The role of serum MMP-3 levels in evaluating the therapeutic response in rheumatoid arthritis newly diagnosed Syrian patients

Abstract

Background & Aim: Rheumatoid Arthritis,) RA) is a health and social problem that has irreversible negative effects if early diagnosis is not made. Elevated serum MMP-3 levels reflect articular inflammation, while their low levels are an important indicator of symptom improvement. Therefore, our research aimed to study the levels of MMP-3 serum and its reliability to evaluate the therapeutic response in a group of RA patients.

Research materials and methods: Our study included 43 patients (7 males and 36 females) newly diagnosed according to the criteria of ACR/EULAR 2010, and they were classified according to the treatment applied into several groups: the group of patients who received Methotrexate alone (N=24), the group of patients who received Methotrexate and Sulfasalazine (N=11), and the group of patients who received a TNF-a antagonist (N=8). Serum levels of MMP-3 were measured by Enzyme Linked Immune Sorbent Assay. Serum samples were taken in two phases: at diagnosis and after treatment.

Our results showed that the mean serum MMP-3 levels at the start of diagnosis was higher (486.49ng/ml) than the mean of its levels after treatment (322.3ng/ml) with a statistically significant difference (P<0.05). We also found that the mean levels of MMP-3 has decreased from what it was before treatment, in three treatment groups (P<0.05). A real statistically significant difference (P=0.009) was found in serum MMP-3 levels after treatment between patients who achieved remission, their mean of MMP-3 levels were (277.28ng/ml) compared to the group of patients who did not achieve remission (346.42 ng/ml). Our study demonstrated a positive correlation between the amount of decrease in serum MMP-3 levels with the amount of decrease for each of the variables; ESR (r = 0.381), DAS28 (r = 0.515) and the number of swollen joints (r =0.350). Using the ROC Curve, we found at the specific value of MMP-3 (317.8 ng/ml) a sensitivity of 67.9% and specificity of 80% for differentiating between a group of rheumatoid arthritis patients according to achieving remission. Conclusion: Serum levels of MMP-3 are elevated in patients with newly diagnosed rheumatoid arthritis, and its decrease in serum levels after treatment is an important indicator for evaluating therapeutic response.