Publications of Faculty of Medicine:MATRIX METALLOPROTEINASES 3, 9 AND TISSUE INHIBITOR METALLOPROTEINASE 1 IN PAIRED SERUM AND SYNOVIAL FLUID SAMPLES OF PATIENTS WITH EARLY RHEUMATOID ARTHRITIS: Abstract

aim of this study is to determine serum and synovial fluid levels of stromelysin-1 (MMP3), gelatinase-B (MMP9) and TMP1 in patients with early RA and to search for a relationship with disease activity and the rate of radiological progression. We measured MMP3, MMP9 and TMP1 levels using an enzyme linked hnmunosorbent assay (ELBA). Paired samples of serum and synovial fluid (SF) were collected from 40 patients with RA presenting with knee effusion and 20 matched healthy subjects as a control group presenting with traumatic non hemorrhagic knee synovial effusion. Radiographs of the hands, wrists and forfeet were taken for all RA patients at baseline and after 2 years. Radiographic damage and scoring were evaluated according to Larsen-Dale index. There were significant elevation in the mean serum and SF levels of MMP3, MMP9 and TDdPl in RA patients at entry hi comparison with the control group (P<0.001) for all comparisons except serum TIMP1 (P<0.05) being 5.7,2.1,1.3 folds higher in serum and 122.3,20.5,17.7 folds higher in the SF. The mean SF levels of MMP3 and TIMP1 in RA patients were significantly higher than their serum levels (P<0.001) being 266 and 12.3 folds higher respectively, as regard the MMP9 there was insignificant difference (P>0.05). The serum and SF levels of MMP3, MMP9 and TIMP1 were significantly increased in higher grades of disease activity (P<0.001). According to Larsen grading at the entry of the study, 15 patients (38%) were grade I and 25 patients (62%) were grade II. There were higher serum MMP3 and higher SF MMP3, MMP9 and TMP1 in patients with higher radiological grade of severity. At the end of the study, 18 RA patients (45%) showed radiological progression, there were highly significant elevations in the mean serum and SF levels of MMP3 (P<0.001) and significant elevation in the mean SF levels