMP3 vs. ESR under normal CRP, or MMP3 vs. CRP under normal ESR"

Items Normal CRP Normal ESR
ESR MMP3 CRP MMP3
Total cases 32 32 28 28
Positive cases 17 13 13 11
Positive rate/% 53.13 40.63 46.43 39.29

Table 3

Comparison of CRP, ESR, MMP3 positive rate in patients with the duration less than 6 months"

Items Total cases Positive cases Positive rate/%
MMP3 55 44 80.00
CRP 55 42 76.36
ESR 55 45 81.82

Table 4

Comparison of MMP3 positive rate among groups of RA patients"

Group Total cases MMP3 positive Positive
rate/%
Normal CRP and/or normal ESR 45 20 44.44
Normal CRP increased ESR 17 9 52.94
Increased CRP normal ESR 13 7 53.85
Normal CRP normal ESR 15 4 26.67

Figure 1

Comparison of MMP3 levels in early RA patients of different CRP, ESR grouping, OA patients and healthy controlA, increased CRP increased ESR; B, normal CRP normal ESR; C, normal CRP increased ESR; D, increased CRP normal ESR; OA, osteoarthritis; HC, healthy control."

Table 5

Correlation between MMP3 level and clinical characteristics"

Items Increased CRP increased ESR Normal CRP and/or normal ESR
r P r P
CRP 0.125 0.254 0.336 0.024*
ESR 0.318 0.003# 0.069 0.651
IgA -0.100 0.376 0.099 0.531
IgG 0.237 0.035* -0.112 0.478
IgM 0.107 0.346 -0.259 0.097
RF -0.245 0.053 -0.122 0.435
anti-CCP -0.293 0.012* -0.008 0.964
Tender joint count 0.149 0.181 -0.074 0.628
Swollen joint count 0.153 0.167 -0.023 0.883
DAS28 0.248 0.025* -0.017 0.916

Table 6

Comparison of IgA, IgG, IgM levels in early RA patients with different CRP, ESR grouping"

Groups IgA/(g/L) IgG/(g/L) IgM/(g/L)
Increased CRP increased ESR 3.28±1.37 14.98±4.77 1.25±0.72
Increased CRP normal ESR 2.51±1.16 14.21±6.54 0.72±0.26*
Normal CRP increased ESR 3.80±1.67 14.99±4.08 1.43±0.77
Normal CRP normal ESR 2.44±0.87* 13.27±2.49 0.98±0.39
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