Matrix metalloproteinase-3 as a marker of subclinical activity in rheumatoid arthritis patients: Relation to ultrasonographic activity

Background: Rheumatoid arthritis (RA) isa chronic disease which may result in progressive joint destruc-tion even with clinical remission. Ultrasound (US) can detect subclinical disease activity and matrix met-alloproteinase 3 (MMP-3) has a role in disease activity in RA. Aim of the work: To evaluate the level of MMP-3 in RA patients and its ability to predict sonographic activ-ity in patients with clinical remission or low disease activity (LDA). Patients and methods: This study included 45 RA patients with a disease activity score (DAS28) <3.2 and 45 matched healthy control. US evaluation using modified German US7 score was performed and accord-ingly patients were classified into those with sonographic remission (grey scale 0-1) or activity. MMP-3 level was assessed by enzyme-linked immunosorbent assay. Results. The mean age of the patients was 45 +/- 9.5 years and 86.7% were females. Sonographic remission was achieved in 20 (44.4 %) patients. There was a significant difference in serum MMP-3 between patients and control (17 +/- 4.5 vs 6.3 +/- 2.2 ng/ml; p < 0.0001). There was no difference between patients with clinical remission (n = 37) and those with LDA (n = 8). Serum MMP-3 tended to be higher in patients with sono-graphic activity than in those with sonographic remission (18 +/- 5.3 vs 15.6 +/- 2.8 ng/ml; p = 0.3). Serum MMP-3 significantly correlated with erythrocyte sedimentation rate (p = 0.002) and synovitis score (p = 0.002). Conclusion: Serum MMP-3 was higher in RA patients than in control and was associated with the ultra -sound synovitis score. However, serum MMP-3 was not able to differentiate patients with sonographic remission from those with subclinical activity. (c) 2022 Egyptian Society of Rheumatic Diseases. Publishing services provided by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).