Inflamatuar bağırsak hastalarında matriks metalloproteinaz-3, matriks metalloproteinaz-9 ve metalloproteinaz -1 doku inhibitörünün spondiloartropati gelişiminde rolü
THE ROLE OF MATRIX METALLOPROTEINASE-3, MATRIXMETALLOPROTEINASE-9 AND TISSUE INHIBITOR OF MATRIXMETALLOPROTEINASE-1 IN THE DEVELOPMENT OFSPONDYLOARTHROPATHY IN INFLAMMATORY BOWEL DISEASE PATIENTSObjective: It is known that extraintestinal findings are frequently seen in Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease). Joint manifestations are the most frequently occurring ones among them. It is considered in recent studies that matrix metalloproteinases and tissue inhibitors of metalloproteinases may be effective directly in the emergence of disease activity and extraintestinal findings in IBD, and in the tissue reconstruction in the course of local disease in Ankylosing Spondylitis (AS). In this study, the roles of anti-matrix metalloproteinase-3, anti-matrix metalloproteinase-9 and tissue inhibitor of matrix metalloproteinase-1 antibodies inthe development of spondyloarthropathy are planned to be investigated in order to obtain an idea about their posing the risk of developing SpA and AS in IBD cases. Also we planned in this study, serum levels of matrix metalloproteinase-3 (MMP-3),matrix metalloproteinase-9 (MMP-9) and tissue inhibitors of metalloproteinase-1 (TIMP-1) to statistical analyses to test their exact degrees of clinical usefulness as biomarkers for detecting high disease activity in Ankylosing Spondylitis, comparing them with erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP).Methods: This study was carried out on the outpatients applying to the rheumatology and gastroenterology polyclinic in Ankara University Faculty of Medicine between June 2011 and July 2012. In this study, serum MMP-3, MMP-9 and TIMP-1 levels of20 AS, 20 IBD, 20 with IBD and AS, and 20 healthy volunteers were compared with two-step sandwich ELISA method. Activity index of IBD patients were also analyzed. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) provided the gold standart for measuring disease activity. BASDAI scores werecalculated patients of AS. Patients with BASDAI ? 4 were regarded as having high disease activity. The results were compared with MMP-3, MMP-9, TIMP-1, ESR and CRP.Results: As a result of these comparisons, the highest level of MMP-3 was detected in the IBD group. (3351 ± 5956, p<0,045) MMP-3 levels of patients with IBD and patients with IBD + AS were found to be statistically and significantly higher thanthose of patients with AS. (p<0,007, p<0,035) It was found that MMP-3 values of IBD patients were higher than those of IBD+AS patients and the control group, but this difference was not statistically significant (p < 0,570, p < 0,180). The highest MMP-9 levels were found in the control group. (1035 ± 261, p <0,48) It was found that MMP-9 values of AS patients were higher than those of both the IBD group and IBH+AS group, but this difference was not statistically significant. (p < 0,494, p < 0,260) It was interpreted that the reason for the determination of the highest MMP-9 values in the control group was that the patients in the AS and IBD + AS groups received anti-TNF treatment, and anti - TNF therapy led to a fall in MMP levels.As for TIMP-1 values, the highest values were detected in the IBD group. (p<0,006) TIMP-1 values of the IBD group were statistically more significant as compared to those of both the AS and IBD+AS groups. (p < 0,033, p < 0,008) Within AS patients, MMP-3 levels were higher in patients with high disease activity compared with those low disease activity, and corraleted significiantly with BASDAI. (r = 0,841, p<0,05)In the non-parametric correlation analysis conducted between disease duration and serum MMP-3, MMP-9 and TIMP-1 levels, no statistically significant difference was found. (p: 0.071 and 0.257 and 0,295).Conclusion: In this study, we showed seruım MMP-3 is a potentially more accurate marker of AS disase activity than ESR and CRP. To validate the usefulness of MMP- 3, much largerscale multicentre studies will be needed.