Dursun ELMAS2, Ali ŞAHİN1, Orhan KÜÇÜKŞAHİN3, Nuran TÜRKÇAPAR4, Murat TÖRÜNER5, Hülya ÇETİNKAYA5, Emre KÜLAHÇIOĞLU2 Alexis K. OKOH2, Murat TURGAY4

1Department of Internal Medicine, Division of Rheumatology, Medical Faculty of Cumhuriyet University, Sivas, Turkey
2Department of Internal Medicine, Medical Faculty of Ankara University, Ankara, Turkey
3Department of Internal Medicine, Division of Rheumatology, Medical Faculty of Yıldırım Beyazıt University, Ankara, Turkey
4Department of Internal Medicine, Division of Rheumatology, Medical Faculty of Ankara University, Ankara, Turkey
5Department of Internal Medicine, Division of Gastroenterology, Medical Faculty of Ankara University, Ankara, Turkey

Keywords: Ankylosing spondylitis, inflammatory bowel disease, metalloproteinase-3, metalloproteinase-9, tissue matrix metalloproteinase inhibitor-1

Abstract

Objectives: This study aims to investigate whether clinical measures of disease activity and function in ankylosing spondylitis (AS) and inflammatory bowel disease (IBD) are associated with matrix metalloproteinase-3 (MMP-3), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase -1 (TIMP-1), and if MMPs can be more useful than C-reactive protein and erythrocyte sedimentation rate in predicting disease activity in AS.
Patients and methods: MMP-3, MMP-9 and TIMP-1 levels were measured by ELISA in 20 patients with AS, 20 patients with IBD, 20 patients with IBD and AS (35 males, 25 females; mean age 38.1 years; range 19 to 62 years), and 20 healthy volunteers (10 males, 10 females; median age 38.5 years; range 24 to 63 years) as a control group. Bath Ankylosing Spondylitis Disease Activity Index, Truelove-Witts activity criteria for ulcerative colitis, and Crohn's Disease of Activity Index scoring systems were used.
Results: Highest MMP-3 level was in IBD group (33.51±59.56 ng/mL, p<0.045). MMP-3 levels were significantly higher in patients with IBD and IBD+AS than in patients with AS (p<0.007 and p<0.035, respectively). Highest MMP-9 levels were in the control group (10.35±2.61 ng/mL, p<0.48). MMP-9 levels were higher in AS group patients than those in IBD and IBD+AS groups, but the difference was not statistically significant (p<0.494 and p<0.260, respectively). Highest TIMP-1 levels were in the IBD group (8.11 ng/mL, p<0.006). TIMP-1 levels of IBD group were significantly higher than both AS and IBD+AS groups (p<0.033 and p<0.008, respectively). A statistically significant correlation was detected between serum MMP-3 levels and disease activity and Bath Ankylosing Spondylitis Disease Activity Index score in patients with AS (r=0.841, p<0.05).
Conclusion: We concluded that serum MMP-3 levels may be a better biomarker than C-reactive protein and erythrocyte sedimentation rate in showing disease activity in AS.