Imbalanced MMP-3 and MMP-12 serum levels in systemic lupus erythematosus patients with Jaccoud’s arthropathy and a distinctive MRI pattern

Abstract

Objective Metalloproteinase (MMP)-3 and MMP-12 are proteolytic enzymes especially implicated in joint inflammation. This study aims to evaluate their association with arthritis features and hand MRI abnormalities in patients with SLE. Methods Fifty SLE patients, with a mean (s.d.) age of 48.1 (14.6) years were tested for MMP-3 and MMP-12 serum levels, then further classified according to the presence of X-ray erosions and joint deformities. Eighteen RA patients aged 47.9 (11.8) and 14 healthy people aged 46.0 (11.0) were enrolled as control groups. A subgroup of 28 SLE patients underwent a dominant-hand MRI; the detected changes were classified and semi-quantitatively scored as capsular swelling, synovitis, edematous or proliferative tenosynovitis, bone oedema, bone erosions. Statistical analysis was performed using multiple regression models. Results MMP-3 were significantly higher in patients with Jaccoud’s arthropathy (JA) (22.1 ng/ml, P < 0.05) and independently associated with hsCRP serum levels (B-coeff 0.50; r = 0.30; P < 0.05). MMP-12 serum levels were significantly lower in patients with JA (0.18 ng/ml, P < 0.05) and inversely associated with the prednisone daily dose (B-coeff –0.03; r = −0.44; P < 0.01). Capsular swelling and edematous tenosynovitis, the most prevalent hand MRI changes in patients with JA, associated with higher MMP-3 (B-coeff 0.12; r = 0.66; P < 0.01 and B-coeff 0.08; r = 0.59; P < 0.01, respectively) and lower MMP-12 serum levels (B-coeff –7.4; r = −0.50; P < 0.05 and B-coeff –5.2; r = −0.44; P = 0.05, respectively). Conclusion Imbalanced MMP-3 and MMP-12 serum levels are influenced by inflammation and glucocorticoids in SLE patients and associated with JA and distinctive hand MRI changes.

Erosive arthritis in systemic lupus erythematosus: not only Rhupus

“…82 Finally, Piga and colleagues observed higher levels of MMP3 in SLE patients with JA in comparison with those without this deforming arthropathy; conversely, lower levels of MMP12 were observed in the same group of patients. 83…”

Case report: Joint deformity associated with systemic lupus erythematosus

“…Since erosive JA also shows characteristics of RA, we proposed that patients with SLE and erosive JA should be regarded as having rhupus. Contrary to the traditional view, some literatures have reported that JA patients without radiography findings can be detected fewer and smaller bone erosion than rhupus patients through ultrasound, CT and MRI 35,36 . Therefore, the severity of bone erosion may be the real key to distinguish the two diseases.…”

“…Contrary to the traditional view, some literatures have reported that JA patients without radiography findings can be detected fewer and smaller bone erosion than rhupus patients through ultrasound, CT and MRI. 35 , 36 Therefore, the severity of bone erosion may be the real key to distinguish the two diseases. However, it is not excluded that these SLE patients may actually have rhupus.…”

Arthritis in Systemic Lupus Erythematosus: From 2022 International GISEA/OEG Symposium

“…Cytokines are strongly related to tissue repair and destruction mechanisms, modulating the extracellular matrix (ECM) homeostasis by promoting the production of metalloproteinases (MMPs) and other enzymes. Recently, the serum levels of higher MMP-3 and lower MMP-12 were associated with JA deformities, and most importantly, their levels were associated with capsular swelling and oedematous tenosynovitis, the most prevalent hand MR changes in patients with JA [ 32 ]. This evidence suggests that both inflammation and impaired mechanisms of tissue remodeling might be involved in the development of JA.…”

“…Among these, the possible role of MMP-3 and MMP-12 serum levels has been investigated, with regard to their ability to discriminate different phenotypes of SLE-related joint involvement. In particular, MMP-3 serum levels were significantly higher in JA patients compared with rhupus syndrome and NDNE arthritis [ 32 ]. Finally, the possibility to search biomarkers in other anatomical sites involved in erosive arthritis development from a pathogenic point of view is very attractive.…”